I, _____________, of legal age, single and residing at______after having been duly sworn to according to law hereby depose and state:

      1. That I am the complainant in the criminal case filed against _______, which is recorded as Case No. ______ before Prosecuting Fiscal ________ of the municipality of _________ for grave threats;

      2. That after mulling over the incident for some time and thinking that it was just a case of misunderstanding between me and my neighbor, I have decided to withdraw my accusations against __________;

      3. That I have executed this affidavit in order to attest to the truth of the foregoing circumstances and that my desistance to pursue said case is of my own free will and volition and that there was no coercion or consideration that took place for me to make such decision.

      IN WITNESS WHEREOF, I have hereunto set my hand this ___day of January, 2003 at the City of Manila.