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Republic of the Philippines)

Province of Davao del Sur )S.S.


City of Digos )
x--------------x

COMPLAINT - AFFIDAVIT

I, ____________________, Filipino, of legal age, single and a resident of Barrio


Bukid, Jose Abad Santos, Davao Occidental, Philippines, after being sworn to in
accordance with law, depose and state THAT:

1. I am the same person who is the complainant in the instant case;

2. That I am the designated poll watcher at the Precinct 30A-30B of the


Barangay Barrio Bukid, Jose Abad Santos during the May 14, 2018
Barangay Elections;

3. That sometime on May 14, 2018 at around 3:30 o’clock in the afternoon,
the Electoral Board closed the voting and started counting the ballots
of Barrio Bukid, Precincts 30A, 30B and 31A in one box;

4. That the total who voted at the Barangay was 304 and 103 for the SK;

5. That during the start of their counting, I observe that their procedure
was not proper and in violation of the rules;

6. That during the counting at around 8:00 o’clock in the evening, the
Chairman of the Electoral Board, _____________________ together with
his team committed several election offenses;

7. First, I observed that Chairman of the Electoral Board,


___________________ ask to take a break when there were only Five (5)
ballots left to be counted during the canvassing Precincts 30A to 30B;

8. After their break, they were accompanied now by Edgar Florentino and
resumed the counting but claimed there are 100 ballots left where he
said “Naa pa diay 100 ka balota diri sa SK na nalimtan namo” but when
I checked, the 100 ballots were for the Barangay candidates and
started to count the 100 ballots;

9. Upon his counting of such additional 100 ballots, we were shock to hear
him count that those alleged additional 100 ballots were not from the
SK but for the Barangay candidates;

10. During his counting of such 100 ballots, Chairman ________________ was
reading first each the ballots, then teared the detachable coupon from
the ballot, signed the ballot and then casted the ballot to the ballot box
which is highly irregular since such tearing of the detachable coupon
and his signature on the ballot should have been made during the
voting procedures and not during counting;

11. Accordingly, I am executing this Affidavit freely and voluntarily for the
purpose of attesting to the truth of the foregoing statements and in
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support of a case/s I will file against respondent
____________________________, for conspiring to commit an Election
Offense in violation of the Omnidbus Election Code and Resolutions of
the COMELEC in view if the highly irregular and anomalous conduct of
the counting/canvassing of votes under Precinct 30A-30B of Barangay
Barrio Bukid, Jose Abad Santos, Davao Occidental.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of May,
2018 at Digos City, Davao del Sur, Philippines.

__________________
Complainant
Proof of Identity: _____________________

SUBSCRIBED AND SWORN to before me this _________________ at Digos City,


Davao del Sur, Philippines. I hereby certify that I have examined the Affiant and
that I am fully satisfied that he has voluntarily executed and understood the
contents of his Complaint-Affidavit.

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