Republic of the Philippines }

Province of South Cotabato }S.S.

CITY OF KORONADAL }
x====================x

AFFIDAVIT OF DESISTANCE

We, Spouses Inocentes P. Piabol and Alma P. Piabol, both Filipinos, both
of legal age, husband and wife and residents of Carpenter Hill, City of
Koronadal, South Cotabato, after having been duly sworn to in accordance with
law, hereby deposes and says:

1. We are persons involved in a vehicular accident that occurred on

December 13, 2020 at around 6:00 o’clock in the morning in Brgy.
Carpenter Hill, City of Koronadal, South Cotabato, involving the vehicle
driven by ALEIN EMPINADO and registered in the name of MARI
CLAIRE C. EROY identified as Toyota Sedan, bearing plate no.
GAL3134;

2. That for and in consideration of the amount of FORTY EIGHT

THOUSAND FIVE HUNDRED TWENTY ONE PESOS AND 98/100
(P48,521.98) in cash, we received to our full and complete satisfaction,
and the payment and settlement made by MARI CLAIRE C. EROY of
the hospital and medical bills and additional of THIRTY THOUSAND
PESOS (P30,000.00) as an acceptable and amicable settlement and
TWENTY THOUSAND PESOS (P20,000.00) for damage to property as
we have already settled our differences;

3. We do hereby freely, voluntarily and absolutely release, clear, absolve,

and discharge the said MARI CLAIRE C. EROY AND ALIEN
EMPINADO, from any action, cause of action, sum of money, liability,
damages, claims and demands whatsoever, which in law or in equity
we have, or which we, our heirs, insurer, successors and assigns
hereafter may have upon or by reason of physical injuries and
medication arising from the said accident;

4. That we further warrant that we will institute no further actions, civil,

criminal or otherwise, against the said MARI CLAIRE C. EROY AND
ALIEN EMPINADO arising from, by reason of, or in connection with, the
aforementioned vehicular accident which resulted to physical injuries.

5. We also manifest that the said payment and settlement made by the
owner shall not be taken by us, our heirs, our insurer or assigns, as a
confession and/or admission of liability on our part in connection with
the aforementioned accident;

6. That we have fully read or cause to be interpreted, and understood the

contents of this affidavit, that the same reflects my true intention, and
that we are also fully aware of the legal effects of executing and signing
the same.

1
 IN TRUTH WHEREOF, we have hereunto set our hands this 11th day of
May 2021 in the City of Koronadal, South Cotabato, Philippines.

SPOUSES INOCENTES P. PIABOL AND ALMA P. PIABOL

Affiants
OSCA ID no. 8957 OSCA ID no. 18440

SUBSCRIBED AND SWORN TO before me this 11th day of May 2021 in

the City of Koronadal, South Cotabato, Philippines. I HEREBY CERTIFY that I
have personally examined the affiant and I am satisfied that she have read and
understood the contents of her affidavit of desistance and freely and voluntarily
executed and signed the same.

Doc. No. 473

Page No. 95
Book No. V ATTY. RAUL ANTON U. MALIFER
Notary Public
Series of 2021. Koronadal City/ Tampakan
nd
Unit 2A, 2 flr., JTCT Bldg., General Santos Dr., Kor. City
PTR OR no. 2349579/Jan. 4, 2021/ Kor. City
IBP OR No. 121903/Jan. 4, 2021 /SocGen Chapter
Roll No 70724
MCLE Compliance No. VI-0027255, May 7, 2019
Notarial Commission No. 490-43, Granted on Jan. 22, 2020
Valid until December 31, 2022
TIN 723-709-147