Republic of the Philippines

OFFICE OF THE NCIP

REGIONAL OFFICE VI

CASE NO.___________
Complainant,

-versus- FOR:

Respondents.
x-----------------------------------------------------x

COMPLAINT

COMES NOW, the complainant,and most respectfully avers:

1. That the complainant, _____________________, _____ years of age, Filipino, single and a
resident of ________________;

2. That the respondent _________ is of legal age, Filipino, and residents of

________________________;

3. That the complainant is a member of ___________________ and

particularly_________________ and that filing of this complaint is in representation of
Indigenous People;

4. That the respondent made a defamatory statement against the Indigenous People
particularly ATI ethnic group, accusing of receiving money during the election. This
statement is posted in social media last May 5, 2021 that mocked, disrespect and put into
the ridicule the Indigenous People because of his sweeping statement that affects the
integrity and negative impression to the Indigenous People.

Attached hereto as “Annex A”- the screen shot of the posted statement in the
Facebook.

22. That base on facts and circumstances stated above, I _______________________________________

as a resident and member of the community of Barangay Hilwan Calinog, Iloilo is formally
charging crimanal and administrative complaint against former Barangay Officials;
 22.1 Criminal Complaint for violation of Section 3, paragraphs (e) and (f) of RA
3019, as amended otherwise known as “The Anti-Graft and Corrupt Practices Act;
violation of Section 4 paragraphs (a), (b) and (c) of RA 6713 otherwise known as the
"Code of Conduct and Ethical Standards for Public Officials and Employees;
Malversation of public funds or property provided under Art. 217 of the Revised
Penal Code (RPC); Illegal use of public funds or property under Art. 220 of the RPC;
and Falsification of public documents under Art. 171 of RPC.

22.2. Administrative Complaint for the acts or omissions of the above barangay
officials constituting: Dishonesty; Neglect of duty; Misconduct; Falsification of public
documents; and Conduct prejudicial to the best interest of public service which are
provided under Section 46, Book V, Title I, Chapter 7 of Executive Order No. 292
otherwise known as the Administrative Code of 1987.

CONTRARY TO LAW

City of Iloilo, Philippines, July ______ 2019.

Complainant

SUBSCRIBED AND SWORN TO before me this _____day of July, 2019 at Iloilo City, and I
HEREBY certify that I have personally examined the above Complainant and that I am fully
satisfied that he voluntarily and of his own free will executed his Complaint-Affidavit and
understood the same.

____________________________

Doc. No.:________
Page No.:________
Book No.:_______
Series of 2019.

VERIFICATION & CERTIFICATION OF

NON-FORUM SHOPPING

I, __________________, _______ years of age, Filipino, maaried and a resident of

______________________, after having been duly sworn in accordance with the law hereby
depose and state:

1. That I am the Complainant in this case and that I have caused the preparation
of the same Complaint-Affidavit;
 2. That I attest to the truth of all the allegations in the same Complaint-Affidavit
of my own personal knowledge;

3. That I have read all the contents thereof;

4. That the allegations contained therein are true and correct of my personal
knowledge;

5. That I have not commenced any other action or proceeding involving the
same issues or matter in any court, tribunal or quasi-judicial agency and, to
the best of my knowledge, no such action or proceeding is pending therein;

6. That if I should thereafter learn that the same or similar action or proceeding
has been filed before the Supreme Court, Court of Appeals, or any other
tribunal or quasi-judicial agency, I undertake to report such within five (5)
days therefrom to the court wherein the original pleading and sworn
certification contemplated therein have been filed.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of July, 2019 in
the City of Iloilo, Philippines.

AFFIANT

SUBSCRIBED AND SWORN to before me this __day of July, 2019 at Iloilo City
Philippines, by Affiant who exhibited her competent evidence of identity bearing her
signature the specifics of which are indicated below her name.

________________________________________________

Doc. No.:________
Page No.:________
Book No.:_______
Series of 2019.