Republic of the Philippines )

Province of Samar )
City of Calbayog )S.S.

JOINT AFFIDAVIT OF DESISTANCE

KNOW ALL MEN BY THESE PRESENTS:

We, RODRIGO DACLES PAJARDO and BERNARDO DABALOS

MENCHAVEZ, all legal age, Filipinos, married, and a residents of Tinambacan
District, Calbayog City, Samar, Philippines, after having been sworn in
accordance with law, hereby deposes and states the following:

1. On September 16, 2019 at Brgy. Tinambacan, Calbayog City, Samar,

while we are driving a motorcycle, we got involved in a vehicular accident
with a Toyota Innova bearing Plate No. POS-846 driven by XUNRONG
ZOU;

2. We suffered physical injuries arising from the vehicular accident to which

Xunrong Zou generously answered for the medical and hospitalization
expenses;

3. We are not a holder of any government issued driver’s license;

4. We were not able to present the official receipt and the certificate of
registration of the motorcycle that we were driving;

5. Xunrong Zou is not at fault and completely free of any liability as the said
incident is purely an accident and unintentional resulting from
circumstances that Xunrong Zou has no control or influence whatsoever;

6. In view of the foregoing, we hereby desist from pursuing any criminal, civil,
or administrative action against Xunrong Zou. We hereby quitclaim,
release, discharge and waive any and all actions of whatever nature,
expected, real or apparent, which we may have against Xunrong Zou by
reason of or arising from our injuries and damage to our property. Any
and all actions which we may have commenced either solely in our name
or jointly with others before any office, board, bureau, court, or tribunal
against Xunrong Zou are hereby deemed and considered voluntarily
withdrawn by us and we will no longer testify or continue to prosecute said
actions;

7. We execute this affidavit freely and voluntarily fully aware of the legal
consequences of our actions.

IN WITNESS WHEREOF, I have here unto affixed my signature this ___th

day of _______________ 2019.

RODRIGO D. PAJARDO BERNARDO D. MENCHAVEZ

Affiant Affiant

_____________________ _____________________

Page 1 of 2
 Witness Witness

SUBSCRIBED and SWORN TO before me on the ___th day of

_______________ 2019, Calbayog City, Samar, affiant exhibited to me his/her
___________________ issued on __________________ at _______________,
and who signed said document in my presence and sworn as to said document
that he understood the contents thereof and that the same was his/her free and
voluntary act and deed.

ATTY. JEFFREY R. BERNATE

Notary Public for Calbayog City and Province of Samar
Bernate Cmpd., P-1, Brgy. Capoocan, Calbayog City,
Samar
Roll No. 67531 / May 24, 2017
IBP No. 066065 / Jan. 09, 2018 / Samar
MCLE Compliance No. VI-0011184 / April 14, 2022
PTR No. 5282535 / Jan. 04, 2019 / Calbayog City
Notarial Commission No. 1908
Notarial Commission Expiration: Dec. 31, 2020

Doc. No. ______

Page No. ______
Book No. ______
Series of 2019

Page 2 of 2