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    Affidavit of Desistance Laguna Arewa

    Uploaded by

    Howard Untalan
    1. Joselito Atienza was involved in a vehicular accident on July 29, 2020 while driving an Isuzu Elf truck owned by Sorosoro Ibaba Development Cooperative (SIDC) where he works as a company driver. 2. As a result of the accident, Joselito sustained physical injuries requiring treatment and medication which SIDC covered. 3. Joselito releases and absolves SIDC from any liability or claims arising from the accident and will not pursue any legal action against SIDC in connection with the accident.

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    © All Rights Reserved
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    Affidavit of Desistance Laguna Arewa

    Uploaded by

    Howard Untalan
    28 views2 pages
    1. Joselito Atienza was involved in a vehicular accident on July 29, 2020 while driving an Isuzu Elf truck owned by Sorosoro Ibaba Development Cooperative (SIDC) where he works as a company driver. 2. As a result of the accident, Joselito sustained physical injuries requiring treatment and medication which SIDC covered. 3. Joselito releases and absolves SIDC from any liability or claims arising from the accident and will not pursue any legal action against SIDC in connection with the accident.

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    Affidavit of Desistance Laguna Arewa

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    1. Joselito Atienza was involved in a vehicular accident on July 29, 2020 while driving an Isuzu Elf truck owned by Sorosoro Ibaba Development Cooperative (SIDC) where he works as a company driver. 2. As a result of the accident, Joselito sustained physical injuries requiring treatment and medication which SIDC covered. 3. Joselito releases and absolves SIDC from any liability or claims arising from the accident and will not pursue any legal action against SIDC in connection with the accident.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    28 views2 pages

    Affidavit of Desistance Laguna Arewa

    Uploaded by

    Howard Untalan
    1. Joselito Atienza was involved in a vehicular accident on July 29, 2020 while driving an Isuzu Elf truck owned by Sorosoro Ibaba Development Cooperative (SIDC) where he works as a company driver. 2. As a result of the accident, Joselito sustained physical injuries requiring treatment and medication which SIDC covered. 3. Joselito releases and absolves SIDC from any liability or claims arising from the accident and will not pursue any legal action against SIDC in connection with the accident.

    Copyright:

    © All Rights Reserved
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    REPUBLIC OF THE PHILIPPINES )

    PROVINCE/CITY OF ______________ ) SS.

    AFFIDAVIT

    I, JOSELITO F. ATIENZA, of legal age, Filipino citizen, and a resident of Sta. Rosa, Alaminos,
    Laguna, after having been duly sworn to in accordance with law, hereby voluntarily depose and say:

    1. That I am a driver of Isuzu Elf Truck having Plate No. ACN 7090 that figured in an accident sometime
    in the morning of July 29, 2020, 9:30AM while I were traveling along the New Diversion Road, Sitio
    Upper Sapinit, Brgy. Silangang Malicboy, Pagbilao, Quezon;

    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 Isuzu pickup is Sorosoro Ibaba Development Cooperative (SIDC), were I work
    as a Company Driver and had likewise extended to my full satisfaction all the assistance that it could
    provide to cover for the expenses incurred owing to my 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) 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 arising from, by reason of, or in connection with, the aforementioned vehicular 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 his 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


    _______________________________.

    _____________________________
    JOSELITO F. ATIENZA
    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 2020.

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