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Sample Format of Sworn Statement (Narrative)

The document is an affidavit from a witness describing a dispute they observed. It states that on a specific date, the witness saw an argument occur between two described individuals at a specified location. The witness provides details about what they saw, such as the time of day, their location at the time, and how the verbal dispute escalated into a physical altercation. The affidavit is intended to serve as evidence that the witness observed this dispute occur between the named individuals.

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guillenisiderio
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1K views

Sample Format of Sworn Statement (Narrative)

The document is an affidavit from a witness describing a dispute they observed. It states that on a specific date, the witness saw an argument occur between two described individuals at a specified location. The witness provides details about what they saw, such as the time of day, their location at the time, and how the verbal dispute escalated into a physical altercation. The affidavit is intended to serve as evidence that the witness observed this dispute occur between the named individuals.

Uploaded by

guillenisiderio
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Republika ng Pilipinas )

Lungsod ng Davao City, )S.S


x- - - - - - - - - - - - - - - - x

SINUMPAANG SALAYSAY

AKO, si _____________________________, Filipino, ___ taong gulang, walang


asawa, naninirahan sa _________________________________________
______________________________, matapos na makapanumpa nang naaayon sa
saligang batas ng Pilipinas ay nagsasaad ng mga sumusunod:

Na, noong _________________________, isang pagtatalo ang nangyari sa pagitan


nina ____________________________, __________, _______________, may height
na ____________ at ang kanang suot na damit ay
__________________________________________________________ at
___________________________, ________, ___________________, may height na
_______________ na matatagpuan sa ________________________
___________________
Na ako, ay naka saksi ng isang pagtatalo sa
________________________________ ___________________;

Na, noon ______________________, bandang ___________ ng hapon/umaga


ako ay patungong ______________________ sakay ng _____________ na matatagpuan
sa ________________________________ Na, habang ako ay nagpapahinga sa aking
inuupoan, ako ay pansamantalang napalingon sa aking gilid nga aking mapansin ang
dalawang tao na nag-uusap, na habang tumatagal ay nagkakaroon na ito ng tensyon at
ang magandang pag-uusap nila ay na uwi sa isang pagtatalo, hanggang sa nauwi ito sa
isang magulong away;
Ginawa ko ang Sinumpaang Salaysay na ito upang bilang patunay at na ako ay
nakasaksi sa isang pag-aaway sa pagitan nina ____________________, at
_____________________;

Na, aking pinatutunayan na ako ay hindi naghain ng reklamong katulad nito sa


mga taong nabanggit sa iba pang ahensya o sangay ng pamahalaan maliban dito.

BILANG PATUNAY, ako ay lumagda sa ibabaw ng aking pangalan ngayon ika-


______ ng _________, _____.

_________________
Lagda

SINUMPAAN AT PINATOTOHANAN sa harap ko ngayon ika __________


ng ___________, _____. Pinatutunayan ko na ang nagsalaysay ay aking nasiyasat at
ako ay may sapat na paniniwala na siya ay kusa at malayang nagsalaysay.

_____________________
Administering Officer

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