Republic of the Philippines

Department of Justice
OFFICE OF THE CITY PROSECUTOR
Angeles City, Pampanga
Anna Camille M. Tadeo
Complainant
-versus____________________________
Respondent

COMPLAINT-AFFIDAVIT
The COMPLAINANT, Anna Camille M. Tadeo, accuses
___________________, of THEFT committed as follows:
1. Complainant is a guest lecturer at Holy Angel University,
Angeles City, Pampanga;
2. As guest lecturer, she teaches the subject Sales, Credit
and Bailment to the 4th year Legal Management class of
said university;
3. On September 24, 2015, at about 8:45 in the evening,
within the premises of the university, particularly at room
PGN 306, Complainant left her wallet, containing Php9,000
and other cards and paraphernalia on a table on said
classroom;

4. At about 9:30 p.m., when Complainant was already at

home, she noticed that her wallet was missing;
5. Complainant hurriedly returned to said classroom to
recover her missing wallet. Unfortunately, the wallet was
nowhere to be found;
6. Dismayed, Complainant immediately inquired from one of
her students in said class, whether one of them saw her
wallet;
7. One of the said students, namely _________________,
responded that s/he last saw the wallet beside herein
Respondent. This was in line with Complainants
recollection, as she remembers setting said wallet beside
herein Complainant before it went missing;
8. After further inquiry, one of Complainants students finally
confessed that s/he saw Respondent, pocketing the wallet;
9. Despite numerous chances given by Complainant to
Respondent for the latter to return said wallet, Respondent
stubbornly refuses to do so.
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:
__________________________
__________________________