REPUBLIC OF THE PHILIPPINES )

CITY OF BACOLOD . . . . . . . . . . . ) s.s.

x ---------------------------------------- x

AFFIDAVIT OF DESISTANCE

I, JEANVIE GUINE ALEGRE SOLEÑO, of legal age, Filipino, widow, a

resident of Brgy. Mandalagan, Bacolod City, Philippines, after having been sworn
according to law, depose and say:

That I am the wife of KENNETH SOLEÑO Y GENORAGA the driver of a

motorcycle with Plate No. 1780FB, who died due to vehicular accident that happened on
November 19, 2021, along Lacson St., Bacolod City, Philippines;

That after going over the circumstances surrounding the incident, I believe that
what happened was purely accidental and unintentional, without fault on the part of
ARDIE CHESTER ONG Y SY the driver of the Toyota Land Cruiser with Plate No.
ZMA 495, the other vehicle that was figured in the afore-said accident;

That Mr. Ong offered and gave us financial assistance to cover the expenses and
losses we incurred in relation to the said incident, and to help us start anew, which we
received and accepted on the date stated below;

That due to the foregoing reason, I hereby declare that I am no longer interested in
filing any action against the said ARDIE CHESTER ONG Y SY;

That I execute this affidavit of my own free will and volition and for the purpose
of desisting from filing any case against the aforementioned person and I hereby waive
all rights and claims pertaining to said incident now and forever;

IN WITNESS WHEREOF, I have hereunto set and affixed my signature this ____
day of March 2022, in the City of Bacolod, Philippines.

JEANVIE GUINE ALEGRE SOLEÑO

Signed in the presence of:

_______________________ _________________________

SUBSCRIBED AND SWORN TO before me this ___ day of March 2022, in

________________________, Philippines. Affiant exhibited to me her Philhealth ID No.
11-050515841-5 bearing her picture and signature as competent evidence of identity.

Doc. No. ___; NOTARY PUBLIC

Page No. ___;
Book No.___;
Series of 2022.