Sample of Affidavit of Complaint

Republic of the Philippines )

____________, ________ ) s.s.
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AFFIDAVIT OF COMPLAINT
The UNDERSIGNED, __________________________, accuses _________, of
_____________, committed as follows, to wit:
That on or about _________, at about _____________ in the
_________________, ______________, Philippines, the said accused did then and
there willfully, unlawfully, feloniously, and by means of _____________, committed
_____________, upon the undersigned directly by oert acts to wit: !state the details
how the crime was committed).
The undersigned executed this affidait to attest the truthfulness of the foregoing
facts and to support the filing of "riminal "ases against
for iolations of ________________________.
, t!i" da# of , $
____________________________
Offended Pa%t#
SU&SCRI&ED AND S'ORN to before me this ___ day of _______ at
_______________. I (ERE&) CERTIF) that # hae personally examined the herein
offended party and # am satisfied that they oluntarily executed and understood their
gien affidait.
_________________________
*+d,e
$#T%&''&':
__________________________
__________________________