Sample of Affidavit of Complaint

Republic of the Philippines )

____________, ________ ) s.s.
x- - - - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF COMPLAINT

The UNDERSIGNED, __________________________, accuses _________, of

_____________, committed as follows, to wit:

That on or about _________, at about _____________ in the

_________________, ______________, Philippines, the said accused did then and
there willfully, unlawfully, feloniously, and by means of _____________, committed
_____________, upon the undersigned directly by overt acts to wit: (state the details
how the crime was committed).
The undersigned executed this affidavit to attest the truthfulness of the foregoing
facts and to support the filing of Criminal Cases against
_______________________________ for violations of ________________________.

___________, this _____ day of __________, ____.

____________________________
Offended Party

SUBSCRIBED AND SWORN to before me this ___ day of _______ at

_______________. I HEREBY CERTIFY that I have personally examined the herein
offended party and I am satisfied that they voluntarily executed and understood their
given affidavit.

_________________________
Judge

WITNESSES:

__________________________

__________________________