ANNEX 1

Event Number: Date/Time Type:

16-052-171 _____________ _________
Location: Beat: Division:
____________ Mary -1 Foothill
Details:
The reporting party was watching television when she observed the boy named Rocky fallen
while sleeping in his bed without any movement. She immediately checks his condition and
found out that he is covered with blood. With such alarm she shouted for help and went to the
hospital. The hospital confirmed the death of Rocky due to subdural hematoma because of the
accident.

QUEZON CITY POLICE

 Republic of the Philippines
11th Judicial Region
REGIONAL TRIAL COURT
Branch 3
Davao City

LAWRENCE S. DOMINGO,
Petitioner,

Vs. SPEC. PRO.NO._____________

FOR: DECLARATION OF
NULLITY OF MARRIAGE OF
ART. 36 FC and A.M. No.
12-11-10-SC

RACHEL M. DE JESUS,
Respondent,
x-----------------------------------x

ANNEX 1A

JUDICIAL AFFIDAVIT OF
Tracy Dayber

I, TRACY DAYBER, 29 years old, single, residing at Purok 8 Walang Hanggan,

Quezon City, after having been sworn to in accordance with the law do hereby depose
and state:

That Atty. BENJAMIN A. RECTO is the counsel who conducted and supervised
my examination as a witness at his office Room 45 Fuentes Building, Jasmin St. Davao
City;

That I am answering the questions herein fully conscious that I do so under oath
and that I may be criminally liable for false testimony or perjury;
 That following are the Questions propounded by Atty. Benjamin A. Recto and my
answer in Tagalog language:

Q1: Sir kilala mo ba si Rachel De Jesus?

A1: Opo, Sir

Q2: Bakit mo kilala?

A2: Nakilala ko na lang po siya dahil ang tricycle ko na po ang service niya sa tuwing
pupunta siya ng mall o palengke para mag-grocery.

Q3: Kailan mo siya huling hinatid at anong oras?

A3: Noong October 25, 2015, mga bandang alas diyes ng umaga po.

Q7: Paano mo siya nakita?Sa iyong pagkakaalala, ano ang naging reaksyon o kilos ni
Mrs. De Jesus nang mga oras na iyon?
A7: May ihinatid po ako na isang pasahero na madadaanan ang bahay nila.Umiiyak po
siya at nagsisisigaw ng tulong kaya agad agad din ko po siyang isinakay sa tricycle.

Q7: Bakit siya umiiyak?

A7: Nahulog daw po kasi ang anak niya at kitang kita ko po na duguan na ang bata.

Q4: Saan mo sila hinatid?

A4: Sa Quezon Doctors Hospital at pagkatapos po nun dumiretso po kami sa police
station para magpa-blotter.

Q5: Habang papunta kayo sa hospital, ano hitsura ng bata? May senyales pa ba ito ng
buhay?
A5: Duguan na po ang bata pero may pulso pa po siya ng makarating kami sa hospital.

Q6: Bakit kayo dumiretso sa police station?

A6: May pagdududa po kasi si Madam (Mrs de Jesus) na ang nangyari ay aksidente
lamang na maaaring napabayaan ng kanilang katulong na nagbabantay sa bata.

Q7: May idadag ka pa ba?

A7: Kung meron man po, doon na lang sa korte.

IN WITNESS WHEREOF, I have hereunto set my signature this 16 th day of

January 2016 at Davao City, Philippines.

TRACY DAYBER
Judicial Affiant
 JURAT

SUBSCRIBED AND SWORN to, before me this 16 th day of January 2016 at

Davao City, Philippines by the Affiant, who is personally known to me and known to me
personally to be the same person who executed the foregoing Judicial Affidavit.

