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Affidavit of Desistance Mindoro

1. Faustino S. Manalo was involved in a motorcycle accident on January 15, 2021 in Bauan, Batangas while driving a motorcycle registered to John Lorenz Chua. 2. As a result of the accident, Manalo sustained physical injuries requiring treatment and medication. 3. Manalo releases Sorosoro Ibaba Development Cooperative and their driver, Nicanor Dimaano, from any liability or claims related to the accident, and agrees not to take any further legal action against them.

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Howard Untalan
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95 views2 pages

Affidavit of Desistance Mindoro

1. Faustino S. Manalo was involved in a motorcycle accident on January 15, 2021 in Bauan, Batangas while driving a motorcycle registered to John Lorenz Chua. 2. As a result of the accident, Manalo sustained physical injuries requiring treatment and medication. 3. Manalo releases Sorosoro Ibaba Development Cooperative and their driver, Nicanor Dimaano, from any liability or claims related to the accident, and agrees not to take any further legal action against them.

Uploaded by

Howard Untalan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES )

PROVINCE/CITY OF ______________ ) SS.

AFFIDAVIT

I, FAUSTINO S. MANALO, of legal age, Filipino citizen, and a resident of Brgy. Alagao, Bauan,
Batangas, after having been duly sworn to in accordance with law, hereby voluntarily depose and say:

1. That I am a driver of one Racal Motorcycle having Plate No. DA 80210 (registered to John Lorenz
Claveria Chua) that figured in an accident sometime in the morning of January 15, 2021, 11:00 AM
while I were traversing Brgy. San Diego Proper, Bauan, Batangas;

2. That as a result of the said accident, I, sustained physical injuries necessitating treatment and
medication;

3. That I fully understand and accept that said unfortunate event is purely accidental in nature;

4. That the owner of the Mitsubishi FB L300 (Plate No. DAB 3927) is Sorosoro Ibaba Development
Cooperative (SIDC), being driven by Mr. Nicanor Dimaano (with PDL N01-02-194241) working as a
Company Driver and had likewise extended full satisfaction all the assistance that it could provide to
cover for the expenses incurred owing to the treatment and medication;

5. That in view of the foregoing, I do hereby freely, voluntarily, and absolutely release, clear, absolve, and
discharge the said Sorosoro Ibaba Development Cooperative (SIDC) and Mr. Nicanor Dimaano
from any action, cause of action, sum of money, liability, damages, claims and demands whatsoever,
which in law or in equity I have, or which I, my heirs, insurer, successors and assigns hereafter may
have upon or by reason of the injuries sustained by me arising from the said incident;

6. That I further warrant that I will institute no further action, civil, criminal or otherwise, against the said
SIDC and Mr. Nicanor Dimaano arising from, by reason of, or in connection with, the aforementioned
accident. I also manifest that the said payment/settlement made by SIDC shall not be taken by me, my
heirs, my insurer or assigns, as a confession and/or admission of liability on their part in connection with
the aforementioned accident; and

7. That I 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


_______________________________.

_____________________________
FAUSTINO S. MANALO
Affiant

SUBSCRIBED AND SWORN to before me, this __________________, in ______________________


_____________________, by the above-named affiant who presented to me his _______________________
________________________ as competent evidence of his identity.

_________________
NOTARY PUBLIC

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2021.

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