You are on page 1of 1

Republic of the Philippines) Province of _________________)S.S. City/Municipality of ____________) x---------x AFFIDAVIT OF DENIAL I,_____________, ilipino, of le!al a!

e, "arrie#, an# as resi#ent of____________, Philippines, havin! been #uly s$orn in accor#ance $ith la$, hereby #epose an# state% &. 'hat I a" NOT the sa"e person as one ()*+ ,(RCIS- a!ainst $ho" a co"plaint for Collection of Su" of Money $as file# in the .uris#iction of Cebu, Philippines/ 0. 'hat I have never been the sub.ect of any civil or cri"inal co"plaint, char!e or procee#in! before any prosecutor or court/ 1. (s such, I a" executin! this (ffi#avit to certify or attest to the truth of the fore!oin! facts an# for purpose of #enyin! that I a" the sa"e ()*+ ,(RCIS- $ho is the sub.ect of the afore"entione# case an# for $hatever le!al purpose that this (ffi#avit "ay serve. I, 2I',*SS 23*R*- , $e have set our han#s this__________, in the City of____________, Philippines.

__________________________
AFFIANT SUBSCRIBED AND SWORN TO before me a Notary Public for and in the City of _____________, affiant exhibiting to me his Passport with Passport No ___________ issued on ________________ at ___________________

!oc No _____" Page No _____" 'oo) No ______" *eries of +,--

N#TA$% P&'(IC

You might also like