Republic of the Philippines}

City of Davao}s.s.
x- - - - - - - - - - - - - - - -x

AFFIDAVIT

I, ____________________, of legal age, Filipino and a resident of Surigao City, Surigao

del Norte, after having been sworn to in accordance with law, do hereby depose and state:

1. That I am the same person whose personal circumstance is herein above-

described;

2. That a certain _________________is our neighbor and because of the proximity

of his office and our house friendship and trust was built;

3. That Mr._________________ is known to me as the Branch manager of

_________________________;

4. That sometime on _______________________, 2013, __________________,

Branch Manger of ______________________________________approach me and offered to
me 4 checks to be encashed (Attached as “Annexes A – 1 to A - 4”) ;

5. That according to _____________________ the said checks are given to him by

the security guards as a form of payment by the security guards because of their existing debts ;
6. That through deceitful acts ______________________persuaded me and by the
trust I have in him I acceded to his offer;

7. That I have accepted the checks and encashed it in good faith;

8. That I have no knowledge of the fact that the owners of the 4 checks have no debt
or whatsoever to ___________________and that _______________has the obligation to remit
the checks to the owners;

9. That I have no means to check the veracity of the claim of

__________________that the checks was given to him as a form of payment by the owners of
the checks;
10. That I am executing this affidavit to attest to the truth of the foregoing facts and to
inform the appropriate agencies concerned about the said facts and for whatever legal purposes
this document may serve best.

1
 IN WITNESS WHEREOF, I have hereunto set my hand this __________________ at
Davao City, Philippines.

______________________
Affiant
CEI:

SUBSCRIBED AND SWORN to before me this __________________ at

_____________, Philippines. I hereby further certify that I have personally examined the above-
named affiant and I am satisfied that he have read and understood the contents of his affidavit
and that he voluntarily executed the same.