Republic of the Philippines

DEPARTMENT OF JUSTICE
National Prosecution Office
Office of the City Prosecution
[City]

[Name] __________,
Complainant,
I.S. No. ___________

- versus - FOR: Qualified Theft punished

under Article 310 in relation to
Article 308, Revised Penal Code

[Name] __________,
Respondent.
x-------------------------------------x

COMPLAINT-AFFIDAVIT

I, [Name of Complainant], [Nationality], [Civil Status], of legal age, and with

residence address at [Residence Address], after being sworn in accordance with
law, hereby depose and state:

1. Respondent is a [Nationality], [Civil Status], of legal age, and with

residence address at [Residence Address], where he/she may be served with
the notices, orders and processes of this Honorable Office.

2. Respondent is employed at my [house/business] as [helper/

laborer/driver, etc. ] since up to the time of the incident complained of. As
such employee, respondent has access to [describe property stolen].

3. On or about [date and time of incident], respondent, with intent to

gain [and with grave abuse of discretion], without using force or violence,
willfully took possession of [object taken], without my knowledge or consent,
and against my will.

Note: Under Article 310 of the Revised Penal Code, theft is qualified if:

1. committed by a domestic servant;

2. committed with grave abuse of confidence;

3. the property stolen is a motor vehicle, mail matter, or large cattle;

4. the property stolen consists of coconuts taken from the premises of a plantation;

5. the property stolen is fish taken from a fishpond or fishery;

6. the property is taken on the occasion of fire, earthquake, typhoon, volcanic

eruption, or any other calamity, vehicular accident or civil disturbance.

Note: In theft qualified by grave abuse of confidence, there must be an allegation in the
information and proof that there existed between the offended party and the accused
such high degree of confidence or that the stolen goods have been entrusted to the
custody or vigilance of the accused.In other words, where the accused had never been
vested physical access to,or material possession of, the stolen goods, it may not be said
that he or she exploited such access or material possession thereby committing such
 grave abuse of confidence in taking the property. [see Viray vs. People, G.R. No.
205180, November 11, 2013 citing People v. Maglaya, G.R. No. L-29243, November
28, 1969]

However, theft committed by a domestic servant is always qualified, and there is no need
to prove grave abuse of confidence.

Motor vehicle includes all vehicles propelled by power, other than muscular power. This
now falls under the Anti-Carnapping Act of 1992 (R.A. No. 6539).

4. I discovered that the [property] was missing and taken by respondent

when [state circumstances and witnesses if any].

5. I am executing this Complaint-Affidavit to attest to the truth of all the

foregoing and to cause the prosecution of respondent for violation of Article
308 in relation to Article 310 of the Revised Penal Code, as amended.

IN WITNESS WHEREOF, I have hereunto set my hand this [Date] day

of [Month] [Year] in [Place].

[Name of Complainant]
Affiant

TO THE TRUTH OF THE FOREGOING, I have signed this Complaint-Affidavit on

[Date] .

[Signature]
[Name]
Complainant-Affiant

[Use the following if oath taken before the prosecutor]

CERTIFICATION

SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of [Month]

[Year].

I hereby certify that I have personally examined the affiant and am satisfied
that he voluntarily executed and understood his complaint-affidavit.

[Signature]
Investigating Prosecutor

[Use the following if oath taken before the notary public]

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public for the City of
[Place], this ____ day of [Month] [Year] at [Place], complainant exhibiting to me his
[Government issued ID] issued on [Date of issue] at [Place of issue], bearing his
photograph and signature.
 The undersigned Notary Public certifies that he personally examined the
affiant and that he is satisfied that he voluntarily executed and understood his
complaint-affidavit

Notary Public

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 20___.