REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

9th JUDICIAL REGION
PAGADIAN CITY

JUANA DELA CRUZ CIVIL CASE NO. 12345

Petitioner,
FOR
– versus –

DECLARATION OF NULLITY
OF MARRIAGE

JUAN DELA CRUZ

Respondent.

x———————————————x

JUDICIAL AFFIDAVIT OF JUANA DELA CRUZ

This Judicial Affidavit of JUANA DELA CRUZ, the Petitioner, is executed to serve as
her direct testimony in the instant case.

This Judicial Affidavit is being offered to prove:

A) All the allegations in the Petition including all annexes appended thereto and

which were already marked as exhibits during the Pre-Trial of this case;
B) All other related matters, facts and circumstances relevant and material to
this case.

This Judicial Affidavit was taken at the office of Atty. Notariana Grande at Unit 7827,
RCB Tower, 108 Legaspi St., Legaspi Village, Pagadian City.

Questions were propounded by Atty. Grande and these questions are numbered
consecutively and each question is followed by the answer of the witness.

1. Do you swear to tell the truth and nothing but the truth?

  I do.

2. Are you aware that you may face criminal liability for false testimony or
perjury if you will not tell the truth?

I am.
 3. Please state your name, age address and occupation?

I am Juana Dela Cruz, 39 years old, married, and residing at Barangay Sto.
Niño, Pagadian City.

4. Are you the same Juana Dela Cruz, the Petitioner in this case?

Yes.

5. Do you know the Respondent in this case, Mr. Juan Dela Cruz?

Yes, he is my husband.

...............

Affiant further sayeth naught.

JUANA DELA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me this 10 th day of June 2022 at Pagadian City,
Affiant exhibiting to me her Passport bearing No. SS12345678 issued on 8/9/19 and
expiring on 8/8/29.

Doc No. ________;

Page No. _______ ;
Book No. _______;
Series of ________.

ATTESTATION

I hereby state, under oath, that I faithfully recorded the questions I asked and the
corresponding answers that the witness gave and that neither I nor any other
person present or assisting me has coached the witness regarding the latter’s
statement.

ATTY. NOTARIANA GRANDE

Notary Public for Pagadian City
Appointment No. 123
Until December 31, 2022
Roll No. 123456789
IBP No. 12345/Jan. 20xx/Pagadian City
PTR No. 12345/Jan. 20xx/Pagadian City
MCLE No. I – 001234; 09/09/20xx