Sunteți pe pagina 1din 3

Republic of the Philippines

COURT
th
11 Judicial Region, Branch ___
City

NAME OF PLAINTIFF, CASE NO. _____________


Plaintiff,

- versus - FOR: _________________


NAME OF DEFENDANT,
Defendants.
x---------------------x

JUDICIAL AFFIDAVIT OF
NAME OF WITNESS

This Judicial Affidavit of _______________ is executed to serve


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,
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 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?

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. ___; Notary Public


Page No. ___;
Book No. ___;
Series of 2013.

S-ar putea să vă placă și