Republic of the Philippines

REGIONAL TRIAL COURT

SIXTH JUDICIAL REGION
BRANCH ___,
ANGELES CITY

PEOPLE OF THE PHILIPPINES

-versus- Criminal Case No:5

For: Serious Physical Injuries

JUAN DELA SERNA

Accused.

x----------------------------------------x

COMPLAINT AFFIDAVIT

I, Jose David, 27 years of age, married, a resident of 1234 Jose

Santos Street Angeles City, after having been sworn to in accordance
with law, do hereby depose and state:

1. That on June 24, 2014 at around 9 o’clock in the evening while

I was walking home from my work as a Professor in Angeles
University Foundation, I accidentally bumped certain Juan Dela
Serna at the corner of Jose Abad Santos Street and Manuel L.
Quezon Street;
2. That without warning, he suddenly attacked me with a baseball
bat;
 3. That despite being gripped to stop by the bystanders nearby,
he still kept on attacking me;
4. That due to the said incident, I was admitted on June 24 2018
to July 24, 2018 at Our Lady of Mt. Carmel Medical Center, I
was diagnosed to have epidural hematoma frontoparietal area
left secondary to mauling. I have attained an avulsed wound on
my head left side. Subsequently, I was discharged, however on
follow-up check, I was advised by my attending physician for
an additional rest of 15 days. And again advised to rest for
another 15 days for 3 consecutive check-ups which resulted for
inability to go to work for 60 days after the 30 day
confinement.
5. In view of the foregoing, I am executing this complaint-affidavit
in order to file a case of Serious Physical Injuries against Juan
Dela Serna.

IN WITNESS WHEREOF, I have hereunto set my hand this 24th day of

July 2018 in Angeles City.

Jose David
Affiant

SUBSCRIBED AND SWORN TO before me this 24th day July 2018 in

Angeles City. I hereby certify that I have personally examined the affiant
and I am satisfied that he fully understood and voluntarily executed his
complaint-affidavit.
Public Prosecutor