REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

________ Judicial Region
Branch __, __________________________

AFFIDAVIT OF DESISTANCE

I, __________________, Filipino, of legal age, and resident of _____________________, after having

been duly sworn to in accordance with law, depose and state:

1. I am the private complainant in a criminal case for violation of _________________ against

__________________docketed as Criminal Case No. ________________ pending before the Regional
Trial Court of __________, Branch _____;

2. After several conferences with the accused, I hereby declare that the same arose out of
pure misunderstanding and misapprehension of facts;

3. Based on the said misunderstanding, misapprehension of facts and also for the welfare of
our child, I manifest that I now withdraw my complaint against the accused and that I am
no longer interested, and I hereby desist, in prosecuting the above-mentioned case;

4. This Affidavit of Desistance should, however, not be understood as a waiver or

relinquishment of any of my rights to pursue any legal action that I may file in connection
with any act or omission that the accused may commit in the future;

5. I hereby release the accused from any and all criminal liabilities and waive any right of
action against the accused in connection with the above case;

6. I fully understand the legal consequences of this Affidavit of Desistance;

7. I am executing this affidavit to attest to the truth of the foregoing statements and
respectfully pray that the aforementioned case against _____________ be withdrawn and/or
dismissed.

IN WITNESS WHEREOF, we have hereunto set my hands this _________________________

in _________________, Philippines. _______________________ 
 

Private Complainant

Assisted by: _______________________

Private Prosecutor

SUBSCRIBED AND SWORN TO before me this ____________in __________________________,

Philippines, affiant exhibiting tome her ________________________ issued at _________________issued
on ___________________ as her valid proof of identification.

Doc. No.____;
Page No. ___;
Book No. ___;
Series of 20_____.