AFFIDAVIT OF DISINTERESTED PERSON

I, ________________________________ , of legal age, Filipino, and a resident

of _______________________________________________________________, after
having been duly sworn to in accordance with law, hereby depose and state:

1. That, I have personally known____(complainant) ______ for a period of _______

years as my ___(relation)________;

2. That I have personally witnessed that he/she received unwanted sexual/

misogynistic/ transphobic/ homophobic/ sexist remarks and comments from
__________________________________ on ________________ in
______________________;

3. That this fact is known to me because

___________________________________
________________________________________________________________
________________________________________________________________;

4. That I am voluntarily executing this affidavit to attest to the truth and veracity of
the foregoing set of facts without any promise or reward or any other monetary
consideration, threat, or intimidation but solely for the purpose of declaring my
personal knowledge on the matter.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_______________ day of _________________, ___________ at
_______________.

___________________________
Affiant

Government issued ID No. ______

Issued on ___________________
Issued at ___________________

SUBSCRIBED AND SWORN to before me this _______ day of _________,

________ at the City of ______________, Philippines, the affiants exhibiting to me
his/her government issued ID written below his/her name

Doc. No. ________

Page No. ________
Book No. ________
Series of ________ NOTARY PUBLIC