MEMORANDUM OF AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

This Memorandum of Agreement, made and executed in ______________ this

____ day of January 2019 by and between:

A, Filipino, of legal age, widow, and a resident of ______________, hereafter

referred to as the FIRST PARTY,

-- and –

B, Filipino, of legal age, single, and also a resident of ______________, hereafter

referred to as the SECOND PARTY,

WITNESSETH:

WHEREAS, on 04 January 2019, the FIRST PARTY, while crossing the street,
was accidentally hit by the motorcycle of the SECOND PARTY;

WHEREAS, by reason of the said accident, the FIRST PARTY suffered physical
injuries over her body that needs further therapy;

NOW THEREFORE, the PARTIES hereby agree of the following:

1. That on top of the medical expenses that the SECOND PARTY has already
shouldered, which totaled to more or less P25,000.00 already, upon the execution
of this Agreement, the SECOND PARTY shall hand in to the FIRST PARTY the
amount of P30,000.00 to finance the further out-patient therapy of the latter;

2. That in consideration of the foregoing, the FIRST PARTY hereby waives and
forever releases the SECOND PARTY from any Criminal and/or Civil Liabilities
by reason of the said incident that happened on 04 January 2019.

IN WITNESS WHEREOF, the parties have signed this Memorandum of

Agreement at the place and on the date first above written.

A B
First Party Second Party
ID__________ ID__________

Signed in the presence of:

___________________________ ___________________________
 ACKNOWLEDGMENT

Republic of the Philippines )

Province of _____________ ) S.S
City of ___________)

BEFORE ME, a Notary Public for and in the City of _____________,

Philippines, this ____ day of January 2019 in _____________ personally appeared A
and B, exhibiting to me their respective government-issued identification documents,
bearing their photographs and signatures, known to me to be the same persons who
executed the foregoing Memorandum of Agreement, and who acknowledged to me that
the same is their free act and deed.

This instrument which consists of two (2) pages including this page where this
acknowledgment is written has been signed on all pages by the parties and their
instrumental witnesses.

WITNESS MY HAND AND SEAL.

Doc No. ___ ;

Page No. __ ;
Book No. __ ;
Series of 2019.

ACKNOWLEDGMENT RECEIPT
 I, ANNIE A. GUNGOB, hereby acknowledge receipt of P30,000.00 from
RICHARD J. BAROY as his final payment for the hospital expenses and further
therapy of the injuries that I suffered, which I incurred due to the road mishap/accident
that happened on 04 January 2019.

Done this 10th day of January 2019 at Dumaguete City.

Received by:

ANNIE A. GUNGOB