COMPROMISE AGREEMENT

(With Waiver, Release, and Quitclaim)

I, (name), Filipino, of legal age, married (or single), and residing at

(adress), after having been sworn in accordance with law hereby depose
and state that:

1. On 13 May 208, while traversing the northbound lane of

Maharlika Highway in Salacot, San Miguel, Bulacan, the car I was driving
figured a minor collision with one service tricycle.

2. The vehicle I was driving is registered under the name of and

driven by Mr. (name). While the service tricycle is owned and driven by Mr.
Romeo Villacorta.

3. Due to this unfortunate event, the van incurred minor scratch at

the (area of damage). A photograph of which is attached hereto and marked
as Annex “1”.

4. Subsequently, I received from Ms. Julie Ann Villacorta,

daughter of the owner of the service tricycle, a downpayment of Two
Thousand Pesos (Php 2,000.00).

5. On even date, I agreed with Ms. Villacorta and her family to

settle the issues and controversies arising from the minor vehicular accident,
immediately and amicably. We arranged that Ms. Villacorta will pay the total
amount of repair including the downpayment mentioned in paragraph 4
hereof.

6. I hereby confirm that I have agreed to a full and complete

settlement of all my claims, demands, causes of actions whatsoever, which
in law or equity, I have or hereafter may have upon or by reason of minor
vehicular accident, and that such settlement is fair and for the best interests
of and advantageous to all the parties to avoid a costly, protracted, time -
consuming and onerous litigation of respective claims, counterclai ms,
demands, counter demands, etc.

7. I acknowledge that I received the cash as mentioned in

paragraph 4 from Ms. Villacorta and the (name of bank) check with face
value of (amunt) with Nissan Cavite Branch as payee.

8. Accordingly, I hereby absolutely release, completely clear, free

and forever discharge Mr. Romeo Villacorta and Ms. Julie Ann Villacorta
from any action, cause of action, sum of money, form of liability, damages,
claims, obligation, indebtedness, in whatever nature, arising from or in
connection with the aforementioned accident.

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 9. I further warrant that I will no longer pursue any criminal, civil,
administrative, or any other case nor testify against the parties in any
proceedings in connection with the accident and hereby manifest that the
payment and settlement made between us shall not be taken by me or my
heirs and assigns as confession and/or admission of liability on the part of
Mr. Villacorta and Ms. Villacorta.

10. I hereby reiterate that all claims, demands, rights, duties,

obligations, sums of money, contracts, controversies, agreements,
promises, torts, judgments, executions, liabilities, damages, or causes of
actions (collectively, the “CLAIMS”) of every kind and nature, however, or
wherever arising, indirect, contingent or actual, liquidated or unliquidated,
which have arisen or which might or could have arisen under any law, from
any relationship, incident or transaction arising or occurring under all
contracts, agreements or relationship, or anything in connection therewith
and, generally, all CLAIMS arising out of or is necessarily connected with
Mr. Villacorta and Ms. Villacorta existing or arising at any time prior to or at
the time of execution hereof, are hereby SATISFIED, ACQUITTED,
DISCHARGED and RELEASED.

11. I also bind myself to cooperate and provide all necessary

information and documents that may be needed and/or requested by Ms.
Villacorta for repair purposes.

12. I further agree that this agreement is strictly confidential as well

as the terms and conditions hereof. As such, I bind myself not to divulge the
provisions of this agreement, i.e. the settlement amount, to any other third
person.

13. I likewise warrant that the execution of this RELEASE, WAIVER

AND QUITCLAIM is free and voluntary, and that no inducements, threats,
representations or influences of any kind were made or exerted by or on
behalf of Mr. Villacorta and Ms. Villacorta, and with full knowledge,
understanding and awareness of my rights under the law. I also warrant that
I have read and fully understood this RELEASE, WAIVER AND QUITCLAI M
and the effect thereof and that this was translated to a language known and
understood by me.

IN WITNESS WHEREOF, I hereby freely and willingly sign this (date)

May 2018 in ______________ City.

(Name)
Affiant

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 Signed in the Presence of:

Witness Witness Witness

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )

_______________ CITY ) SS.

BEFORE me, a Notary Public for and in (place) City, personally

appeared Affiant (name) who presented to me his _______________ issued
on ______________ at ____________________ as competent proof of his
identity, known to me to be the same person who executed the foregoing
Compromise Agreement with Release, Waiver, Quitclaim and who
acknowledged to me that the same is his free and voluntary act and deed.

WITNESS MY HAND AND SEAL this (date) May 2017 at (place) City.

NOTARY PUBLIC
Doc. No. ____;
Page No. ;
Book No. ;
Series of 2018.

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