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    Affidavit of Denial Sample

    CITY OF MAKATI                       ) S.S.


    I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state:

    1. That I was born on ________________ in __________________________;

    2. That I established my permanent residence in __________________, Philippines;

    3. That on ___________________, I applied for a Record Clearance from the National Bureau of Investigation;

    4. That I received an information from the National Bureau of Investigation on ______________ that my namesake, a certain _______________________, has a pending criminal case for Attempted Homicide docketed as Criminal Case No. 1234 pending before Branch 67 of the Metropolitan Trial Court of Quezon City;

    5. That I hereby unequivocally deny involvement in the aforementioned case;

    6. That I also declare under oath that I am not in any way involved in any case proceeding as either plaintiff/complainant or defendant/accused in the Philippines and abroad, specifically with regard to the aforementioned case;

    7. That I have been employed or residing in Hong Kong for ________ years to this date;

    8.That ___________________________________________________ (cite other proof/s or reason/s to substantiate your claim that you are not involved in the aforementioned case/s, if any); and

    9. That I am executing this Affidavit to attest to the foregoing facts and to deny absolutely and entirely any involvement in the case/s aforementioned and for all legal intents and purposes.

    IN WITNESS WHEREOF, I hereby affixed my signature this ___________________ in Makati City, Metro ManilaPhilippines.


    SUBCRIBED AND SWORN TO before me this _____________ in ______________Philippines, affiant exhibiting to me his/her competent evidence of identity by way of ______________ issued at _____________ on ______________.
    Doc. No. _____;
    Page No. _____;
    Book No. _____;
    Series of 2013.

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