Republic of the Philippines

MUNICIPAL TRIAL COURT

11th Judicial Region
San Isidro, Davao Oriental

THE PEOPLE
OF THE PHILIPPINES Criminal Case No.
______________
-versus-

__________________________, For:
Accused. _____________________

JUDICIAL AFFIDAVIT

I, _________________, of legal age, Filipino and a resident of

_______________________________, Philippines, after having been
duly sworn to in accordance with law, hereby depose and
state:

PRELIMINARY STATEMENT:
The person conducting this direct examination consisting
of Question and Answer is _________________________with office
address _________________________. I am answering all these
Questions fully conscious and aware that I do so under oath
and may face criminal liability for False Testimony and Perjury
for any false statements taken under oath.

PURPOSE:
The testimony is offered for the following purposes:

To prove;
To prove;
To prove;
To prove all other matters as may be discussed in the judicial
affidavit.

With the kind permission of this Honorable Court.

QUESTION 1:
What is your name, age, status, address, and other
personal circumstances?
ANSWER:
QUESTION 2:
How do you know?
ANSWER:

QUESTION 3:
What happened last _________________________?
ANSWER:

QUESTION 4:
How did you know it was him ?
ANSWER:

QUESTION 5:
Do you know any reason as to why he was looking for
you?
ANSWER:
QUESTION 6:
What did you observe, if any, with regard to his demeanor?
ANSWER:
QUESTION 7:
What happened next, if any?
ANSWER:

QUESTION 8:
What happened next, if any?
ANSWER:
QUESTION 9:
What are these documents you are showing me?
ANSWER:

ATTY. :
Your Honor, we request that copies of these Receipts and
Billings consisting of 3 pages be attached hereto marked as
Exhibit “A”, “A-1,” and “A-2” and made integral part hereof.
QUESTION 10:
What happened next, if any?
ANSWER:

QUESTION 11:
What happened next, if any?
ANSWER:

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QUESTION 12:
What happened next, if any?
ANSWER:

QUESTION 13:
What happened next, if any?
ANSWER:

QUESTION 14:
What happened next, if any?
ANSWER:

What happened next, if any?

ANSWER:

QUESTION 16:
What did you do next?
ANSWER:

QUESTION 18:
Do you confirm everything in this Judicial Affidavit?
ANSWER:
Yes, based on recollection of events.
AFFIANT FURTHER SAYETH NAUGHT.

_________________________
(Affiant)

SUBSCRIBED AND SWORN to before me this ___ day of

________________ at _________________________, Philippines, affiant
personally known to me.
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2019.

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ATTESTATION CLAUSE

I, _________________________, with office address at

__________________________________________________, Philippines, attest
under oath as follows:

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 a) That I personally conducted the direct examination
of _________________________in the instant Criminal case pending
before the _________________________

b) That I faithfully recorded the Questions I asked the

witness and the corresponding Answers she gave me; and

c) That neither I nor any other persons then present

coached, or taught, the witness regarding her Answers which
she gave voluntarily and knowingly based on her own personal
knowledge and recollection.

_________________________
(Affiant)

SUBSCRIBED AND SWORN to before me this ____ day of

__________________, at Davao City, Philippines, affiant exhibiting
to me his _________________________as competent evidence of his
identity.
Doc. No._____;
Page No._____;
Book No._____;
Series of 2019.