REPUBLIC OF THE PHILIPPINES

Province of Negros Occidental) S.S.

City of Bacolod)

AFFIDAVIT OF NO INTEREST
I, ANACLETO Y QUINATADTAD, of legal age, Filipino, married and a resident
of Purok Masinadyahon, Brgy. Bata, Bacolod City, Negros Occidental, after having
been duly sworn to in accordance with law, do hereby depose and state the following:

1. That I am the same ANACLETO Y QUINATADTAD, involved in a vehicular

accident on February 25, 2018 at Lacson St., Fronting 722 Metro Polis
Tower, Brgy. Mandalagan, Bacolod City, involving the pedicab (trisikad)
that I was driving and that of Toyota Fortuner bearing Plate No. FGS 690,
owned and driven DAHLIA D. DIONEO, a resident of St. Francis Subd.,
Silay City, Negros Occidental;

2. That I have already entered in an amicable settlement with DAHLIA D.

DIONEO relative to the said incident;

3. That I hereby release, clear, and discharge DAHLIA D. DIONEO from any
action, cause of action, sum of money, liability, damages, claims and
demands whatsoever, which in law or in equity I have, or which my heirs,
insurer, successors and assigns hereafter may have upon or by reason of
the injuries sustained by me or my wife, and the damage sustained by my
pedicab (trisikad);

4. That I further warrant that I will institute no further action against DAHLIA
D. DIONEO arising from, by reason of, or in connection with, the
aforementioned vehicular accident;

5. That I also manifest that the said settlement made with DAHLIA D.
DIONEO shall not be taken by us, our heirs, our insurer or assigns, as a
confession and/or admission of liability on his part in connection with the
aforementioned accident;

6. That I am executing this affidavit to attest to the truth of the foregoing and
for whatever legal purposes that this statement may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this _____ day of

_____________, 2018, in the City of Bacolod, Philippines.

ANACLETO Y QUINATADTAD
AFFIANT

SUBSCRIBED AND SWORN to before me, this _____ day of ______________,

2018, in the City of Bacolod, Negros Occidental.

Doc No. _______

Page No. _______
Book No. _______
Series of 2018
REPUBLIC OF THE PHILIPPINES
Province of Negros Occidental) S.S.
City of Bacolod)

AFFIDAVIT OF NO INTEREST
I, JOEBERT L. SEMBRANO, of legal age, Filipino, single and a resident of
Purok Marapara, Brgy. Bata, Bacolod City, Negros Occidental, after having been duly
sworn to in accordance with law, do hereby depose and state the following:

1. That I am the same ANACLETO Y QUINATADTAD, involved in a vehicular

accident on February 25, 2018 at Lacson St., Fronting 722 Metro Polis
Tower, Brgy. Mandalagan, Bacolod City, involving the pedicab (trisikad)
that I was driving and that of Toyota Fortuner bearing Plate No. FGS 690,
owned and driven DAHLIA D. DIONEO, a resident of St. Francis Subd.,
Silay City, Negros Occidental;

2. That I have already entered in an amicable settlement with DAHLIA D.

DIONEO relative to the said incident;

3. That I hereby release, clear, and discharge DAHLIA D. DIONEO from any
action, cause of action, sum of money, liability, damages, claims and
demands whatsoever, which in law or in equity I have, or which my heirs,
insurer, successors and assigns hereafter may have upon or by reason of
the injuries sustained by me or my wife, and the damage sustained by my
pedicab (trisikad);

4. That I further warrant that I will institute no further action against DAHLIA
D. DIONEO arising from, by reason of, or in connection with, the
aforementioned vehicular accident;

5. That I also manifest that the said settlement made with DAHLIA D.
DIONEO shall not be taken by us, our heirs, our insurer or assigns, as a
confession and/or admission of liability on his part in connection with the
aforementioned accident;

6. That I am executing this affidavit to attest to the truth of the foregoing and
for whatever legal purposes that this statement may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this _____ day of

_____________, 2018, in the City of Bacolod, Philippines.

JOEBERT L. SEMBRANO
AFFIANT

SUBSCRIBED AND SWORN to before me, this _____ day of ______________,

2018, in the City of Bacolod, Negros Occidental.

Doc No. _______

Page No. _______
Book No. _______
Series of 2018