BENJAMIN A. RECTO
Notary Public Until July 9, 2016
MCLE Certificate No. V-09678
IBP No. 672388, 1/6/2015, Davao City
PTR No. 97328, 1/8/2015
Roll No. 8888
Room 45 Fuentes Building, Jasmin St. Davao City

ATTESTATION

I, ATTY. Benjamin Recto, attest that I personally conducted/supervised the

examination of the witness, that I have faithfully recorded or caused to be recorded the
questions asked of this witness and the corresponding answers that the witness gave, that
I did not or any other person present during the taking of the statement coach the witness
regarding the answers given by him, that the witness understood the questions and
voluntarily gave the answers herein

BENJAMIN A. RECTO
Lead Council

SUBSCRIBED AND SWORN TO before me this 16th day of January, 2016 in

Davao City, Philippines

Doc No._______
Page No.______
Book No.______
Series of 2016
 Republic of the Philippines
11th Judicial Region
REGIONAL TRIAL COURT
Branch 3
Davao City

LAWRENCE S. DOMINGO,
Petitioner,

Vs. SPEC. PRO.NO._____________

FOR: DECLARATION OF
NULLITY OF MARRIAGE OF
ART. 36 FC and A.M. No.
12-11-10-SC

RACHEL M. DE JESUS,
Respondent,
x-----------------------------------x

ANNEX 2

JUDICIAL AFFIDAVIT OF
MR. PEDRO N. NAKAKITA

I, PEDRO N. NAKAKITA, 35 years old, single, residing at Purok 4 Libertad, Cagayan

De Oro City, after having been sworn to in accordance with the law do hereby depose
and state:

That Atty. BENJAMIN A. RECTO is the counsel who conducted and supervised
my examination as a witness at his office Room 45 Fuentes Building, Jasmin St. Davao
City;

That I am answering the questions herein fully conscious that I do so under oath
and that I may be criminally liable for false testimony or perjury;
 That following are the Questions propounded by Atty. Benjamin A. Recto and my
answer in Tagalog language:

Q1: Sir, kilala mo ba si Lawrence Domingo?

A1: Opo katrabaho ko po siya.

Q2: Bakit mo siya kilala?

A2: Katrabaho ko pa siya at kaibigan.

Q3: Lagi mo ba siya kasama sa trabaho?

A3: Opo kasi magkatabi kami sa office at pareho kami ng trabaho.

Q4: Ano ang madalas ninyong gawin pagkatapos ng trabaho?

A4: Madalas kaming mag inuman.

Q5: At pagkatapos mag inuman?

A5: Nagyaya po siya pumunta sa club na kilalang kilala siya.

Q6: Bakit mo naman nasabi na kilalang kilala siya dun?

A6: Kasi po may babae siya dun. Sa kanya lang po nagpapatable at madalas silang
lumalabas.

Q7: Saan sila pumupunta?

A7: Sa motel po.

Q8: Bakit mo alam?

A8: Kasi ako yung humatid sa kanila kung madalas po.

Q9: Saan Motel mo sila Hinahatid?

A9: Sa Lita’s Motel po.

Q10: May sasabihin ka pa ba?

A10: Kung meron pa po sa korte na lang po.

IN WITNESS WHEREOF, I have hereunto set my signature this 16 th day of

January 2016 at Davao City, Philippines.

Pedro N. Nakakita
Judicial Affiant
 JURAT

SUBSCRIBED AND SWORN to, before me this 16 th day of January 2016 at

Davao City, Philippines by the Affiant, who is personally known to me and known to me
personally to be the same person who executed the foregoing Judicial Affidavit.

BENJAMIN A. RECTO
Notary Public Until July 9, 2016
MCLE Certificate No. V-09678
IBP No. 672388, 1/6/2015, Davao City
PTR No. 97328, 1/8/2015
Roll No. 8888
Room 45 Fuentes Building, Jasmin St. Davao City

ATTESTATION

I, ATTY. Benjamin Recto, attest that I personally conducted/supervised the

examination of the witness, that I have faithfully recorded or caused to be recorded the
questions asked of this witness and the corresponding answers that the witness gave, that
I did not or any other person present during the taking of the statement coach the witness
regarding the answers given by him, that the witness understood the questions and
voluntarily gave the answers herein

