AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

This Agreement, made and entered into by and between ___________________,

Filipino Citizen, of legal age and resident of _________________, hereinafter referred to as
the FIRST PARTY, and

_______________, Filipino Citizen, of legal age and resident of ________________,

hereinafter referred to as the SECOND PARTY:

-WITNESSETH-

That on or about _______________, a vehicular accident transpired at

____________________ involving the herein parties;

That both parties entered into an amicable settlement wherein

_________________________________;

That in view of the foregoing development, both parties had an agreement/settlement

wherein the ____________ will not file any case against the __________________, in
connection with the aforementioned incident provided that the _______________ will fulfill
the aforementioned condition;

That both parties agreed to comply with all of the foregoing in good faith.

IN WITNESS WHEREOF, parties hereunto set their hands herein below this
_____________________ at ________________Philippines.

_________________ __________________
First Party Second Party
___No. ________________ ___No. ________________
Issued on _______________ Issued on _______________
At _____________________ At _____________________

SIGNED IN THE PRESENCE OF:

Acknowledgement
REPUBLIC OF THE PHILIPPINES )
) S.S.
BEFORE ME this __________________________ at _____________Philippines,
personally appeared all above-named persons, known to me and to me known to be the same
persons who executed the foregoing instrument and acknowledged to me that the same is
their free act and voluntary deed.
WITNESS MY HAND AND SEAL on the date and place first written above.

Doc. No.
Page No.
Book No. ____
Series of 2023