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REPUBLC OF THE PHILIPPINES

Metropolitan Trial Court


National Capital Judicial Region
Makati City
Branch _______

PEOPLE OF THE PHILIPPINES,


Plaintiff,

-versus- CRIM. CASE NO. ________________


For: Crime of Expulsion (Art. 127)
John Doe,
Accused.
x--------------------------------- x

JUDICIAL AFFIDAVIT
Direct testimony of __________
In the form of Question and Answer

This Judicial affidavit was given by _____________, of legal age, Filipino, and residing
at ____________________________________________________.

This Judicial Affidavit was given by the private complainant/affiant before the Public
Prosecutor,in English, a language which he knows and fully understands at the Prosecution
Office, 15thFlr. New Makati City Hall, Makati City.

This Judicial Affidavit will constitute and serve as his direct testimony pursuant to
Administrative Matter No 12-8-8-SC otherwise known as the “Judicial Affidavit Rule”

That the private complainant/affiant answered the questions asked of him/her fully
conscious that he/she does so under oath, and that he/she may face criminal liability for any false
testimony or perjury contained therein.

Manifestation: the testimony of the witness is being for the following purposes:

1. To prove the allegations in the complaint.


2. The witness will testify on all other matters which may be relevant to the case,
identify the parties involved and will also identify documents pertinent thereto.

1. Q: Please estate your full name, address, occupation, and other personal circumstances,
for the record?
A:

2. Q: Mr. Witness, do you know the accused in this case? Kindly identify him if he/she is
present in court.
A:

3. Q: Do you remember executing any document in relation to the instant case?


A:

4. Q: I am showing you a _______page Salaysay dated ___________. Is this the same


document you are referring to?
A:

5. Q: There’s signature on the _______ page on top of the name, whose signature is this?
A:

Manifestation and Marking:

Your Honor, the witness identified and handed over to the Public Prosecutor a copy of the
document dated ________ and we request that said document attached to the records be
accordingly marked as Exhibit “ ” and “ ” , and the signature be marked as Exhibit “ “ for the
prosecution.

6. Why did you execute such document?


A:

Manifestation and Marking:

Your Honor, the witness identified and handed over to the Public Prosecutor a copy of the
document dated ________ and we request that said document attached to the records be
accordingly marked as Exhibit “ ” and “ ” , and the signature be marked as Exhibit “ “ for the
prosecution.

7. Q: Will you tell this Honorable Court what you were doing at that particular date and
time?
A:

8. Q: While you were there, do you recall any unusual incident that happened?
A:

9. Q: According to you, you were arrested for allegedly engaging in prosecution? What
happened next, if any?
A:

10. Q: After you were brought to the police station, what happened next, if any?
A:

11. Q: According to you, no case was filed against you. So what did the arresting officers do,
if any?
A:

12. Q: According to you, these police officers ordered you to be transferred to another town
without any authority. What did you do, if any?
A:

13. Q: After you were transferred to another town, what did you do next, if any?
A:

14. Q: Do you affirm the truth and veracity of your Salaysay?


A:

Counsel: That will be all for the witness, your Honor.

I have executed this Judicial Affidavit in order to attest to the truth of the foregoing and
as part of my direct testimony in the above-captioned case.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


November 2014 in Makati City.

Witness-Affiant
SWORN ATTESTATION

I, ____________________ of legal age, Filipino, Public Prosecutor and with office at


th
15 Flr. New Makati City Hall, Makati City, under oath, hereby depose and state:

1. I am the Public Prosecutor assigned to the MTC, Br. ____.


2. I conducted and supervised the examination of ____________________
whose herein Judicial Affidavit is being offered in lieu of his/her direct testimony
in the foregoing criminal case entitled “_________________”.
3. I attest that I faithfully recorded or caused to be recorded both the questions
propounded upon the witness, ______________ and the corresponding answers
he gave. I further attest that I and/or any other person or assisting me at the time
did not coach or influence the witness as to his given answers.
4. I am well aware that under Administrative Matter No. 12-8-8-SC, any false
attestation shall subject me to disciplinary actions including the disbarment.
5. I attest to the truth of the foregoing statements, in compliance with law and for
whatever legal intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affix my signature below on this ____ day
of November in Makati City.

Affiant

SUBSCRIBED AND SWORN to before me, on this _____ day of November 2014 in
Makati City; affiant having personally appeared before me and exhibited competent proof of
her/his identity in the form of a Passport with No. ________________ bearing his/her picture
and signature, and duly issued by the Department of Foreign Affairs on ___________________.

FURTHER, I hereby certify that I have personally examined the affiant and I am
satisfied that he wilfully and voluntarily executed the foregoing Judicial Affidavit, and that
he/she read and understood the contents thereof.

Doc. No.
Page No.
Book No.
Series of 2014

AMAV/