BENJAMIN A. RECTO
Lead Council

SUBSCRIBED AND SWORN TO before me this 16th day of January, 2016 in

Davao City, Philippines

Doc No._______
Page No.______
Book No.______
Series of 2016
 Republic of the Philippines
11th Judicial Region
REGIONAL TRIAL COURT
Branch 3
Davao City

LAWRENCE S. DOMINGO,
Petitioner,

Vs. SPEC. PRO.NO._____________

FOR: DECLARATION OF
NULLITY OF MARRIAGE OF
ART. 36 FC and A.M. No.
12-11-10-SC

RACHEL M. DE JESUS,
Respondent,
x-----------------------------------x

ANNEX 3

JUDICIAL AFFIDAVIT OF
Dr. JUAN DE MATINAG

I, Dr. JUAN DE MATINAG, 35 years old, single, residing at Purok 7 Plotado,

Cagayan De Oro City, after having been sworn to in accordance with the law do hereby
depose and state:

That Atty. BENJAMIN A. RECTO is the counsel who conducted and supervised
my examination as a witness at his office Room 45 Fuentes Building, Jasmin St. Davao
City;

That I am answering the questions herein fully conscious that I do so under oath
and that I may be criminally liable for false testimony or perjury;
 That following are the Questions propounded by Atty. Benjamin A. Recto and my
answer in Tagalog language:

Q1: Sir kilala mo ba si Rachel De Jesus?

A1: Opo, Sir

Q2: Bakit mo kilala?

A2: Pumunta po siya sa akin para magpa konsulta at mag pa-verify sa kanyang tunay na
kalagayan.

Q3: Pwede mo bang sabihin kung paano siya sinuri at kung ano ang iyong nakita sa
kanyang pagka tao.
A3: Kinausap ko po na ayon sa mga tanong na ginawa naming sa pagsuri at pagintindi na
kanyang kalagayan. Nakita ko po na stress lang po siya at wala naman siya
deperensiya. Normal naman po siya.

Q4: Ano ang ibig sabihin na Normal?

A4: Na siya po ay nasa tamang pag iisip at walang sakit kung anu man.

Q5: Pano mo po mapapatunayan ang iyong mga sinasabi?

A5: Dito po sa documento (Annex 3A) na hawak ko po. Na siyang resulta ng aking pag-
susuri sa kanya.

Q6: Pano mo ipapaliwanag ito?

A6: Ipapaliwanag ko nalang ito pag natanong po ako sa korte.

Q7: May idadag ka pa ba?

A7: Kung meron man po, doon na lang sa korte.

IN WITNESS WHEREOF, I have hereunto set my signature this 16 th day of

January 2016 at Davao City, Philippines.

Dr. JUAN DE MATINAG

Judicial Affiant
 JURAT

SUBSCRIBED AND SWORN TO, before me this 16 th day of January 2016 at

Davao City, Philippines by the Affiant, who is personally known to me and known to me
personally to be the same person who executed the foregoing Judicial Affidavit.

BENJAMIN A. RECTO
Notary Public Until July 9, 2016
MCLE Certificate No. V-09678
IBP No. 672388, 1/6/2015, Davao City
PTR No. 97328, 1/8/2015
Roll No. 8888
Room 45 Fuentes Building, Jasmin St.
Davao City

ATTESTATION

I, ATTY. Benjamin Recto, attest that I personally conducted/supervised the

examination of the witness, that I have faithfully recorded or caused to be recorded the
questions asked of this witness and the corresponding answers that the witness gave, that
I did not or any other person present during the taking of the statement coach the witness
regarding the answers given by him, that the witness understood the questions and
voluntarily gave the answers herein

BENJAMIN A. RECTO
Lead Council

SUBSCRIBED AND SWORN TO before me this 16th day of January, 2016 in

Davao City, Philippines

Doc No._______
Page No.______
Book No.______
 Series of 2016
ANNEX 3A

Mandaluyong Medical Hospital

Department of Psychiatry
54th Street Bulalacao, corner Shaw Blvd, Mandaluyong City

PSYCHOLOGICAL REPORT

Personal information:

Name: Rachel M. de Jesus

Age: 34 years old
Address: Davao City
Civil Status: Married
Name of Spouse: Lawrence S. Domingo

Physical Observation
Mrs. De Jesus came in for her testing appointment wearing v- neck cyan printed shirt and
black jeans. She has a skinny body and a fair complexion.

