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Affidavit for Preliminary Attachment

(Caption and title of case)
PROVINCE OF _________________
MUNICIPALITY OF_____________


I, __________________________________ , of legal age, single / married, and resident
of ____________________________________________ after being sworn in
accordance with law, depose and say:
1. That I am the plaintiff in the above – entitled case;
2. That on ______________________, 20__, defendant executed and signed the
following promissory note (see attached document), to wit:
“ I, _________________________________, hereby obligate myself to
pay ________________________________________________ the sum
of ___________________________________________ (P _____) on or
before ____________________, 20_____ .”
3. That a sufficient cause of action exists against the defendant named therein;
4. That the aforementioned obligation of defendant is now overdue and the said
defendant failed and refused to pay in part or in whole his obligation.
5. That this action is one of those specifically mention in Sec. 1 of Rule 57 of the
Rules of Court, whereby a writ for preliminary attachment may lawfully issue; namely:
___________state the nature of the suit__________________________________
___________please see below_________________________________________
Rule 57, Section 1. Grounds upon which attachment may issue.
At the commencement of the action or at any time before entry of
judgment, a plaintiff or any proper party may have the property of the
adverse party attached as security for the satisfaction of any judgment
that may be recovered in the following cases:
(a) In an action for the recovery of a specified amount of money or
damages, other than moral and exemplary, on a cause of action arising
from law, contract, quasi-contract, delict or quasi-delict against a party
who is about to depart from the Philippines which intent to defraud his
(b) In an action for money or property embezzled or fraudulently
misapplied or converted to his own use by a public officer, or an officer of
a corporation, or an attorney, factor, broker agent, or clerk, in the course
of his employment as such, or by other person in a fiduciary capacity, or
for a willful violation of duty;

or in the performance thereof.(c) In an action to recover the possession of property unjustly or fraudulently taken. known to me as the same person who personally signed the foregoing instrument before me and avowed under penalty of law to the whole truth of the contents of said instrument. or (f) In an action against a party who does not reside and is not found in the Philippines. VII Series of 2007 ATTY _________________________________ COMMISSION NO. or is about to do so. 00001 IBP Lifetime Roll No. bearing his photograph and signature. or on whom summons may be served by publication. No. 123 Page No. as security for the satisfaction of any judgement that may be recovered. 6. Affiant personally came and appeared with _____________(Competent Evidence of Identity)______ issued by the _________(Government Agency)______ on ___(date)__ at ________(place)_________. July 7. A Writ of Attachment be immediately issued against property of defendant. ________ MCLE COMPLIANCE No. 1234567 . 2. 7. That there is no sufficient security for the claim sought to be enforced by this action. (d) In an action against a party who has been guilty of a fraud in contracting the debt or incurring the obligation upon which the action is brought. The defendant be ordered to pay the plaintiff the amount of ___________________________. has been concealed. __________. or any part thereof. or disposed of to prevent its being found or taken by the applicant or an authorized person. 01/07/07 . _____________________ NOTARY PUBLIC for _____________________ UNTIL DECEMBER 31. __________(place)________________ this ____day of _____________ . __________________ (Plaintiff) (JURAT) SUBSCRIBED AND SWORN TO BEFORE ME. detained or converted. removed. (e) In an action against a party who has removed or disposed of his property. a notary public in and for _________(City/Province)____________ this ____th day of ____________ 20___. plaintiff prays that: 1. WHEREFORE. 01/07/07 . 2007 . ________ PTR NO 1234567 . 20 ___. (P ________) with ___ % interest per annum from the date this complaint is filed. Doc. 69 Book No. when the property. That said defendant is about to leave the country with the intent to defraud his creditors. 200_ OFFICE: _____________________ ROLL NO. with intent to defraud his creditors.