Republic of the Philippines)

City of Lapu-Lapu…………..)s.s.

AFFIDAVIT OF DESISTANCE

I, Rolen A. Lana, Filipino, and of legal age and a resident of Sitio Colo,
Marigondon, Lapu-Lapu City, after being duly sworn in a manner prescribed by law,
hereby depose and say, THAT;

1. I am the father of Kristel Mae Booc (KRISTEL for bevity), minor and a
resident of Sitio Colo, Marigondon, Lapu-Lapu City;

2. KRISTEL was under my custodial care;

3. On December 18, 2019 at around 6 pm, a tourist van with the plate number
GAA 8701, silver, Toyota Grandia, approaching the circumferential road at
Masiwa, Marigondon, accidentally hit KRISTEL when the latter run across the
street which causes the sudden death of the forgoing;

4. The said tourist van was impounded at Lapu-Lapu City Police Station 4,
Marigondon, Lapu-Lapu City as a consequence of the aforementioned
incident;

5. After evaluating the facts and circumstances, I arrived at a conclusion not to

pursue in filing a criminal/civil case against the driver Alejandro C. Quimbo,
and the tourist van operator Amadora transport respectively, for we have
already settled the matter extra-judicially with equitable terms and
conditions, and decided to let the police authority release the above-
mentioned vehicle;

6. I will not hold the police authority and any other government agency liable in
releasing the said vehicle, since the matter was already fixed by the Driver
and/or the Van Operator amicably;

7. I am not forced, threatened or intimidated in the execution of this affidavit

but rather this is done on my free will and volition signifying my intention,
wish and desire to WAIVE, and ABANDON all our rights, interest and
participation from further prosecuting criminally and civilly the afore-named
person and entity;

8. In view of the fact that the acts of the aforementioned person/entity were not
motivated by personal interests and the said incident was purely
unavoidable accident, I hereby manifest that I am no longer interested in the
prosecution of the case against them and that there was no strong evidence
or proof that will give rise to any liability whatsoever to the abovementioned
persons;

9. All the contents herein were read and understood by us and I know the legal
consequences of the execution of this affidavit.

10. In view of the foregoing, I am executing this affidavit to attest to the

truthfulness of the foregoing fact and for whatever legal intents and purposes
this may serve.
 IN WITNESS WHEREOF, we have hereunto set our hand this _______________, in
Lapu-Lapu City, Philippines.

Rolen A. Lana
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this, in Lapu-Lapu City,

Philippines. Affiant exhibited to me his Barangay Clearance with his signature and
issued by the Punong barangay Lucrecia M. Amores, dated December 21, 2019.

Doc. No. : ________

Page No.: ________
Book No. : ________
Series of 2019