Republic of the Philippines
Fifth Judicial Region
MUNICIPAL CIRCUIT TRIAL COURT
Branch ____
Sorsogon City
XXXXX, Civil Case No. __________
Plaintiff,
FOR: _________________
vs.
XXXXX,
Defendant.
x---------------------------------------------------------x
JUDICIAL AFFIDAVIT OF
XXXXX
COUNSEL, respectfully submits the Judicial Affidavit of XXXXX
conducted under the supervision of Atty. Your Name of Bgy. Piot,
Sorsogon City.
Offer of Testimony: The testimony of the witness is respectfully offered
to prove 1.) that xxxx and 2.) by testifying on other material and
relevant matters in connection thereto.
Examination Questions and Answers
I, XXXXX, of legal age, Filipino, and xxxx Sorsogon City, fully
conscious that I am answering the questions asked of me under oath,
and that it was explained to me that I may face criminal liability for
false testimony or perjury should I tell a lie, hereby testify to, as
follows:
Lawyer:
Atty. Your Name
Q1. Why are you here in my office?
A1. xxxx.
Page 1 of 3
Q2. xxxx?
A2. Xxxx.
Q3. Do you attest to the veracity of the foregoing facts and the
authenticity of the documents?
A3. Yes, I do.
Q4. Do you want to sign this judicial affidavit of yours?
A4. Yes sir.
IN WITNESS WHEREOF, I have hereunto set my hand this
______________ at Sorsogon City.
XXXXX
Affiant
ID No. _______
Issued by _____
SUBSCRIBED AND SWORN to before me on the day and place
above written.
ATTY. YOUR NAME
Notarial Commission No. XXXX
Notary Public until Dec. 31, 2022
Roll of Attorneys No. XXXX
Doc. No.:_________; IBP NO.: XXXX – Jan. 22, 2020-Mla
Page No.:_________; PTR NO.: XXXX – Jan. 14, 2020-Sor
Book No.:_________; MCLE Compliance No. VI – 0XXXX
Series of :2021. Piot, Sorsogon City
Republic of the Philippines }
Province of Sorsogon } S.S
City of Sorsogon }
CERTIFICATION
I, Your Name, Filipino, of legal age and a resident of Piot,
Sorsogon City, Philippines, subscribing under oath, hereby depose and
state that:
1. That I am the Lawyer who conducted or supervised the
examination of the witness;
Page 2 of 3
2. That I have faithfully recorded or caused to be recorded the
questions I asked and the corresponding answers that the
witness gave;
3. That neither I nor any other person then present or assisting me
coached the witness regarding the latter’s answers; and I attest to
the authenticity of the annexes thereof.
IN WITNESS WHEREOF, I have hereunto set my hand this
__________________ at Sorsogon City, Province of Sorsogon,
Philippines.
YOUR NAME
Counsel for the Plaintiff
Roll of Attorneys No. XXXX
IBP NO.: XXXXX – Jan. 22, 2020-Mla
PTR NO.: XXXXX – Jan. 14, 2020-Sor
MCLE Compliance No. VI - XXXXX
Piot, Sorsogon City
SUBSCRIBED AND SWORN to before me, on the date and
place first above-written with identification document with numbers
shown below his name.
Doc No._______
Page No.______
Book No.______
Series of 2021.
Page 3 of 3