SAMPLE Judicial Affidavit of Robert Oltz

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Republic of the Philippines

SUPREME COURT
MUNICIPAL TRIAL COURT IN CITIES
TANJAY CITY

PEOPLE OF THE PHILIPPINES,


Plaintiff,
-versus- CRC NO. 1313
ROBERTS OLTZ, FOR: MALICIOUS MISCHIEF
Accused.

x----------------------------------/

JUDICIAL AFFIDAVIT

I, Robert Oltz of legal age, married, Filipino and residing at Tanjay City
state under oath as follows:

PRELIMINARY STATEMENT
The person interrogating me is Atty. Cristine Joy Jagodilla with address
at Ancheta Apartment Siliman Extension Dumaguete City. The interrogation
is being held at the same address. I am answering her questions fully
conscious that I do so under oath and may face criminal liability for false
testimony and perjury.

QUESTIONS AND ANSWERS

Q1:Please state your name and personal circumstances.


A1:I am Robert Oltz
Q2: Do you know the complainant?
A2: Yes maam.They are the owner of the Toyota Hiace Commuter van
number VJ5461
Q3: Was there an instance which transpired which caused to have this
Judicial Affidavit?
A3: Yes ma’am.
Q4: When did it happen?
A4: It happen on July 15,2017

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Q5: Where did it happen?
A5:It happened at Barangay Tuigas,Tanjay City,Province of Negros Oriental.
Q6: Where had you been prior to that place.
A6: I was with my friends house, we drank an alcohol beverages at the time
in celebration for the upcoming fiesta.
Q7: Are you an habitual drinker?
A7: No maam. I only drink alcohol on occasional basis.
Q8: What happened next.
A8: At around 9oclock in the evening I decided to go home because I felt
drank.
Q9: What did you do?
A9: I went to the place where I park my car.
Q10: What is the make and model of your car?
A10: Toyota Hiace Commuter Van.
Q11: Where did you park your vehicle?
A11: It was park near the amusement area in Barangay Tugas.
Q12: What happened during that time?
A12: When I arrive at the parking lot, I saw a van that is similar to my van,
since I had several drinks I am really not feeling well at that time.
Q13: What did you do when you arrive at the car?
A13: I tried looking for the keys inside my pocket, but I failed to locate it.
Q14: What did you do?
A14: Since my headache is terrible I really wanted to go home immediately,
I had decided just to open the window using a huge stone I found nearby by
crushing the window and accessing the handle.
Q15: Then what happened next ?
A15: After I crushed the window ,someone appear beside me.
Q16: Did you know him?
A16: No maam. I just learn of his name when we are brought to the
police station for proper disposition after a certain barangay captain arrest
me.
Q17: Do you have any why they arrest you?
A17 : Not at first maam. Because I really believe at that time that I was
entering my own car.
Q18:What happened at the police station.

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A18:: I was inform maam that the car I had damaged belong to someone
else.
Q19: What did you do then?
A19: I just follow the instruction of the police officer.
Q20: Will there be anything else you want the court to know?
Q21: None maam.

Robertt Oltz
Affiant
SUBSCRIBED AND SWORN to before me this 19 th day of July 2017 in
the City of Tanjay . Affiant exhibited to me his Driver’s License No.
NO123589, issued by the Land Transportation Office in Guihulngan City on
January 1, 2017 and expiring on January 1, 2021

Atty. Jacklyn Dee


Notary Public
Tanjay City.
PTR No. 01234; 1/4/2017
IBP No. 56789; 1/4/2017
Roll of Attorneys No. 11111
MCLE Compliance No. 22222; 1/4/2017
Doc. No. 100;
Page No. 200;
Book No. 7;
Series of 2017.

ATTESTATION

I, CRISTINE JOY JAGODILLA, with address at Ancheta Apartment


Siliman Avenue Dumaguete City attest under oath as follows:

1) I personally conducted the interrogation of Robert Oltz of Tanjay City


.The accused on the criminal case no 1313 Of Metropolitan Trial Court In
Cities of Tanjay.
2) I faithfully recorded the questions I asked Robert Oltz and the
corresponding answers he gave me; and
3) Neither I nor any other person then presents coached Robert Oltz
regarding his answers.

3
CRISTINE JOY JAGODILLA
Affiant

SUBSCRIBED AND SWORN to before me this 19 th day of July 2017 in


the City of Tanjay. Affiant exhibited to me her Driver’s License No.
NO567891, issued by the Land Transportation Office in Dumaguete City on
September 14, 2016 and expiring on September 14, 2020

Atty. Jacklyn Dee


Notary Public
Tanjay City.
PTR No. 01234; 1/4/2017
IBP No. 56789; 1/4/2017
Roll of Attorneys No. 11111
MCLE Compliance No. 22222; 1/4/2017

Doc. No. 456;


Page No. 789;
Book No. 1;
Series of 2017.

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