Sample of Affidavit of Complaint Republic of the Philippines ) ____________, ________ ) s.s.

x- - - - - - - - - - - - - - - - - - - - - -x AFFIDAVIT OF COMPLAINT The UNDERSIGNED, __________________________, accuses _________, of _____________, committed as follows, to wit: That on or about _________, at about _____________ in the _________________, ______________, Philippines, the said accused did then and there willfully, unlawfully, feloniously, and by means of _____________, committed _____________, upon the undersigned directly by overt acts to wit: (state the details how the crime was committed). The undersigned executed this affidavit to attest the truthfulness of the foregoing facts and to support the filing of Criminal Cases against _______________________________ for violations of ________________________. ___________, this _____ day of __________, ____. ____________________________ Offended Party SUBSCRIBED AND SWORN to before me this ___ day of _______ at _______________. I HEREBY CERTIFY that I have personally examined the herein offended party and I am satisfied that they voluntarily executed and understood their given affidavit. _________________________ Judge WITNESSES: __________________________ __________________________ Sample of Affidavit of Witness Republic of the Philippines ) ____________, ________ ) s.s. x- - - - - - - - - - - - - - - - - - - - - -x AFFIDAVIT OF WITNESS I, ________________________, age, civil status, resident of __________________________, _________, after having sworn in accordance with law, do hereby depose and state THAT: 1. I was present and personally saw that accused, __________, committed the crime of ___________________________ against the victim _______________; 2. 3. 04. (State other circumstances and the relation either to the victim or accused or both); (State the details of the acts committed by the accused against the victim. (State the acts done by the witness and the reason thereof);

I executed this affidavit to attest the truthfulness of the foregoing facts and to support the filing of Criminal Cases against _______________________________ for violations of ________________________. AFFIANTS SAYETH NAUGHT. IN WITNESS WHEREOF, I hereunto affixed my signature this ___day of ____________ at ____________, _______________. _______________________________ Affiant SUBSCRIBED AND SWORN to before me this ___ day of _______ at _______________. I HEREBY CERTIFY that I have personally examined the herein affiants and I am satisfied that they voluntarily executed and understood their given affidavit. _____________________ Notary Public

The place where the affidavit is executed

REPUBLIC OF THE PHILIPPINES ) CITY OF CAGAYAN DE ORO ) S.S COUNTER-AFFIDAVIT

Caption

I, Apipa G. Guro, of legal age, Filipino citizen and a resident of Vamenta, Carmen, Cagayan de Oro City, after having been sworn to in accordance with law hereby depose and state that:

PERSONAL

1. I am the accused in IS no. 08282 for the crime of Estafa thru Falsification of public documents under Article 315 paragraph 2, in relation to Article 172 and Article 48 of the Revised Penal code; 2. I deny the allegation that I misrepresented myself to be Dona Aniqa Macarambon-Bacsarpa [hereinafter Dona Aniqa], the truth being that I have been appointed as the attorney-in-fact of Spouses Bacsarpas. As evidenced by their duly notarized Special Power of Attorney copy thereof is attached here as Annex A.
1

In my capacity as such, I signed and delivered documents pertinent to the transactions in their behalf. 3. Truth to tell, while I categorically received the proceeds of the said loan from the bank, they were eventually turned over to the Spouses on the same day as evidenced by their acknowledgment receipt, a copy thereof is attached here as Annex B 2 4. The antecedental facts that led to this case can be narrated in this manner : On October 1, 2007, Dona Aniqa went to my house and told me that she and her husband are planning to put up a business. Spouses Bacsarpa also wanted to go to the US for a two (2) months vacation. Since Spouses Bacsarpa were in need of money for their business and also for their trip abroad, they requested me to apply for a loan in their behalf; 4. I agreed to become Spouses Bacsarpas attorney-in-fact. As a result, the Spouses delivered to me the owners duplicate copy of TCT No. T-178439 for purposes of constituting a mortgage thereon by executing a Deed of Real Estate Mortgage, which title I delivered to the bank; 5. To this date , Spouses Bacsarpas have not cancelled, revoked or superseded the said Special Power of Attorney, hence, I remain to be their duly appointed attorney-in-fact. 6. All told, I acted within the scope of my authority in obtaining a loan amounting to Php5,000,000.00 and the mortgage of Spouses Bacsarpas real property. As the attorney-in-fact of the Spouses Bacsarpas, I was expressly authorized to sign all documents pertinent to said loan. Hence, while I may have signed the questioned documents in their behalf, I did not commit the crime of forgery. 7. Therefore, the said loan and the documents I executed in behalf of the Spouses were valid, regular and legal. Stated differently, no forgery, falsification, amounting to estafa ever transpired ; 8. I am executing this Counter-Affidavit to attest to the truth that I DID NOT COMMIT THE CRIME OF ESTAFA in whatever form as erroneously and maliciously alleged by the Complainant. IN WITNESS WHEREOF, I have hereunto set my hand this 15th day of December, 2009 at Cagayan de Oro City, Philippines.

BOD

ATTESTATION
APIPA G. GURO Affiant

NAME AND SIGNATURE OF AFFIANT JURAT

SUBSCRIBED AND SWORN TO before me this 15th day of December, 2009 in Cagayan de Oro City, Philippines. I hereby certify that I have personally examined the affiant and that I am fully convinced that she had voluntarily executed her counter-affidavit and that he has read and understood the contents thereof.

AZRIFA MAMUTUK Assistant City Prosecutor Cagayan de Oro City

Copy furnished by Registered mail: Vincy Jane Polinar

Exhibit 1 Exhibit 1