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Sample Format of Sworn Statement Question and Answer

This document contains a sample format for a sworn statement given by Bueron Shela Mae at the Bais City Police station on March 12, 2024 regarding an investigation of Edzilfroy F. Laxina. The statement details Shela Mae witnessing an argument between Paculares Mailyn and April Rose Manlangit that ended with one suspect stabbing and shooting the victim, resulting in the victim's death. Shela Mae provided eyewitness testimony through a series of questions and answers about the incident and was willing to identify the suspects and sign the sworn statement.

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Dumahil Cristina Ambos
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1K views

Sample Format of Sworn Statement Question and Answer

This document contains a sample format for a sworn statement given by Bueron Shela Mae at the Bais City Police station on March 12, 2024 regarding an investigation of Edzilfroy F. Laxina. The statement details Shela Mae witnessing an argument between Paculares Mailyn and April Rose Manlangit that ended with one suspect stabbing and shooting the victim, resulting in the victim's death. Shela Mae provided eyewitness testimony through a series of questions and answers about the incident and was willing to identify the suspects and sign the sworn statement.

Uploaded by

Dumahil Cristina Ambos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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DUMAHIL CRISTINA A. SECTION B.

MWF 6:00-7:00PM CDI 302 BS CRIM 3

Sample Format of Sworn Statement (Question and Answer)

FREE AND VOLUNTARY STATEMENT OF Bueron Shela Mae, a


resident of Brgy. Mansangaban Bais City.GIVEN IN THE
INVESTIGATION OF (Edzilfroy F. Laxina)HERE AT THE OFFICE OF
(Bais City Police station), TODAY (March 12,2024), AT EXACTLY
(8:00AM IN THE MORNING/AFTERNOON/EVENING, IN THE
PRESENCE OF (Rudy Cobol and Emma Jabel)THROUGH
QUESTIONS AND ANSWERS.”
(The person giving the testimony was reminded of all his/her rights in
accordance with what is provided in our New Constitution).
QUESTIONS AND ANSWERS
01. QUESTION- Mister/Miss Bueron Shela Mae will you tell the complete truth and
nothing but the truth in this investigation?"
ANSWER- Yes Sir

02. QUESTION - Are you willing to give your statement freely and voluntarily?"
ANSWER - Yes Sir

03. QUESTION - Can you state for the record your real name and other characteristics
that identify your true person in this investigation?"
ANSWER - Yes Sir. I’m Bueron Shela Mae 30 years old single working as call
center agent , Born in Dumaguete City and Currently Live jn Bais City
Negros Oriental.

04. Q- What is the reason for your presence in our office and for giving your
statement freely and voluntarily?”
A- I am here to state and report about what the suspects do in the victim. I
was setting in the chair Infront of the groceries store owned by Pilmar
Jews, on March 8, 2024 at 5:00 o clock in the evening.

05. Q- When and where did the incident in question occur?”


A - March 8, 2024 at 5 PM in the evening

06. Q - Who is involved in the said incident?”_______________?


A- Paculares Mailyn and April Rose Manlangit

07. Q - How did the incident happened?_________________?


A- I see them arguing and one of the suspects get a knife and stab the victim.

08. Q - Do you know this victims?


A- Yes sir

09. Q- Based on your understanding, can you narrate or describe what really
happened in the said incident?”
A- Here’s what happened I watch them arguing after they argue one of the
suspects get a caliber and shoot the victim in many times resulting to the
death of the victim.
10. Q - To your knowledge, how many of the individuals had firearms and what
were their calibers?
A - Base of what I see only one of them.

"Page 2. Continuation of the voluntary and spontaneous statement of_Rudy Cobol on this ___
day of March 15 2024.

11. Q - Besides you, do you know of any other individuals who witnessed the said
________________?"
A - The owner of the groceries store

12. Q- What did you do after witnessing the said incident?


A- I called for help to bring the victim into the hospital

13. Q - If you were to see them again and come face to face, would you be able
to recognize them?
A - Yes sir

14. Q - For now, I have no further questions for you. Do you have anything else
you would like to add or modify in your statements
A - No sir

15. Q - Were you threatened, promised anything, or given any rewards for
providing this statement?

A - No sir

16. Q - 16. Q – Are you willing to sign this statement, which consists of (Number of
Pages) pages
A- Yes sir

END OF STATEMENT: MARCH 13 2024


Bueron,Shela Mae
Affiant

SUBSCRIBED AND SWORN TO before me this (March 13, 2024) at (Bais City
Police Station)

PCT.Dumahil,Cristina A.
Administering Officer

CERTIFICATION

I HEREBY CERTIFY THAT I have personally examined the herein affiant under oath
and that I am fully satisfied that he/she voluntarily executed and understood his/her
statement.

PCT.Dumahil Cristina A.
Administering Officer

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