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REPUBLIC OF THE PHILIPPINES) CITY OF MANILA ) SS. AFFIDAVIT OF MERIT I, .., of legal age, single/married to ..

, resident of Quezon City, after being duly sworn, depose and say; 1. That I am the defendant in the case entitled vs.., docketed as case No. of the Court of First Instance of ., an action collect a sum of money; 2. That on., the date set for hearing, while on our way to the Court of First Instance of Manila to attend the hearing of said case, a truck bumped the taxicab in which my counsel and I were riding , causing serious physical injuries to my lawyer and myself, which necessitated our hospitalization for two (2) months; 3. That upon our failure to appear, the Honorable Court of First Instance proceeded with the trial and thereafter rendered judgment against me before the amount of P 5000 with interest from January 1, 1961, plus costs. 4. That if I be given a chance to present evidence, I can show that the amount being collected from me by the plaintiff has been fully paid as shown by the receipt, a copy of which is attached as Anne 1 of thise affidavit.

Affiant SUBSCRIBED and sworn to before me this day of ., 200, in ., Philippines. Affiant exhibited to me his /her residence Certificate No. A- issued at ., Philippines, on., 200.. (Seal and Documentary Stamp) NOTARY PUBLIC My commission expires Dec. 31, 200. (Or any other official authorized to administer oaths)

Doc. No..............; Page No..; Book No.; Series of 200.

Z: \modern phil. legals-2\affi.\affi. of merit