Republic of the Philippines

Province of Lanao del Norte

MUNICIPAL CIRCUIT TRIAL COURT
_________________________________
12TH Judicial Region
Lanao del Norte

__________________
Plaintiff, SMALL CLAIMS NO. ______
F O R: COLECTING OF SUM OF
MONEY
-versus-

_____________________
Defendant.
x- - - - - - - - - - - - - - - x

COUNTER-AFFIDAVIT

I, ____________________, of legal age, Filipino, and a resident of Alegria,

Lanao del Norte, Philippines, after having been sworn in accordance with the
law, hereby depose and state:

1. That I am the same _______________ who is the defendant in the above-

entitled case;

2. That I am vehemently denying the allegations of the plaintiff for being all
product of lies and fabrications, purposely designed to harass and
malign my reputations;

3. That on 5 January 2022, I received an amount of Twenty Thousand

Pesos (20,000.00 PHP) from plaintiff ______ as witnessed by ____________,
one of the members of “Paluwagan”, as a contribution to our
“Paluwagan” with Ten (10%) percent monthly interest;

4. However, according to the daughter-in-law of the plaintiff, ____________,

she gave Forty Thousand Pesos (40,000.00 PHP) for the “Paluwagan”;
5. Additionally, I received an amount of Twenty Thousand Pesos
(20,000.00 PHP) from the husband of the plaintiff and another Thirty
Five Thousand (35,000.00 PHP) from the daughter-in-law of the
plaintiff, a total of Fifty Five Thousand Pesos (55,000 PHP);

6. Moreover, on the Affidavit of the plaintiff on paragraph No. 2, we agreed

that on December 5 2022, we will divide the proceeds of our investment
in “Paluwagan”, including the return of our capital and the interest, not
on December 5, 2023;

7. That on the testimony of the plaintiff in her Affidavit, paragraph No. 3,

quote “That until this date, I have not received any payment or return of
my capital and interest despite repeated demands”, contrary, I gave four
(4) times, to wit:
PERSON WHO IS AMOUNT DATE
RESPONSIBLE
16,000.00 PHP December 15, 2022
4,500.00 PHP February 2023
3,000.00 PHP March 2023
500.00 PHP April 2023

Total 24,000 PHP

8. Thus, if plaintiff gave the full amount of Forty Thousand Pesos

(40,000.00), I have a balance of Thirty Thousand Six Hundred Pesos
(30,600.00) to pay;

9. Furthermore, on 12 June 2023, plaintiff received an amount of

12,000.00 from _____, one of the members in “Paluwagan”;

10. Contrary on her allegations about repeated demands; I never received

any demands from the plaintiff.

11. I am executing this affidavit in good faith to attest to the truth of all
foregoing statements and for whatever legal purpose it may serve.

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

September 2023 at _________, Lanao del Norte
 _____________________________
Defendant

SUBSCRIBED AND SWORN to before, this __ day of September 2023 at

_________, Lanao del Norte. Affiant exhibiting to me her
________________________ with No. ________________.

Doc No. ______

Page No. ______
Book No. ______
Series of 2023.