You are on page 1of 1

REPUBLIC OF THE PHILIPPINES) IRIGA CITY )S.S.

AFFIDAVIT OF DESISTANCE I, JERRY MARINAY y MAGDAONG, of legal age, married, Filipino and with residence address at San Agustin Iriga City, Philippines after having been sworn to in accordance with law depose and say: 1. That I am the complainant/husband against Salvador G. Recepcion Jr., driver of the vehicle bearing plate no. EBV 443, registered likewise under the name of Salvador G. Recepcion Jr. for the injuries resulting to death and/or damages sustained to my wife, Helen Galaura Marinay, as a result of the accident which occurred on June 11, 2011 at around 7:15 AM at Barangay Banasi, Pawili, Bula, Camarines Sur;

2. That after careful deliberation over the case and considering the explanation of the said driver/owner, I found that said incident does not merit or warrant criminal prosecution as the injuries resulting to death of my wife and/or damages suffered were purely accidental, further my wife was of unsound mind during the time of the accident; 3. Further the Civil liability has already been fully paid in the Php40,000.00 and Burial expenses; 4. That I am no longer interested in criminally and or civilly prosecuting the case against the aforementioned driver/ registered owner; 5. That I am executing this said affidavit of desistance of my own free will and volition for the purpose of seeking dismissal or signifying my own intention to refrain from further prosecuting the aforesaid driver and/or registered owner and hereby waive all my rights and claims pertaining to the said incident, now and hereafter; 6. That I have fully read the foregoing statements and contents thereof and the same had been read and translated to me in the Tagalog/Bicol dialect, which I understand and that the same are true and correct to the best of my knowledge and belief. AFFIANT FURTHER SAYETH NAUGHT. IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of June 2011 at Iriga City. __________________________________ JERRY MARINAY y MAGDAONG Affiant Signed in the presence of: __________________________________ Signature over printed name _________________________________ Signature over printed name

SUBSCRIBED AND SWORN TO before me this ___ day of June 2011 at _________________________________ Affiant known to me and to me known to be the same person who personally signed and executed this Affidavit of Desistance and acknowledged before me that the same is his free and voluntary act and deed. Doc No.____ Page No.____ Book No.___ Series of 2011

You might also like