Republic of the Philippines

Department of Justice
NATIONAL PROSECUTION OFFICE
PROVINCIAL PROSECUTION OFFICE
Hall of Justice, Carig Sur,
Tuguegarao City, Cagayan

DOMINADOR FUGGAN SR.

Complainant,
NPS No. _________________
-versus-
FOR: SLIGHT PHYSICAL INJURIES

ROMEL LAVADIA &

SP02 SAMUEL MELAD
Respondents.
x------------------------------------x

AFFIDAVIT-COMPLAINT
I, DOMINADOR FUGGAN SR., of legal age, Filipino Citizen and a
resident of #1 Bassig Street, Ugac Sur, Tuguegarao City, Cagayan, after
having duly sworn in accordance with law and do hereby depose and say:

1. That I am the complainant in the above-entitled case;

2. That I am charging ROMEL LAVADIA, a civilian and SP02

SAMUEL MELAD, a commissioned police officer with postal
address at Peñablanca, Cagayan for the crime of Slight Physical
Injuries penalized under Article 266 of the Revised Penal Code,
committed as follows:

a. I have attended a Christening in Centro, Peñablanca, Cagayan

where I am one of the Godfathers;

b. During the reception, I was 5 meters away from the respondents

when I saw ROMEL LAVADIA was looking at me raising his
middle finger;

c. Not contended, he went to our table and saying FUCK YOU

and continued raising his middle finger at me;

d. When ROMEL LAVADIA went back to their table, he vexed

me and uttered unsavory words “FUCK YOU BOY”, and to the

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 extent of throwing the plates with foods (pulutan) to me hitting
my body;

e. Due to those incidents, I got irritated and a heated argument

ensued between us;

f. When I confronted him, he assaulted me through fist blow

together with his companion SP02 SAMUEL MELAD;

g. We are pacified by the people in the place, but ROMEL

LAVADIA uttered in Ybanag Dialect “MANAW KA TAW
NGANA BOY BAKA MAPATAY MI SIKAW PAGA”;

h. That to avoid further arguments and physical harm, I left the

place;

3. That on December 18, 2017, I went to Peñablanca Police Station to

report the incident that has been transpired. Copy of the Police
Blotter is attached as ANNEX “A” hereof;

4. That on December 20, 2017, I went to Municipal Health Office-

Penablanca, Cagayan to have an examination of the injuries I
sustained and the doctor recommended for healing and rest period
of nine (9) days. Copy of the Medico-Legal Report is attached as
ANNEX “B” hereof;

5. That due to the sustained injuries, I was not able to work as

Tricycle Driver for two (2) weeks;

6. That I am executing this affidavit to attest to the truthfulness of the

foregoing and for the purpose of charging respondents ROMEL
LAVADIA AND SP02 SAMUEL MELAD for the crime of Slight
Physical Injuries under Article 266 of the Revised Penal Code.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

th
12 day of January 2018 at Tuguegarao City, Cagayan.

DOMINADOR S. FUGGAN SR.

Complainant

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SUBSCRIBED AND SWORN before me this 15 th day of January, 2018 at
Tuguegarao City, Cagayan.

CERTIFICATION

I hereby Certify that I personally examined the affiant and that I am

satisfied that he voluntary executed and understood his complaint-affidavit.

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