In two sessions, it was observed that Mrs. De Jesus, she can fully understand all the
instructions given and was able to communicate her thoughts and ideas. She was able to share
her stories of her past, from happy childhood to sweet teenage life with her friends even having
her first boyfriend. But it was observed that her mood changes every time she talks about her
family. She is longing for her father’s closeness because the latter is away from her for a
considerable length of time. The two met once again during her marriage and no signs of her
father’s presence thereafter. She undoubtedly reminisce her marriage since it was the most
happiest moment for her and made a promise to herself and to her father that she will protect her
family and hold on until to her one last breath. But due to drastic changes in the behaviour of her
husband, she is dreadfully affected by it which causes big fights between them. She had imparted
that some causes of their fights is going home late of her drunk husband and short budget for
their daily allowance. She was painfully affected by the death of her only son, Rocky. She
frequently called her mom and asked to visit her to have motherly advice. It was further observed
that she is being saddened by the fact that she only misses her husband back when they were
boyfriend- girlfriend until to their first weeks as newlywed couple.

Test Results and Interpretation

A. Intellectual Functioning
Mrs. De Jesus was able to respond to any part of the verbal test and in most parts of the
performance test. She just began to cry when she discussed about her family. But she
immediately goes back into her consciousness after releasing her despondencies. She
maintained her sweet smile and calm voice as she began to communicate again. She
immediately recognized and narrated in detailed the pictures shown to her like her
childhood friends, high school batch mates, family picture, her wedding picture and baby
Rocky’s last photo taken.
B. Social Functioning
Socially, Mrs de Jesus’ maturity is much higher her age, equivalent to 40- year old
woman. She prefers to be with her family than going out with her friends or age- group.
She think first of her family than herself, especially her son. She is able to perform some
household chores even without the aid of their maids like cooking of foods, bathing,
preparing of milk every midnight for her son, hushing and humming her son to sleep and
even going out alone for groceries.

In terms of communication, Mrs De Jesus is able to say meaningful statements and is able
to understand instructions. She can communicate with eye contact and even with some
actions as she made some exciting stories.

In terms of locomotion, she is able to stay their house alone without any harm to herself
and with other people, more so she can go outside alone and goes back home safely.

Summary/ Diagnostic Impression:

Normal

Mrs. Rachel M. de Jesus, is a kind of person that is very optimistic and family-oriented
as manifested in the results. She may indicate paranoid tendencies and very sensitive to
criticisms of her environment. She is very close to her family especially to her mother.
She longs for her father’s closeness because the latter is away from her for a considerable
length of time. Mrs. De Jesus is also indicative of emotional and social maladjustments in
her results. However, she manifests strong intellectual strivings and a desire to know
everything at hand correlated with her result that she is very goal-oriented and has set
high standards for herself as loving mother and wife. She is driven by her dreams and
contented with what she has at the moment especially when it concerns with her family.
All in all, Mrs de Jesus may be well-adjusted person in all aspects of development but it
is just and but a normal acts and reactions of a normal person, but sometimes she may be
overpowered by her paranoid tendencies.
 MEDICAL CERTIFICATE

Signature of the Applicant ………………………………………………….

I, Dr. Juan De Matinag after careful personal examination of the case hereby
certify that Rachelle M. De Jesus, whose signature is given above, is not suffering from any
psychological incapacity, that she is capable of marriage and there is no symptoms indicating
abnormal behaviour.

