AFFIDAVIT OF DESISTANCE

I, _____________________________________________________________________,
of legal age, single/married, and a resident of ________________________________
_____________________________________________________________________________,
after having been duly sworn to in accordance with law, hereby depose and
state that:

1. I am the private complainant in Criminal Case/s No./s ______________

Against accused ____________________________________________________
pending before the Regional Trial Court, Branch ___, Quezon City;

2. I am no longer interested in the further prosecution of this/these

case/s as the same arouse out of ___________________________________
____________________________________________________________________;

3. I, therefore, move for the dismissal of the aforestated case/s against

accused ___________________________________________________________.

Further, Affiant sayeth naught.

______________________________
______________________________
Affiant

SUBSCRIBED AND SWORN TO before me on this ______ day of

_____________, 20___ at Quezon City, Metro Manila, Philippines.

______________________________________
Senior Assistant City Prosecutor

I/We am/are waiving the filing of any administrative, civil, or criminal

cases against the private complainant.

______________________________
______________________________
______________________________
Accused