Republic of the Philippines ) City of Tacloban ) s.s.

COMPLAINT-AFFIDAVIT
I, MARICEL DOTADO PETILLA, of legal age, single, Filipino and a resident of Brgy. Libertad, Palo, Leyte, Philippines, after having been duly sworn to in accordance with law, hereby depose and state: 1. That I personally know JUWELL ENGHOY MALDA (MALDA for brevity), 36 years old, and a resident of Brgy. Naga-Naga, Tacloban City as we used to be live-in partners for a period of more or less one (1) month (from October to November 2012); 2. That on November 5, 2012 or thereabout, I discovered that my UCPB Passbook with Serial No. 3491658 was no longer inside the vault protected with password which only MALDA and I knew after I gave him access to the same. A true and faithful copy of the UCPB Passbook is hereto attached as Annex A and made an integral part hereof; 3. That I immediately went to UCPB Gomez, Tacloban City branch to inquire about the status and condition of my account with them. The bank statement revealed three (3) withdrawals of large amount of money which I was never aware of, to wit: i. October 22, 2012 = P85,000.00 ii. October 30, 2012 = P32,000.00 iii. October 30, 2012 =P83,000.00 A true and faithful copy of the bank statement or Account History Inquiry is hereto attached as Annex B and made an integral part hereof; 4. That I requested a copy of the withdrawal slips relating to the withdrawals and found out that my signature was forged and/or falsified as the signature appearing on the documents was not mine; 5. That MALDA willfully, unlawfully, and feloniously falsified the said commercial documents by counterfeiting or imitating my signature as his name and signature clearly appeared on the withdrawal slips as my alleged authorized representative in withdrawing and/or receiving documents on my behalf notwithstanding the fact that I gave him no authority to do such, at all. A certified true copy of the three (3) withdrawal slips are hereto attached as Annexes C and series and made an integral part hereof; 6. That on the following day or on November 6, 2012, I confronted MALDA about the matter and he confirmed not only about his unauthorized and falsified withdrawals of amount from my UCPB account but also the lost wallet and jewelries which he himself pawned as evidenced by the receipts which are currently in his possession. After which, he surrendered the UCPB Passbook when asked of its whereabouts and begged for an apology; 7. That after the said confrontation, MALDA ran off and is now nowhere to be found; 8. That because of imitating or counterfeiting my signature, I am therefore executing this complaint-affidavit freely and voluntarily to file a case for the crime of FALSIFICATION OF COMMERCIAL DOCUMENT under Article 172, par.(1) in relation to Article 171, par.(1) of the Revised Penal Code of the Philippines and/or the appropriate criminal case against JUWELL MALDA, who is of legal age with last known address at Brgy. Naga-Naga, Tacloban City. IN WITNESS WHEREOF, I have hereunto set my hand this ________________ at Tacloban City, Philippines.

MARICEL DOTADO PETILLA Complainant/Affiant SUBSCRIBED AND SWORN to before me this ________________ at Tacloban City, Philippines and I FURTHER CERTIFY that I have personally examined the affiant and I am satisfied that she has read and personally understood the contents of her foregoing Complaint-Affidavit as it was explained and translated to her in WarayWaray, the language within her understanding and comprehension.