I, _Name OF Complainant)_, Filipino, of legal age, married, with residence at ___(address of

complainant)___ , having received the Partial Amount as stipulated in the Compromise Agreement under
Criminal Case No. 2018-SJ-0522, in the sum of Php 150,000.00 to me in hand by
____________________ represented by the mother (_Name of the Mother) , with residence at
___(address of)___ , hereby by these presents Partially Complied the Compromise Agreement.

(_Name of the Mother)

Signature: ______________
Date: __________________

Received by:

(_Name of the Complainant) (_Name of the Complainant)

Signature: ________________ Signature: ________________

Date:____________________ Date:____________________

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

_____________________________ ) SS.

BEFORE ME, a Notary Public, this ____day of ________________, personally appeared the
following:

Name CTC Number Date/Place Issued

(Name of Complainant)
(Name of Respondent)

IN WITNESS WHEREOF, I have hereunto set my hand the day, year and place above written.

Notary Public

Doc. No. .......;

Page No. .......;
Book No. .......;
Series of 20__.