Republic of the Philippines}
CITY OF DIPOLOG . . . . . . }S.S.
AFFIDAVIT - COMPLAINT
That I, _____________________, Filipino of legal age,
married, and a resident of 284 P. Gomez St., Biasong,
__________________, after having been duly sworn to an
oath in accordance with law, and in answer to the
questions asked of me, do hereby depose and say:
That I am formally filing a complaint for GRAVE
ORAL DEFAMATION against ___________________, a
resident of Poblacion North, Pian, Zamboanga del
Norte.
QUESTION & ANSWER
1. Q - Why are you filing a case for Grave Oral
Defamation against _____________________?
A - I am filing a case for Grave Oral Defamation
because she deliberately dragged my name and
made some malicious declaration against me
before the Barangay Pangkat of Barangay
__________________, which utterly cause to
demean, discredit, dishonor, and contempt my
very person without any legal authority or moral
duty to do so.
2. Q -
What is your present occupation and social or
religious affiliation?
A - I am a medical practitioner being a full-fledged
pedriatrician and having a private clinic along
_______________ity. I am also an accredited visiting
consultant in all hospitals in the locality. I am a
member of the _______________ having been
conferred as _________________ Board of said
society. I am also a member of the _______________
3. Q - How well do you know Mrs. ____________?
A - She is my first cousin as her mother is the sister
of my mother. I learned that at present she had a
dispute with our cousin _________ who is a
resident of ____________ City, that leads to two (2)
referred barangay cases. The source of their
problem is when ______________ claimed the
whole estate at Barangay Lugdungan thereby
ejecting the family home of the Villanos family.
4. Q -
When and where did this incident of defamation
occur?
A - It occurred during a barangay conciliation
proceeding in the morning of December 20, 2007
at Barangay ____________ City.
5. Q -
Would you please narrate the fateful incident
which caused you to file this case?
A - At
noontime
of
December
20,
2007,
______________ went to my clinic for some
business with my secretary and in that occasion
informed me also the status of their barangay
cases. When I asked about the details she just
wanted to talk it over in my residence.
Over lunchtime, Mrs. _________ informed me that
my name and the name of my family in Cagayan
de Oro City were being dragged in that barangay
conciliation proceedings of which I was not a
participant of. I was further informed that I am a
land-grabber and to that, I was so downhearted
in front of my husband and my mother-in-law. I
really cried while eating my lunch.
6. Q - What happened after that?
A - I called up my father Mr. _______es at Cagayan de
Oro City and informed him regarding the
denigration and insult that was being made and
uttered at Barangay L___________. In __. On
February 9, 2008, a Saturday, Mrs. _______
brought along with her barangay minutes of
Barangay ________
Q
Do you have anything more to say?
A - No more unless further asked.
IN WITNESS WHEREOF, I have hereunto set my
hand this ____ day of ____________, at ____________,
Philippines.
AFFIANT
SUBSCRIBED AND SWORN to before me on the
date and at the place above indicated.
CERTIFICATION
I HEREBY CERTIFY that I have personally examined
the affiant and that I am satisfied that she voluntarily
executed her affidavit and that she has read and
understood the contents thereof.
