Republic of the Philippines

DEPARTMENT OF JUSTICE
City of Prosecutor’s Office of Quezon City
Hall of Justice, Quezon City

________________________________________,
Represented by _________________________,
Complainant

- versus- I.S. No.___________

_______________________________________,
Respondent

x --------------------------------------------------------- x

COMPLAINT AFFIDAVIT

I, ____________, legal age, with business address at ________________________,

Quezon City, after having been duly sworn in accordance with law depose and state ;

1. That the complainant is ______________________________, (complainant

________ for brevity), a domestic corporation duly organized and existing under
and by virtue of the laws of the Republic of the Philippines, with principal office
address at _______________________, represented by the undersigned under the
direct authority of Secretary Certificate, attached and marked as ANNEX “A”
that form an integral part hereof;

2. That as the authorized representative of _____________________ holding the

position of __________________, with the following major duties and
responsibilities;
2.1 ___________________________.
2.2 ___________________________.
2.3 ___________________________.

2. That the herein respondent is ___________________, Filipino, of legal age,

married and a resident of No. ________________________, Quezon City,
Philippines, where he may be served with subpoena and notices by this Honorable
Office;
3. That the herein respondent _______________ was a regular employee of
___________ as ________________ premium section responsible for high ticket
items starting __________________. Attached is the Approved Request for
Personnel Action for regularization form dated _________________ and marked
as ANNEX “B” forming an integral part hereof.

4. That as a _________________, his duties and responsibilities includes among

others the trust and confidence repose to him of the physical transfer and
arrangement of stocks through proper documentation in his designated area. The
following are the duties and responsibilities;
a.

Attached and marked ANNEX ”C” is the copy of the job description to show the
highest trust and confidence repose to him.

4. That the herein respondent ________, has the direct supervision and control over
the items inside the stock room. Mr._________ is the only person who is
authorized for the movement and physical inventory of all the high ticket items
gadgets. The herein respondent is the only person allowed to conduct Physical
Inventory Count. Attached is the actual Physical Inventory Count made by the
respondent and marked as ANNEX “D-1” , ANNEX “ D-2 “, ANNEX “ D-3 “,
ANNEX “ D-4” to form an integral part hereof.

5. That the essential facts constituting the crime of QUALIFIED THIEF, defined
and penalized under Article 310 of the Revised Penal Code, were committed as
follows ;

5.1 Last June 15, 2015, I, ___________, due to immediate necessity of verifying
the stocks in the stock room and for the reason that the herein respondent was
absent that date, Assistant Branch Manager of Western Farmer’s Plaza
instructed Mr. _________, warehouseman for big items to search a specific
item of cellular phone particularly LG unit with certain serial number. Mr.
_______ entered the stockroom to check the said item and found out that the
same is missing inside the box, only the accessories of said LG cellular phone
unit was seen.

5.2 Mr. ________ immediately called the attention of the security guard on
 duty to record the missing item. As a protocol, Mr. _____ reported the
incident to Ms.______________, Branch Manager of Western Farmer’s
Plaza.

5.3 On the same day June 15, 2015 around 2:23pm in the afternoon, Mr.
______ immediately called the attention of the herein respondent Mr.
_______ via telephone call to inform about the missing item but the
respondent did not answer his cellular phone. Mr. ______ the herein
respondent return call to Mr. ___________ at around 3:00pm and asked what
was the call about, Mr. _______ inform him of the missing item incident.

5.4 On June 16, 2015, Mr. ______ the herein respondent reported to work. At
around 2:00pm the two personnel Mr. _____ and Mr. _______ had an
informal conversation regarding the said missing incident. According to Mr.
_______ their conversation with Mr. ____ to quote “Wala nga kami benta ng
ganung unit at tinanong nya ako kung paano kami nasalisihan”. On the
same date Mr. ___ the herein respondent asked Mr. ______ if he already
checked all the stock items (Cellular Phones) in the stock room. Which Mr.
____ answered and I quote “ Dalawa tayo mag check tulungan lang kita kasi
ikaw lang naman ang otorisado sa stock room na un”.

