Republic of the Philippines )

Quezon City ) S.S.

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AFFIDAVIT

I, ALEXANDRIA P. GONZALES, of legal age, Filipino, and a resident of 18 Oxford Brgy. E.

Rodriguez, Cubao, Quezon City, Manila, after having sworn to in accordance with law, do
hereby depose and state:

1. That on December 13, 2021, Defendant Raphaelle B. Basillio borrowed an amount EIGHT
HUNDRED FIFTY THOUSAND PESOS (Php 850, 000.00). It was agreed upon that the
principal amount of EIGHT HUNDRED FIFTY THOUSAND PESOS (Php 850,000.00) Pesos
shall be paid by the defendant on or before December 25, 2022; a copy of the Loan Agreement
dated December 13, 2021 is hereto attached as ANNEX “B”.

2. That however, despite repeated demand, defendant refused to settle her obligation after it
became due on December 25, 2022;

3. That the matter was brought before the Office of the Punong Barangay of Barangay E.
Rodriguez, Cubao, Quezon City. Nonetheless, defendant willfully failed or refused to obey
summons or to appear for hearing. Thus, a Certificate to File Action was issued on January 5,
2023, a copy of which is hereto attached as ANNEX “C”.

4. That I am executing this affidavit to attest the truth and veracity of the foregoing and for the
purpose of filing the small claims complaint against defendant Raphaelle B. Basillio

IN WITNESS WHEREOF, I have hereunto set my hand this January 8, 2023 at Quezon
City, Metro Manila.

ALEXANDRIA P. GONZALES
AFFIANT

SUBSCRIBED AND SWORN to before me, this January 8, 2023 at Quezon City.

Atty. HOBART C. CHAN

Public Attorney (Pursuant to RA 9406)
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1 A copy of the Special Power of Attorney is hereto attached as ANNEX “A”.