REPUBLIC OF THE PHILIPPINES) PHILIPPINES) TACLOBAN CITY….……………../)S CITY….……………../)S.S. .S.
JUDICIAL AFFIDAVIT - COMPLAINANT I, _____________, ____ years old, Filipino and a residence of _______________ and a ___________ (occupation), after having been duly sworn to in accordance with law, hereby depose: That it was Police Investigator______________, who conducted the examination of the undersigned affiant in Police Station 2, Abucay, Tacloban City; That I hereby state, that in answering the questions asked of me as appearing below, I was fully conscious that I did so under oath and that I may face criminal liability for false testimony or perjury; Question 1: Are you complainant in this case? Answer: Yes, I am.
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Question 2: Why did you file this case against the accused _________? Answer: Because she uttered defamatory words against me in the presence of other persons. Question 3: When and where did it happen? Answer: It happened on August 2, 2012 at around 7:00 o’clock in the morning, just outside of our residence in Brgy. 95-A, Caibaan, Tacloban City. Question 4: What were you doing at the time of the incident? Answer: I was then inside our house, specifically at the dining table, drinking coffee. Question 5: What happened while you were drinking coffee?
Answer: I heard a female voice coming from the direction of our front yard, said in a loud manner “Hoy Elenita, it iyo basura, iyo na liwat ginsarang didi hit akon bungsaran!” Question 6: What did you do when you heard those words? Answer: I went out to verify and when I saw ___________ (suspect), I asked her “Ano it imo problema, aga-aga pa dako na iton imo boses?” Question 7: What did the suspect do, if any, after you asked her? Answer: She pointed her finger at me and uttered in a loud voice “Uy Elenita, ayaw pagmalinis! Bugaw ka man ngani hit im mga anak, mga puta it im mga anak, namagtrabaho ha abroad it im mga anak pagpinuta, nakabalay agi hit pagpinaputa ngan pagpinaputik hin iba-iba nga mga lalaki.”
Question 8: What did you do if any after hearing the said utterance? Answer: I was shocked and I only told her “Hinay hinay ikaw hit imo mga yakan!” and then I went inside the house teary-eyed. Question 9: You mentioned that the utterance was made in the presence of other persons. Who were those persons? Answer: Rinalyn Reyes (witness) was there buying at the sari-sari store just in front of my house. Mrs. Dela Cruz, the owner of the said sari-sari store, was inside her store at that time, attending to Rinalyn. Question 10: What happened if any, after you went inside your house? Answer: Rinalyn Reyes came in after buying from the sari-sari store and comforted me since I was then crying.
Question 11: After the incident, what did you do if any? Answer: After I regained my composure, I went to the Barangay Hall and filed a complaint against Mrs. ______ (suspect). Conciliation meetings were scheduled but Mrs. ___ (suspect) did not show up. Thereafter, I was issued a Certificate to File Action, the original of which is hereto attached as Exhibit ____. Question 12: As a result of the utterances hurled at you by ______ (accused), what if any did you feel? Answer: I felt embarrassed and humiliated…… Question 13: Because of the embarrassment and humiliation that you feel, how much in moral damages would you like to ask?
Answer: I am asking for an award of __________ for moral damages. Question 14: Do you know of any reason why the accused would utter those defamatory remarks against you? Answer: Its probably because there is an existing misunderstanding between our families that started from a land dispute. Question 15: Do you have anything more to add to your statements? Answer: I have none for the moment. IN WITNESS WHEREOF, I have hereunto affixed my signature on this __ th day of _____________, in Tacloban City, Philippines. ________________ Affiant SUBSCRIBED AND SWORN TO before me in the City of Tacloban, Philippines this __ th day of ______________.
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ATTESTATION CLAUSE I certify that I conducted and supervised the examination and have faithfully recorded the questions and the corresponding answers of the witness _____________ and that he/she was never instructed or coached on the answers he/she is supposed to give, the narrations thereof being completely his/her own. IN WITNESS WHEREOF, I hereunto affixed my signature this ____ day of _________________ , in Tacloban City. ______________________ Investigator
