Republic of the Philipppines) City of Roxas . . . . . . . . . . . . )S.S.

COMPLAINT AFFIDAVIT

I, ______________________, of legal age, Filipino, married and a resident of ____________, under oath, depose and state:

1. I am filing a criminal case for Perjury, punished under Article 183 of the Revised Penal Code against ____________, of legal age, Filipino, married, and a resident of _________, (hereafter to be referred as the respondent ); 2. Respondent committed the crime on ___________ by executing an affidavit and furnishing me a copy thereof here at Roxas City thus, within the jurisdiction of the City Prosecution Office of Roxas City; 3. On ________, I received a copy of a subpoena from the Office of the Ombudsman wherein I am required to file a counter affidavit on the alleged falsification I committed which consists in the presentation of what purports to be an original copy of a Department Circular from the Department of Public Works and Highways when in truth there is no original which exists; 4. Moreover, the respondent alleges that I maliciously manoeuvred the award of the bid in favour of a construction company against the procurement law; 5. Finally, the respondent claims that I violated the Anti-Graft Law because of the award to the construction firm which has prejudiced the rights of the government; 6. The affidavit complaint was subscribed before _________, who is an official authorized to administer oaths; 7. It must be stressed that the respondent committed a lie when he asserted in his affidavit that no department circular exists regarding the black listing of some construction companies here in Roxas City; 8. In fact, the DPWH has provided the District Office of the DPWH here in Capiz with a certified copy thereof to prove that an original of the document exists; 9. Respondent knows fully well of the existence of the DPWH Memorandum as his act of alluding the crime of falsification against me has no basis at all except that it is malicious