REPUBLIC OF THE PHILIPPINES )

Province of ____________________) S.S.

City/Municipality of _____________ )
x---------------------------------------x

AFFIDAVIT OF DESISTANCE

I, ________________(Complaining Witness)____________, Filipino,

of legal age, [single]/[married to _________(name of
spouse)_________], and a resident of
___________________(address of affiant)_______________, after
having been duly sworn in accordance with law, hereby depose and
state:

1. That I am the complainant in Criminal Case No.

______________, entitled "People of the Philippines versus
______________", for alleged “RAPE” against accused
_______________________, which case is pending before the
Regional Trial Court, Branch No. _______, _______________
City, Philippines;

2. That I signed the aforesaid complaint against accused

_____________________ against my will;

3. That my grandparents will cut-off my monthly allowances if I

do not sign the complaint;

4. There is no truth to the allegations contained in my sworn

statement executed by me that states:

“ ______________________________________;
_______________________________________;”

5. I hereby inform the Public Prosecutor of _______________

that I am withdrawing my complaint for __________ in Criminal
Case No. _________ entitled "People of the Philippines versus
______________", Regional Trial Court, Branch No.__,
_________City, Philippines.

6. I likewise request the Regional Trial Court, Branch No.__,

_____________City, Philippines, to dismiss with prejudice the
said criminal case.

IN WITNESS WHEREOF, I have hereunto set my hands this

_____________, at ______________, Philippines.
_________________
Complaining Witness

(JURAT)

_______________
Public Prosecutor

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