5.5 At around 7:00pm of June 16, 2015, due to suspicious incident of the missing
item under the custody of Mr. ______ it is my direct instruction and in the
absence of the herein respondent Mr. ______, Mr. Rupert _____ immediately
conducted random inventory and checking and found out that some cellular
phone item particularly Lenovo S820 two pieces and 1 piece Samsung
Galaxy win is missing inside their respective box. Because of the incident and
findings of the inventory conducted, Mr. ______ immediately reported to his
Branch Manager. And at that time called the attention thru telephone call the
herein respondent Mr. ________to inform the said incident and asked him to
report to office the following day in order for them to double check the said
missing items. Attached is the security guard logbook of the missing high
ticket(cellular phone) and marked as ANNEX “E”

5.6 On June 17, 2015, only Mr. ______ reported to work and Mr. ____ the herein
respondent was absent despite their agreement to check the missing items as
stated above. On the same day Mr. ____ continuously contacted Mr. _____ via
 text messages and call but of no avail. The following day June 18, 2015 still
Mr. _____ did not reply nor called the office of his whereabout.

5.7 On June 19, 2015, Mr. ____________ tried to call Mr. ______ the herein
respondent but still of no avail. The wife of Mr. _____ was the one who
answer the telephone call saying to quote “ Dala ko ang telepono ng partner
ko”.

To support the above allegations, attached is the Sinumpaang Salaysay of Mr.

____________ and marked as “ANNEX “F” to form an integral part of this complaint
affidavit.

6. That Mr. _________ being the authorized person who has control and disposition
of high ticket items(cellular phone) the herein respondent did not report to work
after the incident happen last June 17, 2015 up to present. That such action is a
clear manifestation of waiving his right to defend the allegations against him to
the continued prejudice of the company.

7. That on June 21, 2015, because of the non appearance and not reporting for work
of the herein respondent Mr. ______, an Incident Report was conducted as a
matter of company policy to evaluate his abandoned post and checked all the
items under his direct custody. Which resulted in finding out all the missing high
ticket items(cellular phones). Attached is the Incident report form and marked as
ANNEX “G”.

8. That for purposes of due process, a Notice to Explain were sent to the herein
respondent as well as series of telephone call and text messages for him to appear
before my office to explain and defend himself of the allegations regarding the
missing high ticket items(cellular phone) but of no avail. Attached is the Notice to
Explain and marked as ANNEX ”H”.

9. That on July 14, 2015, audit investigation was conducted for all the missing items
by Ms. ___________, internal auditor and Mr. __________ Audit Manager of
Internal Audit Validation for Missing Items Western New Farmer’s Plaza.
Attached is the report of all the missing items and its cost and marked as ANNEX
”I”.
10. That Mr. _________, abused his power in exercising his functions and with intent
to gain being the high ticket warehouseman of Western Farmer’s Plaza, whose
functions is shielded with highest trust and confidence by the management
company as shown in his Job Summary specific duties and responsibilities.

11. That the non appearance of the herein respondent despite series of
communications made thru text messages and telephone call is a clear
manifestation of evading his obligation to answer the allegation of taking the
property of _____________a without the consent of the latter company.

12. That I am executing this Complaint-Affidavit to attest to the truth of the foregoing
statements and to file a criminal charge against respondent Mr. _______ for
QUALIFIED THIEF and such other offense/s as may be found by this Honorable
Office after conducting preliminary investigation.

IN WITNESS WHEREOF, I have hereto set or hands this ___ day of November 2015
in Quezon City.

_______________________
Affiant
SUBSCRIBED AND SWORN to before me this ___ day of November 2015 in Quezon
City by the Affiant. I hereby certify that I have personally examined the affiant and that I
am satisfied that he voluntarily executed and understood the foregoing Complaint-
Affidavit

ASSISTANT CITY PROSECUTOR