Republic of the Philippines)

Province of_______________)S.S.
City/Municipality of____________) 
x - - - - - - - - - x

AFFIDAVIT OF DESISTANCE

I,____________,Filipino, single, with

residence__________, under oath allege:

1.That I am the complainant in Criminal Case

No.__________for alleged "RAPE" against
accused___________, which case is pending before the
Regional Trial Court, Branch______,
_____________City, Philippines;

2.That I signed the aforesaid complaint against

accused__________against my will, my signature in the
complaint having been obtained thru force, violence
and intimidation done to me by my parents;

3.There is no truth to the allegations contained in

my sworn statement executed by me against my will
on___________at____________, taken by____________.
There was no force, violence or intimidation done
against me by said accused___________. I was not
forced by him to submit to his desires. It was all in
accordance with my own will, volition and consent
that I went personally to him because we love each
other and I agree and consent to live with him as my
husband;

4.I therefore respectfully request that the above-

mentioned case filed against said___________be
dismissed as in fact I now withdraw my complaint
against him and I further manifest under oath that I
am now desisting from testifying against him in Court
or in any other government entity or agency in
connection with the said criminal case.

IN WITNESS WHEREOF, I have hereunto set my hand

this___________at____________, Philippines.
AFFIANT