City of San Jose del monte ) S.S.

Sinumpaang Salaysay

I, ________, Filipino, of legal age, and with residence at CSJDM Bulacan, after having
been duly sworn in accordance with law, hereby depose and state that:
a. On January 14, 2022, around 10:00 P.M., I was at accused house located at CSJDM,
where I am temporarily residing while waiting for the results of my board exam.
b. We drink beer because it was my birthday. After consuming two large bottles of Red
Horse beer together, I felt dizzy and sleepy.
c. Accused allowed me to lie down on his "papag" (wooden bed), where I fell asleep.
d. I was awakened when I felt someone on top of me, who turned out to be the accused.
e. I struggled to get up from the "papag" and from the hold of accused, but the latter held
her hands and pinned down my feet with his thighs.
f. I could not shout as I am so weak. Accused then pulled down my shorts and panty, and
spread my legs. Thereupon, accused inserted his penis into my vagina, which caused my
pain. Then, I passed out.
g. When I woke up the following day, I saw the naked accused lying beside me. I was
trembling and felt that my private part was swollen. I took a bath, got my things, went to
my grandmother's office and told her the incident.
h. My grandmother asked a jail officer to accompany me to the police station.

IN WITNESS WHEREOF, I have hereunto set my hand this 15 th day of January 2022,
in CSDJM, Bulacan

Affiant