Republic of the Philippines)

City of Tacloban ) s.s.

x----------------------------------------x

JOINT-AFFIDAVIT OF SETTLEMENT

We, ____________________ and _____________________, both of legal age, Filipinos,

married/single, and residents of Tacloban City, do hereby depose and state, THAT:

1. We are both involved to a minor traffic accident on __________ in Tacloban City

involving our vehicles, respectively, causing damage, dents and scratches on the various
parts of our vehicles;

2. We have come to amicably settle the matter since our said vehicles are covered with
insurance. We likewise, do freely, voluntarily, and absolutely release, clear, absolve, and
discharge each other from any liability, damages of any case arising from the incident;

3. We warrant that we will desist from pursuing any action before the Prosecution Office,
and will no longer institute civil, criminal, or otherwise, against one another arising from,
by reason of, or in connection with, the aforementioned vehicular accident;

4. We have fully read or caused to be interpreted, and understood the contents of this
affidavit, that the same reflects my true intention, and that I am also fully aware of the
legal effects of executing and signing of the same.

IN WITNESS WHEREOF, I have hereunto set my hand this _________________ in

_____________________, Philippines.

___________________________ __________________________
Affiant Affiant

SUBSCRIBED AND SWORN to me this ____ of ___________ 2020, Tacloban City,

Philippines, affiant ID is ______________________________.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2020