(Affidavit of Denial of Criminal Cases)

Republic of the Philippines)

Province of _________________)S.S.
City/Municipality of ____________) 
x---------x

AFFIDAVIT OF DENIAL
I,_____________, Filipino, of legal age,(single / married / widow), and as
resident of____________, Philippines, having been duly sworn in accordance
with law, hereby depose and state:

That I am NOT the same person as

one____________a.k.a.__________who was charged under I.S.
No._____________/ Criminal Case No._____________before
the___________for the crime of___________;
That I have never been the subject of any criminal complaint, charge or
proceeding before any prosecutor or court;
 

As such, I am executing this Affidavit to certify or attest to the truth of the

foregoing facts and for purpose of denying that I am the _____________
who is the subject of the aforementioned case and for whatever legal
purpose that this Affidavit may serve.

IN WITNESS WHEREOF, we have set our hands this__________, in the City

of____________, Philippines.

(JURAT)