Form No.

1--Complaint Affidavit for Filing of BP 22 Case (Complaint Affidavit for Filing of BP 22 Case) COMPLAINT-AFFIDAVIT I, _____________, Filipino, of legal age, (single / married / widow), and a resident of _____________, Philippines, after being sworn to in accordance with law, depose and state: That I know the person of __Respondent__, who is a resident of _____________, Philippines; That sometime in the morning of __date of issue__, at __place of issue__, Philippines, the said __Respondent__ issued in my favor a __Name of Bank__ Check No. _____________ in the amount of P_____________ as supposed payment for the loan accommodation of P_____________, which I have extended to (him/her); That the said check is drawn against the account of the said __Respondent__ at __Name of Bank__ with Account No. _____________; That at the time the said __Respondent__ issued the delivered the said check to me, (he/she) made the assurance and representation that the said check is a good check and would be covered by sufficient funds when presented for payment; However, when the above-mentioned check was deposited, the same was dishonored and returned by the bank on the ground that the same was drawn against a "CLOSED ACCOUNT".A true and faithful machine reproduction of the said check is hereto attached as Annex "____"; As such, I immediately notified said __Respondent__ of the dishonor and return of the said check and demanded from (him/her) that (he/she) make good the said check within _____________ (____) days from receipt thereof. A true and faithful machine reproduction of my demand letter to (him/her) is hereto attached as Annex "____" When said __Respondent__ failed to heed my demands, I endorsed the said check to my legal counsel who immediately sent a formal demand letter through registered mail with return card on _____________, which was received by the said __Respondent__ on _____________.As of date however, __Respondent__ has unjustifiably ignored all these demands to pay the said account and/or to redeem the said returned check. A true and faithful machine reproduction of my demand letter to (him/her) is hereto attached as Annex ____" I am therefore executing this Complaint-Affidavit in support of the charges for Violation of Batas Pambansa Bilang 22 against the said __Respondent__, who may be served with subpoena and other processes of this Honorable Office at (his/her) last known address at _____________, Philippines; IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at _____________, Philippines.

Administering Officer .COMPLAINANT SUBSCRIBED AND SWORN to before me this _____________ at _____________.I hereby certify that I have examined the Affiant and that I am fully satisfied that (he/she) has voluntarily executed and understood the contents of (his/her) Complaint-Affidavit.

committed as follows.Form No. holding her breasts and taking liberties upon her person by force and against the will of the undersigned. when the latter was about to enter a public toilet. at about _________ (a. COMPLAINANT (JURAT) Witnesses: ___________________ ___________________ . unlawfully. _____________. Philippines. the said accused _____________ did then and there willfully. 2--Complaint for Acts of Lasciviousness (Complaint for Acts of Lasciviousness) (caption) COMPLAINT The undersigned. Province of _____________ and within the jurisdiction of this Honorable Court. _____________.m. and feloniously embrace the undersigned.m. __Date__./p. accuses _____________ of the crime of ACTS OF LASCIVIOUSNESS.). to wit: That on or about _____________. Contrary to law. in the City/Municipality of _____________.

m. 3--Complaint for Adultery (Complaint for Adultery) (caption) COMPLAINT The undersigned. the said accused _____________ did then and there voluntarily. voluntarily. Province of _____________ and within the jurisdiction of this Honorable Court. unlawfully. _____________. accuses _____________ of the crime of adultery. Contrary to law.). Philippines.Form No./p. _____________.m. and the latter knowing her to be married to _____________. and feloniously had sexual intercourse with her co-accused _____________. in the City/Municipality of _____________. to wit: That on or about _____________. __Date__ COMPLAINANT (JURAT) Witnesses: ________________ ____________________ . committed as follows. who is not her husband. and feloniously had carnal knowledge with her. unlawfully. at about _________ (a.

Contrary to law. taking and carrying her away on board a black passenger van. Province of _____________ and within the jurisdiction of this Honorable Court. the said accused.m. against her will and with lewd designs. __Date__. at about __________ (a. _____________. COMPLAINANT (JURAT) Witnesses: ________________ __________________ . did then and there willfully. to wit: That on or about _____________.Form No. accuses _____________ of the crime of FORCIBLE ABDUCTION.m. _____________. in the City/Municipality of _____________. committed as follows. 5--Complaint for Forcible Abduction (Complaint for Forcible Abduction) (caption) COMPLAINT The undersigned. unlawfully and feloniously abduct a woman named _____________ who is a minor of 14 years while she was on her way home from school. Philippines./p.).

PROSECUTOR Witnesses: ____________________ ____________________ . in the City/Municipality of _____________.m. Contrary to law.). Philippines. to the damage and prejudice of the said _____________ in the amount of P_____________. and feloniously set on fire the building belonging to _____________. knowing it to be occupied by at that time by one or more persons./p. accuses _____________ of the crime of ARSON. __Date__. 1--Information for Arson (Information for Arson) (caption) INFORMATION The undersigned. _____________. to wit: That on or about _____________. at about _________ (a. _____________. committed as follows. Province of _____________ and within the jurisdiction of this Honorable Court. the said accused did then and there willfully.Form No.m.

m. Province of _____________ and within the jurisdiction of this Honorable Court.Form No. Philippines./p. and feloniously assault. committed as follows.m. _____________. the said accused. in the City/Municipality of _____________. PROSECUTOR Witnesses: ____________________ ____________________ (Certification of Preliminary Investigation) . _____________. armed with a jungle knife. unlawfully. and with evident intent to kill. __Date__. attack and wound one _____________ inflicting mortal wounds in various parts of his body resulting to his instantaneous death. Contrary to law. to wit: That on or about _____________. accuses _____________ of the crime of HOMICIDE. at about _________ (a.). did then and there willfully. 7--Information for Homicide (Information for Homicide) (caption) INFORMATION The undersigned.

the said accused did then and there.m. under the express obligation of holding the same in trust for _____________ and to remit the proceeds of the sale of the said goods. willfully. and feloniously. _____________. accuses _____________ of the crime of SWINDLING / ESTAFA.). if sold.m. PROSECUTOR Witnesses: ____________________ ____________________ (Certification of Preliminary Investigation) . committed as follows. _____________. at about _________ (a. the said accused having received from _____________ a variety of Ready-to-Wear goods valued at P_____________ for the purpose of selling the same on commission. unlawfully. Contrary to law. __Date__. Philippines.Form No. misappropriate and convert the said goods or their proceeds to his own personal use and benefit to the damage and prejudice of _____________ in the amount of P_____________. in the City/Municipality of _____________. to wit: That on or about _____________. 17--Information for Swindling Estafa (Information for Swindling Estafa) (caption) INFORMATION The undersigned. or to return the same in case of non-sale. within ________ (____) days from receipt thereof. Province of _____________ and within the jurisdiction of this Honorable Court./p.

Sign up to vote on this title
UsefulNot useful