Republic of the Philippines

_____________________ } s.s.
_____________________

AFFIDAVIT OF WITNESS
I, RAMER A. ACOSTA, of legal age, Filipino, with residence and postal address at
Brgy. Mancial, Paranas, Samar, after having been sworn in accordance with law hereby
depose and state the following:

[1] That, I purchase thru installment basis one motorcycle model

SC125 at RUSI Catbalogan Branch thru its Officer-in-Charge
CHRISTOPHER LAMORTE;

[2] That, on August 11, 2018, my father-ROGELIO ACOSTA and

I went to RUSI Catbalogan Branch to purchase a motorcycle.
That I paid an amount of Four Thousand Five Hundred Pesos
(Php4,500) representing down payment for the unit.
However, I was shocked when the amount reflected on the
receipt was only One Thousand Pesos (Php1,000) nstead of
Php4,500;

[3] That, Further on that same day I also made an advance payment
of One Thousand Four Hundred Ten Pesos (Php1,410) to
which Mr. Lamorte failed to issue a receipt;

[4] That, I was likewise not issued receipt when I made payment of
Two Thousand Ninety (Php2,090) on _________________;

[5] That, when I demanded for the issuance of receipts for the
payments I made, Mr. Lamorte intimated that I should not be
worry, it’s already reflected on the RUSI’s Computer
records. However to my dismay, the records would show that
the payments I made were not duly recorded;

[6] I am executing this Affidavit of Witness to attest under oath

the truth of the foregoing statements and to substantiate the
filing of a criminal case against CHRISTOPHER
LAMORTE a resident of Brgy. Luyo, Basey, Samar.

IN WITNESS WHEREOF, I hereunto affix my signature this ___________ at

__________________, Philippines.

RAMER A. ACOSTA
Affiant
ID No. _______________
Valid until ________________
 SUBSCRIBED and SWORN to before me this ---------------- at ___________________,
Philippines, affiant presented to me her identification card indicated below her name as proof of
her identity.