Republic of the Philippines

REGIONAL TRIAL COURT

PEOPLE OF THE PHILIPPINES

Plaintiff, CRIMINAL CASE NO.
FOR:
-versus-

____________________________________
Accused.

COMPLAINT AFFIDAVIT

I, (Name of the complainant), of legal age, married, and living at

_______________________+, accused in this case, state under oath as follows:

PRELIMINARY STATEMENT

The person examining me is (Name of the Examining Lawyer) with address at

__________________. The examination is being held at the same address. I am
answering his questions fully conscious that I do so under oath and may face
criminal liability for false testimony and perjury.

PURPOSE: This affidavit/testimony of complainant is being offered to prove that

the accused _________________________________________________.

1. Question: Please state your name and other personal circumstances.

Answer: I am ________________________, of legal age, single/married, and
living at Sta. Catalina, Negros Oriental.

2. Question: Are you the same person referred to in this case recorded Criminal
Case No. ____________?
 Answer:

3. Question: What is your occupation?

Answer: I am a (the complainant must be a
civilian)____________________________________________________________
_________________________________________________________

4. Question: Where were you on ______________________?

Answer: I was in (The location of where the offense was committed must be
outside any military reservation or is not a military
objective)__________________________________________________________
________________________________(details on the crime committed).

5. Question: Can you tell me what happened during the ______________

incident?
Answer: Yes, sir..
_______________________________________________________________
__________________________________________

6. Question: Did your assailants identify themselves?

Answer; Yes sir. They shouted at us _______________________

7. Question: Did you resist the CTG?

Answer: No sir. They were armed and
___________________________________________

8. Question: What happened at on or about 11:30 pm of the same date?

Answer: At around
__________________________________________________________________
________________________

9. Question: So what happened after?

Answer:
__________________________________________________________________
__________________________________________________

(Question: I am showing to you a copy of an OR with serial

no._____________________, with a make _________, model ______________, is
this the same vehicle burnt by the CTG?)
(Question: I am showing to you a copy of a CR with serial
no._____________________, with a make _________, model ______________, is
this the same vehicle burnt by the CTG?)

10. Question: Did this case affect also your family/business?

Answer: Yes, sir.

11. Question In what way this case affect your family?

Answer: This case cause them serious anxiety, and fear, that I might be
dismissed from my work and will result to financial problems.

12. Question: How about to your work?

Answer: This case cause the suspension of my promotion.

13. Question: What are you praying to this Honorable Court?

Answer: I am praying that this Honorable Court will grant me moral damages in
the amount of Php 500,000.00.

14. Question: Who much did you spend for attorney's fees?
Answer: Php 30, 000.00, sir.

15. Question: And for your appearance fees?

Answer: Php 15, 000.00, sir.

16. Question: Do you have anything more to say?

Answer: No sir.

__________________________
Affiant

SUBSCRIBED AND SWORN to before me this _________ day of ______ at

______________, Philippines, Affiant personally known to me.

ATTESTATION
 I, __________________, with office address at
___________________________________, attest under oath as follows:

I personally conducted the interrogation of

__________________________________, of Sta. Catalina, Negros Oriental, for
CRIMINAL CASE NO. entitled PEOPLE OF THE PHILIPPINES
v._____________________, before the __________________________,
Philippines;

I faithfully recorded the questions I asked _______________________ and

the corresponding answers he gave me;

Neither I nor any other person present coached __________________

regarding his answers.

_________________________
Affiant

SUBSCRIBED AND SWORN to before me this _________ day of

_________________ at _____________________, Philippines, Affiant exhibited
to me his _______________________________________________.
 Republic of the Philippines
REGIONAL TRIAL COURT

PEOPLE OF THE PHILIPPINES

Plaintiff, CRIMINAL CASE NO.
FOR:
-versus-

____________________________________
Accused.

JUDICIAL AFFIDAVIT

I, (Name of the witness), of legal age, married, and living at _______________________+, accused in
this case, state under oath as follows:

PRELIMINARY STATEMENT

The person examining me is (Name of the Examining Lawyer) with address at __________________. The
examination is being held at the same address. I am answering his questions fully conscious that I do so
under oath and may face criminal liability for false testimony and perjury.

PURPOSE: This affidavit/testimony of witness is being offered to prove that the accused
_________________________________________________.

1. Question: Please state your name and other personal circumstances.

Answer: I am ________________________, of legal age, single/married, and living at Sta. Catalina,
Negros Oriental.

2. Question: Are you the same person referred to in this case recorded Criminal Case No.
____________?
Answer:

3. Question: What is your occupation?

Answer: I am a (the complainant must be a
civilian)_______________________________________________________________________________
______________________________________
4. Question: Where were you on ______________________?
Answer: I was in (The location of where the offense was committed must be outside any military
reservation or is not a military
objective)_____________________________________________________________________________
_____________(details on the crime committed).

5. Question: Can you tell me what happened during the ______________ incident?
Answer: Yes, sir..
_____________________________________________________________________________________
____________________

6. Question: Did your assailants identify themselves?

Answer; Yes sir. They shouted at us _______________________

7. Question: Did you resist the CTG?

Answer: No sir. They were armed and ___________________________________________

8. Question: What happened at on or about 11:30 pm of the same date?

Answer: At around
_____________________________________________________________________________________
_____

9. Question: So what happened after?

Answer:
_____________________________________________________________________________________
_______________________________

(Question: I am showing to you a copy of an OR with serial no._____________________, with a make

_________, model ______________, is this the same vehicle burnt by the CTG?)
(Question: I am showing to you a copy of an CR with serial no._____________________, with a make
_________, model ______________, is this the same vehicle burnt by the CTG?)

10. Question: Did this case affect also your family/business?

Answer: Yes, sir.

11. Question In what way this case affect your family?

Answer: This case cause them serious anxiety, and fear, that I might be dismissed from my work and will
result to financial problems.
12. Question: How about to your work?
Answer: This case cause the suspension of my promotion.

13. Question: What are you praying to this Honorable Court?

Answer: I am praying that this Honorable Court will grant me moral damages in the amount of Php
500,000.00.

14. Question: Who much did you spend for attorney's fees?
Answer: Php 30, 000.00, sir.

15. Question: And for your appearance fees?

Answer: Php 15, 000.00, sir.

16. Question: Do you have anything more to say?

Answer: No sir.

__________________________
Affiant

SUBSCRIBED AND SWORN to before me this _________ day of ______ at ______________,

Philippines, Affiant personally known to me.

ATTESTATION

I, __________________, with office address at ___________________________________,

attest under oath as follows:

I personally conducted the interrogation of __________________________________, of Sta.

Catalina, Negros Oriental, for CRIMINAL CASE NO. entitled PEOPLE OF THE PHILIPPINES
v._____________________, before the __________________________, Philippines;

I faithfully recorded the questions I asked _______________________ and the corresponding

answers he gave me;

Neither I nor any other person present coached __________________ regarding his answers.
_________________________
Affiant

SUBSCRIBED AND SWORN to before me this _________ day of _________________ at

_____________________, Philippines, Affiant exhibited to me his
_______________________________________________.