REPUBLIC OF THE PHILIPPINES)

CITY OF I L O I L O) S.S.
x-------------------------x

AFFIDAVIT OF NON-INTEREST
with ACKNOWLEDGMENT RECEIPT

I, APRIL ROSE BATAYO, of legal age, married, Filipino and a resident

of Brgy. Guihaman, Leganes, Iloilo, Philippines, after having been duly sworn
to, in accordance with law, do hereby depose and state:

1. That, I am the mother of DEXTER JADE BATAYO, who was

accidentally and unintentionally bumped and was hospitalized as a result
of a vehicular incident on or about 1:55 o’clock in the afternoon of
December 12, 2023 along the national highway at Brgy. Buntatala,
Leganes, Iloilo, whereby the motorcycle of AQUELINO RECABO,
bearing temporary plate No. 0601-0728292, accidentally hit my son as he
was crossing the other side of that road;

2. That, the said vehicular incident is but purely an accident and we have
amicably settled the said incident;

3. That, I HEREBY ACKNOWLEDGE RECEIPT on hand from

AQUELINO RECABO, the amount of ONE HUNDRED FIFTY
THOUSAND PESOS (PHP 150,000.00), Philippine Currency as FINAL
and FULL payment/settlement of the said incident to cover the medical
expenses incurred in relation to the incident;

4. As such and by these presents, I do hereby RELEASE, REMISE,

WAIVE, QUITCLAIM and forever DISCHARGE the driver and owner
of the said vehicle AQUELINO RECABO, from any action of whatever
nature, arising directly or indirectly, expected, real or apparent, whether
civil, criminal, administrative or otherwise, or from any claim of any kind
or character which I may now have, or may acquire in the future and/or in
which my heirs, executors or administrators may have by reason of any
matter, cause or thing whatsoever arising, directly or indirectly, out of the
above-mentioned Affidavit of Non-Interest with Acknowledgment
Receipt;

5. That, I further undertake not to hold the traffic enforcers or police

authorities civilly, criminally or administratively liable by reason thereof;

6. Finally, I do hereby declare that I have read the contents of this Affidavit
of Non-Interest with Acknowledgment Receipt and have fully understood
every word of it and its meaning and I have affixed my signature
hereunder knowingly, freely, and voluntarily, with the full and complete
knowledge of the meaning and intent of this document and of my rights
under existing laws of equity;
 7. I acknowledge and admit that I understand that this Affidavit shall be
binding upon me and my respective family, heirs, assignees, successors-
in-interest, and all persons claiming right under me and that this document
may be used as evidence against me in any court, agency, office, tribunal,
or board to attest to the truthfulness and voluntariness of the statement, act
and deeds hereby declared;

8. I am executing this Affidavit of Non-Interest with Acknowledgment

Receipt in order to attest to the truthfulness of the foregoing declarations
and for whatever legal purpose it may serve.

AFFIANT FURTHER SAYETH NAUGHT.

APRIL ROSE BATAYO

Affiant
ID No. ____________________

Signed in the presence of:

__________________ & _________________

SUBSCRIBED AND SWORN to before me this __________________,

in _____________________, Philippines, affiant exhibiting to me her valid
government issued ID indicated below her printed name set forth above as
competent proof of her identity.

Doc. No.: ______

Page No.: ______;
Book No.: _____;
Series of 2024.