Republic of the Philippines)

Province of _________________)S.S.
City/Municipality of ____________) 
x - - - - - - - - - x

AFFIDAVIT OF DENIAL

I,_____________, Filipino, of legal age,(single /

married / widow), and as resident of____________,
Philippines, having been duly sworn in accordance
with law, hereby depose and state:

That I am NOT the same person as

one____________a.k.a.__________who was charged under
I.S. No._____________/ Criminal Case
No._____________before the___________for the crime
of___________;

That I have never been the subject of any criminal

complaint, charge or proceeding before any prosecutor
or court;

As such, I am executing this Affidavit to certify or

attest to the truth of the foregoing facts and for
purpose of denying that I am the _____________ who is
the subject of the aforementioned case and for
whatever legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, we have set our hands

this__________, in the City of____________,
Philippines.