REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF JUSTICE
OFFICE OF THE PROVINCIAL PROSECUTOR
CALAUAG, QUEZON

BENWYN B. RAÑESES
Complainant-Affiant,

-versus-
I.S. No. ____________________
For: Reckless Imprudence
Resulting to Damage to Property
Respondent.

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SWORN AFFIDAVIT

I, JOSEPH TANTEO, of legal age, Filipino citizen, with residence and postal address at
____ G. V. VERA AVE., BRGY. MAGSAYSAY, LOPEZ, QUEZON after being sworn to in
accordance with law, do hereby depose and state that:

1. I am the neighbor of the family of BENWYN B. RAÑESES who lives and

resides at 232 G. V. VERA AVE., BRGY. MAGSAYSAY, LOPEZ, QUEZON.

2. On or about eleven o’clock in the evening of December 29, 2018, while I

am in front of my bike shop in G. V. Vera Ave., Lopez, Quezon, I saw one (1) pick up
with conduction sticker ______ driven by ________ passed by my shop going inside
Magsaysay Hospital.

3. A few minutes after, I saw the same ___ pick up with conduction sticker
______ driven by ________ quickly passed by my shop coming from Magsaysay
Hospital going to the main road.

4. After I saw the pick up, I went to sleep around 12 midnight.

5. In the morning of December 30, 2018, DR. BENWYN B, RANESES,

asked me if I saw one (1) pick up which went inside Magsaysay Hospital last December
29, 2018 around 11pm.

6. I told DR. BENWYN B. RANESES that I saw one (1) ______ pick-up
with conduction sticker No. _________ driven by _______ passed by my shop going
inside Magsaysay Hospital.

7. DR. BENWYN B. RANESES told me that around 11pm one (1) pick-up
hit his Honda HRV with Conduction Sticker ________ and immediately sped away
Magsaysay Hospital. He informed me that the same pick up mentioned hit the Honda
HRV and caused damages at the ____ portion of the Honda HRV.
8. I am executing this affidavit to attest to the truth that I saw one (1) ____
pick-up with Conduction Sticker ________ driven by ________ entered the Magsaysay
Hospital around 11pm on December 29, 2018. In support of the filing the criminal
charges against __________, for RECKLESS IMPRUDENCE RESULTING TO
DAMAGE TO PROPERTY under Article 365 of the Revised Penal Code.

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 IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at
____________, Philippines.

JOSEPH TANTEO
Affiant
___________________________________

SUBSCRIBED AND SWORN to before me on the date and place above stated. I further
certify that I have personally examined the Affiant and I am satisfied that he voluntarily executed
his Affidavit and that he understood the contents of the same.

Administering Officer