Republic of the Philippines

Department of Justice
NATIONAL PROSECUTION SERVICE
City of _________

___________________
Complainant,
Case no. __________________________
- versus

___________________,
Respondents.
x---------------------------------------------------------x

COMPLAINT AFFIDAVIT

I, __________________________________, of legal age, male, Filipino, and with residential

address at _______________________________, do hereby depose and state before this
Honorable Office that:

Parties

Facts of the Case

Applicable Law & Jurisprudence

Other Manifestations

PRAYER
WHEREFORE, in view of the foregoing, it is respectfully prayed that this Honorable
Office, after proper notice and hearing, impute probable cause to respondents herein in the
commission of _____________________.
All other reliefs as are just and equitable under the circumstances are likewise prayed for.
_______________, 2017

_____________________________
Complainant