Republic of the Philippines

Regional Trial Court

Tenth Judicial Region
Branch__
Iligan City

ABC,
Complainant, CRIMINAL CASE No.____

-versus-
For: Serious Physical Injuries
DEF, GHI, and JKL,
Defendants,

x-------------------------x

COMPLAINT

I, ABC of legal age, single, Filipino citizen and a resident of Tibanga, Iligan
City, under oath do hereby depose and say:

1. I am the complainant of the serious physical injury case filed before

this Honorable Court;

2. That herein defendants DEF, GHI, and JKL, all of legal age, single,
Filipino citizens and are residents of Tibanga, Iligan City where
summons and court notices may be served;

3. That sometime June 12, 2014, around ten (10) o’clock in the evening,
herein defendants were in a videoke bar just two (2) blocks away
from my house;

4. That herein defendants were drinking and singing in that said

videoke bar;

5. That as I passed by the said videoke bar as mu usual route in

returning home, one of the defendants. DEF, approached me and
invited me to join them;

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 6. That as soon as he talked to me, I noticed that his breath odor was
pungent and his speech was slurred, prompting me to refuse said
offer due to the fact that he was drank;

7. That upon my refusal, herein defendant , DEF, punched me in the

face, in the stomach and he even called the rest of the defendants,
GHI and JKL, to inflict further injury upon me;

8. That upon approach of defendants, GHI and JKL, they grab a wood,
approximately 2x2 of its size, and began to hit me until I was down in
the floor and unable to move;

9. That I was not able to do anything to protect myself because I was

outnumbered;

10.That I was rushed to the hospital at around eleven (11) o’clock in the
evening and was treated by the attending physician for 30 days due
to the gravity of the injury inflicted upon me as evidenced by the
medical documents; (Herein attached as ANNEX A1-a15)

11.That as a result of the aforesaid circumstances I was forced to

employ the services of the counsel to vindicate my rights.

AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have set my hand this 8th day of August, 2014 at
Iligan City, Philippines.

ABC
Affiant

SUBSCRIBED and SWORN before me this 8th day of August, 2014 in the city
of Iligan with affiant appearing before me and exhibiting to me his
Philippine passport bearing no. xxxxxxxxxx0 issued last March 02, 2010 to
be expired on March 02, 2015 by the Department of Foreign Affairs
Regional Consular Office- Region 10, Cagayan de Oro City.

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 Atty. Juan dela Cruz
Notary Public
Doc No. Pala-o, Iligan City
Page No. Roll No. xx1
Book No. IBP No. xxx5
Series of 2014. PTR No. xx3
MCLE NO. xx7

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