Republic of the Philippines

National Capital Judicial Region

_____________ TRIAL COURT
__________ City, Branch _____________

________________________,
______________,

-versus-

______ Case No. ________

_______________________,
_______________.
x------------------------------------------------x

JUDICIAL AFFIDAVIT
OF _______________________

I, __________________, of age, Filipino, and residing at

____________________, after being duly sworn in accordance with
law under direct examination conducted at my given address by
ATTY. ___________________, of age, Filipino, and with business
address
at
____________________________________________________,
hereby depose and state:

ATTY.:
The testimony of this witness is being offered for the following
purposes:
1. To prove ________________;
2. To prove ________________;
3. To prove ________________; and
4. Such other relevant matters.

_________ v. _________
Judicial Affidavit: __________
x------------------------------------------------x
-2-

Q.1
A.1

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A.3

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A.8

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A.11

_________ v. _________
Judicial Affidavit: __________
x------------------------------------------------x
-3-

Q.12
A.12

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_________ v. _________
Judicial Affidavit: __________
x------------------------------------------------x
-4-

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_________ v. _________
Judicial Affidavit: __________
x------------------------------------------------x
-5-

Q.33
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_________ v. _________
Judicial Affidavit: __________
x------------------------------------------------x
-6-

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Q.48
A.48

Affiant further sayeth naught.

IN WITNESS WHEREOF, I hereunto affix my signature this

__________________ in __________________.

__________________
Competent ID: _____________
Issued on: _________________

_________ v. _________
Judicial Affidavit: __________
x------------------------------------------------x
-7-

Issued at: ___________________

SUBSCRIBED AND SWORN TO before me this ___________________
in ___________________, affiant known to me and exhibited to me and
exhibited to me the above competent evidence of identity bearing his photograph
and signature.

Doc. No.:_____;
Page No.: _____;
Book No.: _____;
Series of 2013.

Notary Public

ATTESTATION
I, ATTY. ____________________________________, of age,
Filipino,
and
with
business
address
at
________________________________________________, hereby
depose and state that I have faithfully recorded or caused to be
recorded the questions I asked and the corresponding answers
that the witness gave; and neither myself nor any other person then
present or assisting him coached the witness regarding the latter's
answers.
IN WITNESS WHEREOF, I hereunto affix my signature this
__________________ in __________________.

ATTY. ____________________
Drivers License No. __________
SUBSCRIBED AND SWORN TO before me this ___________________
in ___________________, affiant known to me and exhibited to me and
exhibited to me the above competent evidence of identity bearing his photograph
and signature.
Doc. No.:_____;
Page No.: _____;
Book No.: _____;
Series of 2013.

Notary Public

_________ v. _________
Judicial Affidavit: __________
x------------------------------------------------x
-8-