REPUBLIC OF THE PHILIPPINES )
CITY OF MAKATI ) S.S.
x-------------------------------------x
AFFIDAVIT OF DENIAL
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 Manila, Philippines .
____________________
Affiant
|
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.