Dr. JUAN DE MATINAG

MEDICAL OFFICER

Station: V
Date :
ANNEX 3B
Republic of the Philippines
11th Judicial Region
REGIONAL TRIAL COURT
Branch 3
Davao City

LAWRENCE S. DOMINGO,
Petitioner,

Vs. SPEC. PRO.NO._____________

FOR: DECLARATION OF
NULLITY OF MARRIAGE OF
ART. 36 FC and A.M. No.
12-11-10-SC

RACHELLE M. DE JESUS,
Respondent,
x-----------------------------------x

ANNEX 2
JUDICIAL AFFIDAVIT OF
RAQUEL P. DE JESUS

I, RAQUEL M. DE JESUS, 60 years old, married, residing at Purok 1 Barangay Ligaw,

Davao City, after having been sworn to in accordance with the law do hereby
depose and state:

That ATTY. BENJAMIN A. RECTO is the counsel who conducted and supervised
my examination as a witness at his office Room 45 Fuentes Building, Jasmin St. Davao
City

That I am answering the questions herein fully conscious that I do so under oath
and that I may be criminally liable for false testimony or perjury;

That following are the Questions propounded by ATTY. BENJAMIN A. RECTO and
my answer in Tagalog language:

Q1: Ma'am, kilala nyo po si Rachel M. De Jesus?

A1: Opo.
Q2: Ano ang ugnayan mo sa kanya?
A2: Ako ang ina niya.

Q: Gaano po kayo kalapit sa isa't-isa?

A: Napakalapit po.

Q: Paano mo naman nasabi?

A: Ako ang ina niya at nagpalaki sa kanya. Madalas kami mag-usap tungkol sa mga bagay-bagay
noon at hanggang ngayon. Ako ang nilalapitan ni Rachel kapag kailangan niya ng gabay at payo.
Kapag may problema siya, ipinapaalam niya saakin. At bilang isang magulang, palagi ako
naroon para sa kanya kapag kailangan niya ng tulong.

Q3: Bilang ina niya, masasabi niyo po ba na may problemang mental o sikolohikal ang anak niyo
sa pagiging malapit sainyo?
Q4: Wala naman po. Normal lang 'yon.

Q4: Sa inyong pagkakaalam, meron po ba kayong kasaysayang ng mental disease o

psychological issues sa pamilya niyo?
A4: Wala po.

Q: Ayon kay Lawrence S. Domingo, ang napangasawa ni Rachel, binigyan niyo siya ng babala
tungkol sa kakaibang pag-uugali ng iyong anak. Totoo ba ito?
A: Hindi 'yon totoo. Wala akong nabanggit na babala. At wala namang rason para bigyan siya ng
babala tungkol kay Rachel.

Q5: Mayroon ka pang nais idagdag?

A5: Wala na po.

IN WITNESS WHEREOF, I have hereunto set my signature this xth day of

January 2016 at Davao City, Philippines.

Raquel P. De Jesus
Judicial Affiant

JURAT

SUBSCRIBED AND WORN TO, before me this Nth day of January 2016 at
Davao City, Philippines by the Affiant, who is personally known to me and known to me
personally to be the same person who executed the foregoing Judicial Affidavit.
 BENJAMIN A. RECTO
Notary Public Until July 9, 2016
MCLE Certificate No. V-09678
IBP No. 672388, 1/6/2015, Davao City
PTR No. 97328, 1/8/2015
Roll No. xxx
Room 45 Fuentes Building, Jasmin St.
Davao City

ATTESTATION
I, ATTY. BENJAMIN A. RECTO, attest that I personally conducted/supervised the
examination of the witness, that I have faithfully recorded or caused to be recorded the
questions asked of this witness and the corresponding answers that the witness gave, that I did
not or any other person present during the taking of the statement coach the witness regarding the
answers given by him, that the witness understood the questions and voluntarily gave the
answers herein

BENJAMIN A. RECTO
Lead Council

SUBSCRIBED AND SWORN TO before me this Nth day of January, 2016 in

Davao City, Philippines

Doc No._______
Page No.______
Book No.______
Series of 2016