Republic of the Philippines

NATIONAL POLICE COMMISSION

PHILIPPINE NATIONAL POLICE
NATIONAL POLICE COMMISSION
Camp BGen Rafael T Crame, Quezon City

CHECKLIST
FOR A SUBSTANTIALLY COMPLIANT JUDICIAL AFFIDAVIT

PART 1: GROUP PROFILE

(To be filled out by the Group)

GROUP CRIME
MEMBERS ASSIGNED ROLE
1 PLT VALMYR ANTON C TABIAN 1st Arresting Police Witness
2 PLTCOL RICARDO B TERO Police Investigator of 1st Arresting Police Witness
3 PMAJ JEROME M VILLEGAS Assisting Police Investigator of 1st Arresting Police Witness
4 PLT DUN BLANE TABARES 2nd Arresting Police Witness
5 PLTCOL DANILO YEMA JR Police Investigator of 2nd Arresting Police Witness
6 PCPT EDJEL TABLATE Assisting Police Investigator of 2nd Arresting Police Witness
7 PCPT EDJEL TABLATE Assisting Police Investigator of 1st or 2nd Arresting Police Witness

PART 2: SCORE CARD

(To be filled out by the Checker)

SUBJECT JUDICIAL AFFIDAVIT OF 1ST ARRESTING POLICE WITNESS

CATEGORY PARTICULARS SCORE ASSIGNED
GAINED POINT/S
Format (25 Heading: “Republic of the Philippines, Regional/Municipal Trial Court, ______ City” 1
pts) Case Caption: “People of the Philippines versus __________, Accused;” “Case No. ____;” 1
Designated Crime
Document Title: “Judicial Affidavit of _______” 1
Purpose/s of the testimony of the witness 1
Name, age, residence or business address, and occupation of the witness 1
Name and address of the one who conducted or supervised the examination of the witness 1
and the place where the examination is being held
A statement that the witness is answering the questions asked of him/her, fully conscious 1
that he/she does so under oath, and that he/she may face criminal liability for false testimony
or perjury
Questions asked of the witness and his/her corresponding answers are consecutively 1
numbered
Witness identified the attached documentary and object evidence 3
Documentary or object evidence, if any, attached to the judicial affidavit and marked as 10
Exhibits A, B, C, and so on in the case of the complainant or the plaintiff, and as Exhibits 1, 2,
3, and so on in the case of the respondent or the defendant
Signature of the witness over his/her printed name 1
A jurat for the witness’s execution with the signature of the notary public who administered 1
the oath or an officer who is authorized by law to administer the same
Sworn attestation at the end executed by the one who conducted or supervised the 1
examination of the witness
A jurat for the examining officer’s execution with the signature of the notary public who 1
administered the oath or an officer who is authorized by law to administer the same
Substance Name or identity of the accused 1
(25 pts) Designation of the offense given by the statute. If there is no designation of the offense, 1
reference shall be made to the section or subsection of the statute punishing it
It must state the acts or omissions constituting the offense and specify its qualifying and 15
aggravating circumstances, which must be stated in ordinary and concise language sufficient
to enable a person of common understanding to know what offense is being charged as well
as its qualifying and aggravating circumstances
Place where the offense was committed or where some of the essential ingredients occurred 1
within the jurisdiction of the court
Date of the commission of the crime or the date as near as possible to the actual date of its 1
commission
Name or identity of the offended party 1
Civil damages suffered by the offended party 5
TOTAL SCORE 50

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 SUBJECT JUDICIAL AFFIDAVIT OF 2ND ARRESTING POLICE WITNESS
CATEGORY PARTICULARS SCORE ASSIGNED
GAINED POINT/S
Format (25 Heading: “Republic of the Philippines, Regional/Municipal Trial Court, ______ City” 1
pts) Case Caption: “People of the Philippines versus __________, Accused;” “Case No. ____;” 1
Designated Crime
Document Title: “Judicial Affidavit of _______” 1
Purpose/s of the testimony of the witness 1
Name, age, residence or business address, and occupation of the witness 1
Name and address of the one who conducted or supervised the examination of the witness 1
and the place where the examination is being held
A statement that the witness is answering the questions asked of him/her, fully conscious 1
that he/she does so under oath, and that he/she may face criminal liability for false testimony
or perjury
Questions asked of the witness and his/her corresponding answers are consecutively 1
numbered
Witness identified the attached documentary and object evidence 3
Documentary or object evidence, if any, attached to the judicial affidavit and marked as 10
Exhibits A, B, C, and so on in the case of the complainant or the plaintiff, and as Exhibits 1, 2,
3, and so on in the case of the respondent or the defendant
Signature of the witness over his/her printed name 1
A jurat for the witness’s execution with the signature of the notary public who administered 1
the oath or an officer who is authorized by law to administer the same
Sworn attestation at the end executed by the one who conducted or supervised the 1
examination of the witness
A jurat for the examining officer’s execution with the signature of the notary public who 1
administered the oath or an officer who is authorized by law to administer the same
Substance Name or identity of the accused 1
(25 pts) Designation of the offense given by the statute. If there is no designation of the offense, 1
reference shall be made to the section or subsection of the statute punishing it
It must state the acts or omissions constituting the offense and specify its qualifying and 15
aggravating circumstances, which must be stated in ordinary and concise language sufficient
to enable a person of common understanding to know what offense is being charged as well
as its qualifying and aggravating circumstances
Place where the offense was committed or where some of the essential ingredients occurred 1
within the jurisdiction of the court
Date of the commission of the crime or the date as near as possible to the actual date of its 1
commission
Name or identity of the offended party 1
Civil damages suffered by the offended party 5
TOTAL SCORE 50

PART 3: TOTAL GROUP SCORE

(To be filled out by the Checker)

PARTICULARS SCORE ASSIGNED

GAINED SCORE
Score for Judicial Affidavit of 1st Arresting Police Witness 50
Score for Judicial Affidavit of 1st Arresting Police Witness 50
TOTAL GROUP SCORE 100

Checked by:

Virgil B. Vallecera

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