REPUBLIC OF THE PHILIPPINES

PROVINCE OF ISABELA) S.S.

MUNICIPALITY OF NAGUILIAN)

AFFIDAVIT OF DESISTANCE
I, JULIE ANN B. LOBENDINO, Filipino, of legal age, common-law married, and a resident of Barangay
Surcoc, Naguilian, Isabela, Philippines, after being duly sworn to in accordance with law, hereby depose
and state that:

1. I am the complainant for Violation of the Anti-Violence against Women and their Children Act of 2004 (or
R.A. 9262) against my common law husband, EFRELITO I. PADUA (or “EFRELITO”), in a police blotter
with entry number 13094 dated December 12, 2017;

2. In the said police blotter, I reported that on December 4, 2017 at around 8:00 o’clock in the evening at
Barangay Surcoc, Naguilian, Isabela, my common law husband EFRELITO kicked me in the right eye and
even threatened my life and one of our child while he was under the infuence of alcohol;

3. My common law husband, EFRELITO, asked forgiveness to what he had done to me, and out of my love
and compassion for him, and in view of the love and support that he has since bestowed on me and our
children, I have decided to forgive my common law husband, EFRELITO;

4. I am no longer interested in and therefore DESISTS in initiating a complaint pursuant to the above-
described police blotter against EFRELITO nor to testify/prosecute against him in any jurisdictions or any
courts of the said incident/case;

5. I am executing this Affidavit to attest to the truth of the foregoing and to submit the same to Naguilian
Philippine National Police in order to clear out the said police blotter which have been recorded regarding the
incident, to desists from initiating a complaint against EFRELITO I. PADUA involving the said incident and for
whatever legal purpose it may serve best.

AFFIANT SAYS NONE.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 13 th day of December, 2017 at
San Manuel, Naguilian, Isabela.

JULIE ANN B. LOBENDINO

Affiant
________________________________________

SUBSCRIBED AND SWORN to before me, this 13th day of December, 2017 at San Manuel, Naguilian,
Isabela, affiant exhibiting to me her competent identity document.

Doc. No. 283;

Page No. 58;
JENNIFER M. ROSETE
Book No. I;
NOTARY PUBLIC
Series of 2017.
Not. Pet. No. 1216-01
Until December 31, 2018
Roll No. 64173
PTR NO. 8121904/ 1-5-17/NAGUILIAN, ISABELA
IBP NO. 1049612/ 1-19-17/ISABELA
MCLE Compliance No. V- 0020900
Until April 14, 2019