JUDICIAL AFFIDAVIT

REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT
NATIONAL CAPITAL JUDICIAL REGION
MAKATI CITY, BRANCH ______
__________name______________
Petitioner,

– versus –
CIVIL CASE NO. ____________
Declaration of Nullity of
Marriage
FELIX P. RIZAL
Respondent.
x———————————————x
JUDICIAL AFFIDAVIT
OF
_____________________________
This Judicial Affidavit of __________________, the Petitioner, is executed to
serve as her direct testimony in the instant case.
This Judicial Affidavit is being offered to prove:
A) All the allegations in the Petition including all annexes appended thereto and
which were already marked as exhibits during the Pre-Trial of this case;
B) All other related matters, facts and circumstances relevant and material to this
case.
This Judicial Affidavit was taken at the office of Atty. ________________ at Unit
7827, RCB Tower, 108 Legaspi St., Legaspi Village, Makati City.
Questions were propounded by Atty. ________________ and these questions
are numbered consecutively and each question is followed by the answer of the
witness.
1. Do you swear to tell the truth and nothing but the truth?

I do.

2. Are you aware that you may face criminal liability for false testimony or perjury
if you will not tell the truth?
I am.

3. Please state your name, age address and occupation?

I am ______________________, __ years old, married, and residing at

_____________, Makati City.

4. Are you the same _____________________, the Petitioner in this case?

Yes.

5. Do you know the Respondent in this case, ______________?

Yes, he is my husband.

...............

Affiant further sayeth naught.

______________________________

Affiant

SUBSCRIBED AND SWORN to before me this _______________ at

_______________, Affiant exhibiting to me her Passport bearing No.
SS12345678 issued on 8/9/12 and expiring on 8/8/17.

Doc No. ________;

Page No. _______ ;

Book No. _______;

Series of ________.

ATTESTATION
I hereby state, under oath, that I faithfully recorded the questions I asked and the
corresponding answers that the witness gave and that neither I nor any other
person present or assisting me has coached the witness regarding the latter’s
statement.
ATTY. ______________________

SUBSCRIBED AND SWORN to before me this _______________ at Makati City,

Affiant exhibiting to me his driver’s license bearing No. N11-82-030573 expiring
on 09/08/2013.

Doc No. ________;

Page No. _______ ;
Book No. _______;
Series of ________.
Copy Furnished:

Office of the City Public Prosecutor

Makati City