Republic of the Philippines

Department of Justice
NATIONAL PROSECUTION SERVICE
OFFICE OF THE CITY PROSECUTOR
City of Tagbilaran

_______________________
Represented by __________,
Complainant,

-versus- NPS DOCKET NO. ______________

__________________,
Respondents.
x-------------------------------------------------------------------------x

SUPPLEMENTAL COMPLAINT-AFFIDAVIT

Complainant, by himself, to this Honorable Office, most

respectfully aver THAT:

1. On _______________, I filed a complaint before this

Honorable Office docketed as NPS DOCKET NO.
________________, against _______________ for
Qualified Theft;

2. The respondent unlawfully took the amount of

(Php__________________) with abuse of trust and
confidence, taking advantage of his position as the cashier of
the branch;

3. Culled on the records are some of the cash vouchers, and

receipts of the amount the respondent intentionally and
unlawfully took from the company. (Herein attached marked
as Annex “A-A2”); and

4. I am executing this affidavit to attest to the truth of the

foregoing and to further support my complaint for Qualified
Theft against the respondent ________________.

IN WITNESS WHEREOF, I have hereunto set my hand this

________________ at Tagbilaran City, Bohol, Philippines.

____________________________
Affiant
 SUBSCRIBED AND SWORN to before me this
________________ at Tagbilaran City, Bohol, Philippines.