REPUBLIC OF THE PHILIPPINES

PROVINCE OF ______ ) s.s

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AFFIDAVIT OF DENIAL

I, TOTOY BRUSKO alyas “BOY TIKAS”, Filipino, of legal age,

married, and a resident of 143 Lirio St., Brgy. Naglaban, _____________, Rizal,
after having been duly sworn to in accordance with law, depose and state, that:

1. I am an applicant for a record clearance at the National Bureau of Investigation

in Manila, Philippines;

2. I learned that according to NBI records, a person bearing the alias “Boy ”, but
bearing my last name, has a case before the Municipal Circuit Trial Court of
________________ for Serious Physical Injuries docketed as Criminal Case No.
55555 on August 15, 1998. Said case was forwarded by the Municipal Circuit Trial
Court to Office of the Provincial Prosecutor of Rizal by virtue of an order dated
September 21, 1998. Copy of the aforementioned order is hereby attached as
Annex A;

3. The accused in the aforementioned case bears the same nickname and last name
with me; however, we are of different identity. I later learned that the said person,
alias Boy, died last November 09, 2007 and a copy of his Death Certificate is
hereby attached as Annex B.

4. I have not been charged of any criminal offense, and I therefore hereby declare
that I am not the same person named “Boy Brusko” in the said criminal case;

4. I am executing this affidavit to apprise all those concerned of the foregoing facts
and for whatever other legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of

February, 2014, here in ________________, Philippines.

TOTOY BRUSKO
Affiant

SUBSCRIBED AND SWORN to before me this __ day of February,

2014 here in Tanay, Rizal, Philippines. The identity of the affiant is established by
his Social Security ID with number 00000011100 and Voter’s ID issued by
COMELEC ID No. 5678-1234444400.

NOTARY PUBLIC