Republic of the Philippines}

CITY OF MANILA
} S.S.

AFFIDAVIT
I, NAME, of legal age, Filipino and with office address at Barangay
Hall, Barangay 260, Zone 64, Manila, after having been duly sworn to
in accordance with law, hereby depose and state:
1. I am the duly elected barangay chairman of BARANGAY and
under my jurisdiction is Masangkay Street in Manila;
2.

One of my duties and responsibilities as barangay chairman

is to operate the barangay-owned closed circuit television
(CCTV) cameras installed in our barangay and to save the
footages captured by the said cameras, including the CCTV
camera installed in a lamp post along STREET;

3. I hereby authenticate that the footages captured by the CCTV

camera facing the building of BUILDING for DATE that were
copied and saved in a compact disc (CD) were the same and
true and faithful reproduction of what had been captured by
the said CCTV camera and under my safekeeping;
4. I am executing this Affidavit to attest to the truth of the
foregoing and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hands this
____th day of May 2014 in the City of Manila.

_____________________________
NAME

SUBSCRIBED AND SWORN to before me this ___ day of July

2014, in the City of Manila, affiant exhibiting to me his
___________________________ issued on _________________________ at
___________________________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2014.