REPUBLIC OF THE PHILLIPINES

CITY OF CEBU

AFFIDAVIT OF DESISTANCE

I , ROAN R. BULLONGAN, of legal age, Filipino, single , and a resident of Tabuk City , Kalinga ,after having been duly
sworn to in accordance with law, hereby depose and say;

1. That I the OWNER of a MOTOR CYCLE described as MOTORSTAR MOTORCYCLE bearing Plate No. NG 29976 covered
by Certificate of Registration (CR) No. 239148272 and Official Receipt (OR) No. 1584728331 dated January 23, 2019;

2. That I am complaining against JOVAN B. APPAG , of legal age, Filipino, single and a resident of Dilag, Tabuk City
Kalinga , who was the driver of the vehicle particularly described as KIA RIO bearing Plate No. EG 2502 for the damage
to property of my unit as driven by my brother Mr. Rhaven Bullongan w/ driver's license No.: G11-16-002072 w/
expiration on 08/04/2024 w my vehicle particularly described as -MOTORSTAR MOTORCYCLE bearing Plate No. NG
29976 above-described, after a vehicular accident last May 15, 2019 at Brgy.Laya East, Tabuk City,Kalinga;

3.. That the damage to property sustained by my motor vehicle was purely accidental in nature and do not warrant
criminal prosecution more especially that JOVAN B. APPAG voluntarily defrayed the cost and expenses of its repair;

4. That I am no longer interested in criminally, civilly and administratively prosecuting the case against the
aforementioned driver JOVAN B. APPAG and QM BUILDERS by Allan B. Quirante, owner of the KIA RIO bearing Plate No.
EG 2502;

5. That I execute this affidavit of my own free will and volition for me, I being the owner of MOTORSTAR MOTORCYCLE
bearing Plate No. NG 29976 and for the purpose of seeking dismissal or refraining from further prosecuting whether
criminally, civilly or administratively the aforementioned driver and/or owner of the above-mentioned vehicle and
hereby waive all my rights and claims pertaining to said incident now and hereafter,

6. That the foregoing statements have been fully read by me and/or translated to me in the dialect which I speak and
understand and are true and correct to the best of my personal knowledge and ability.

IN WITNESS WHEREOF,I _______day of ______________ in Tabuk City,Kalinga,Philippines.

ROAN R. BULLONGAN