Republic of the Philippines
COURT th
11 Judicial Region, Branch ___ City NAME OF PLAINTIFF, Plaintiff,
CASE NO. _____________
- versus NAME OF DEFENDANT, Defendants. x---------------------x
FOR: _________________
JUDICIAL AFFIDAVIT OF NAME OF WITNESS
_______________ is executed to serve This Judicial Affidavit of _______________ as his/her direct testimony in the instant case. This Judicial Affidavit is offered to prove: (1) all the allegations in the _______________; (2) including all the ANNEXES appended thereto, which he respectfully requests to be correspondingly marked as EXHIBITS in this case; and (3) all matters related thereto, with reservation to present additional exhibits in the course of the proceedings of the instant case.
QUESTIONS were propounded by plaintiff’s counsel, Atty. _______________, _______________, in English, which the affiant fully understands, understands, while ANSWERS were given/made by witness _______________, , in English/Tagalog/Bisaya dialect and the corresponding translation of his answer is provided after each question, 1. Please
state your name, age, residence address, and occupation. Ans.
__________________ ___________________. _.
2. How are you related to the defendants in this case? Ans.
___________________ ___________________..
3. Please tell me how did you know the complainant complainan t in this case? Ans.
___________________ ____________________________ ___________; __;
4. Showing you a (document), which we request to be marked as our Exhibit “_____”. “_____”. What relation has this document to the ___________________ ______________________ ___ you mentioned? mentioned? Ans.
__________________ _____________________. ___.
5. I have here with me a document which I request to be marked as Exhibit “___”. Do you confirm my action? Ans.
Yes.
6. Do you attest to the truthfulness of your statements and allegations in this Judicial Affidavit? Ans.
Yes.
IN WITNESS WHEREOF, I have hereunto affixed my signature this date, in place, Philippines.
Name of Witness Affiant
SUBSCRIBED AND SWORN to before me this (date and place), Philippines, and I hereby certify that I have personally examined the affiant and that I am convinced that he understood and voluntarily executed this Judicial Affidavit.
Copy furnished: ATTY. ________________ Address THE CLERK OF COURT Address
ATTESTATION
I, ATTY. ______________, of legal age, single/married, and a resident of ________________, after having been duly sworn to in accordance with law, hereby depose and say, that: (1) I am the counsel of _____________ in Case No. ______________; (2) I faithfully recorded or caused to be recorded the questions I asked and the corresponding answers that the witness gave for his Judicial Affidavit; and (3) Neither I nor any other person then present or assisting him coached the witness regarding the latter's answers.
IN WITNESS WHEREOF, I have hereunto affixed my signature this (date and place), Philippines.
ATTY. __________________
Affaint SUBSCRIBED AND SWORN TO BEFORE ME this (date and place), Philippines, affiant exhibited her IBP ID No. __________ as her competent evidence of identity.
Doc No. ___; Page No. ___; Book No. ___; Series of 2013.
Notary Public
