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:

__________________________

__________________________