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Sample Affid of Complaint

This document is a template for an Affidavit of Complaint in the Philippines, outlining the necessary components for filing a complaint, including the complainant's information and version of the facts. It emphasizes the truthfulness of the statements made and the legal consequences of perjury. The affidavit must be signed and notarized to be valid.

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Pimpoy Felizarta
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14 views1 page

Sample Affid of Complaint

This document is a template for an Affidavit of Complaint in the Philippines, outlining the necessary components for filing a complaint, including the complainant's information and version of the facts. It emphasizes the truthfulness of the statements made and the legal consequences of perjury. The affidavit must be signed and notarized to be valid.

Uploaded by

Pimpoy Felizarta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Sample AFFIDAVIT OF COMPLAINT

REPUBLIC OF THE PHIIPPINES)


CITY OF SAN FERNANDO ) s.s.
x------------------------------------x

AFFIDAVIT OF COMPLAINT
I, _________________________________, of legal age, married/single, Filipino,
(Name of Complainant)
with mailing address at _________________________________________________,
____________________________________________________________________,
(Other information of the complainant)
After having duly sworn to in accordance with the law hereby dispose and state that:
(Complainant’s Version of the Complaint and Statement of facts of the case)
1. ___________________________________________________________________
___________________________________________________________________
_________________________________.
2. ___________________________________________________________________
___________________________________________________________________
__________________________________________________________________.

That, I execute this affidavit to attest to the truthfulness of the foregoing facts and for the
purpose of filing an Administrative complaint against (rank, name and
assignment)_____________________________________ for __________________.

That, further I hereby declare under oath that this complaint is not a form of harassment
or retaliation and the supporting evidence/documents herein are authentic and from verifiable
source and fully aware of the consequence of being held liable for perjury in case of false or
misrepresentation in this affidavit.

IN WITNESS WHEREOF, I have hereunto affixed my signature ___ day of ______ 20__
in _________________, Philippines. Affiant Sayeth Naught.

_________________________
(Affiant Name and Signature)

SUBSCRIBED AND SWORN to before me this _____ day of __________, 200_,


complainant exhibiting to me his/her Residence Certificate No. __________ issued at
__________ on ____________________ 200_

_______________________________________________
(Person authorized to administer an oath or A Notary Public)

CERTIFICATION

This is to certify that I personally examined the affiant and I am fully satisfied that
he/she voluntarily executed and understood his/her affidavit.

______________________
(Person authorized to administer an oath or a Notary Public)

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