REPUBLIC OF THE PHILIPPINES )
QUEZON CITY ) S.S.
x-------------------------------------x
AFFIDAVIT OF DENIAL
I, ___________________________, of legal age, Filipino, married and
with postal address at ____________________________, after having been
duly sworn to in accordance with law hereby depose and say:
1. That herein affiant is a resident of the above-mentioned
address;
2. That herein affiant has never been indicted for any offense in
any court, tribunal or any agency of the Philippine
Government exercising judicial function;
3. That there are Criminal Cases for damage to property,
Criminal Case No. _____________, Regional Trial Court,
Branch _____, and that said case was already disposed;
wherein the Accused bore a similar name as herein Affiant;
4. The name of the Accused in said case is
_________________________ (no middle name), while the
affiant’s name is _______________________. Attached herewith
is a copy of _________________________ issued by the Land
Transportation Office marked as ANNEX “A”;
5. That herein Affiant is not the same person as the Accused in
the above-mentioned case;
6. That the purpose of the execution of this affidavit is to affirm
the facts alleged herein and for any legal purpose it may
serve.
FURTHER AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto signed this affidavit this
______________, at Quezon City.
_______________________________
Affiant
SUBSCRIBED AND SWORN to before me this ___________________
at Quezon City, Metro Manila, and affiant is exhibiting to me his
__________________________________________, issued by the Land
Transportation Office, bearing his photograph and signature.
Administering Officer