Republic of the Philippines)

Province of_______________)S.S.
City/Municipality of____________) 
x---------x
AFFIDAVIT OF DESISTANCE
I,____________,Filipino, single, with
residence__________, under oath
allege:
1.That I am the
complainant in Criminal Case
No.__________for alleged "RAPE"
against accused___________, which
case is pending before the Regional
Trial Court, Branch______,
_____________City, Philippines;
2.That I signed the aforesaid
complaint against
accused__________against my will, my
signature in the complaint having
been obtained thru force, violence
and intimidation done to me by my
parents;
 
3.There is no truth to the allegations
contained in my sworn statement
executed by me against my will
on___________at____________, taken
by____________. There was no force,
violence or intimidation done against
me by said accused___________. I was
not forced by him to submit to his
desires. It was all in accordance with
my own will, volition and consent that
I went personally to him because we
love each other and I agree and
consent to live with him as my
husband;
4.I therefore respectfully request that
the above-mentioned case filed
against said___________be dismissed
as in fact I now withdraw my
complaint against him and I further
manifest under oath that I am now
desisting from testifying against
him in Court or in any other
government entity or
agency in connection with the said
criminal case.
IN WITNESS WHEREOF, I have
hereunto set my hand
this___________at____________,
Philippines.
AFFIANT
(JURAT)