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Sample Affidavit of Complaint Format

Pepe Smith filed a complaint against Derek Ramos for unlawful detainer in the Municipal Trial Court of Iba, Zambales, Philippines. Pepe alleges that Derek agreed to rent Pepe's house for 5,000 PHP per month without a written contract. Derek failed to pay rent starting in June 2018 and converted the house into a bar. Pepe suffered psychological and medical damages as a result. Pepe is seeking 500,000 PHP for house restoration costs, 500,000 PHP for medical bills, moral damages, attorney's fees, and the eviction of Derek from the property. Pepe executed this affidavit on September 16, 2019 to support his legal claim.

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ManuelMarasiganMismanos
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827 views3 pages

Sample Affidavit of Complaint Format

Pepe Smith filed a complaint against Derek Ramos for unlawful detainer in the Municipal Trial Court of Iba, Zambales, Philippines. Pepe alleges that Derek agreed to rent Pepe's house for 5,000 PHP per month without a written contract. Derek failed to pay rent starting in June 2018 and converted the house into a bar. Pepe suffered psychological and medical damages as a result. Pepe is seeking 500,000 PHP for house restoration costs, 500,000 PHP for medical bills, moral damages, attorney's fees, and the eviction of Derek from the property. Pepe executed this affidavit on September 16, 2019 to support his legal claim.

Uploaded by

ManuelMarasiganMismanos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Justice
Municipal Trial Court
Iba, Zambales

Pepe Smith
Complainant,

-versus- Case No. _____


For: Parricide

Derek Ramos
Respondent.
x-------------------------------------x

COMPLAINT - AFFIDAVIT

The UNDERSIGNED, Pepe Smith, accuses Derek Ramos, of


Unlawful Detainer, committed as follows, to wit:

That starting June 11, 2018, in the residence for lease at No. 2
Bagumbayan, Iba Zambales, Philippines, the respondent Derek Ra
mos failed to pay the monthly rental amounting to P5,000/Month t
hat was agreed verbally. The facts of the incident are narrated as fo
llows:

1. That I, PEPE SMITH, the undersigned complainant, Filipi


no and of legal age, residing at No. 1 Bagumbayan, Iba, Za
mbales, Philippines.;
2. That the respondent, Filipino and of legal age, Brother in L
aw of the Complainant, residing at No. 2 Bagumbayan, Ib
a, Zambales, Philippines;

3. That Derek Ramos agreed to lease the house of Mr. Pepe S


Mith for residential purposes for Php5,000.00/Mo without
any written agreement;

4. That the respondent failed to pay the rent starting June 11,
2018 also remodeled and converted the house into a bar;

5. That the complainant suffered psychologically, social dam


ages and suffered heart attack upon knowing that his hous
e was converted into a bar;

6. That the amount required for the restoration of the house t


o its former condition is P500,000,The amount of the comp
lainants hospital bill totaled to P500,000, Moral damages a
nd Attorneys fee shall be paid also by the respondent;

7. That due my Health condition (complainant), I am appoin


ting Ms. Myra E as my representative.;

8. In view of the foregoing, I am executing this affidavit to su


pport my Legal claim for Moral and Actual damages also t
he eviction of the respondent DEREK RAMOS as soon as
possible.

IN WITNESS WHEREOF, I have hereunto set my hand this S


eptember 16, 2019 at Iba, Zambales, Philippines.

PEPE SMITH
Complainant
SUBSCRIBED AND SWORN to before me this September 16, 2019
at Iba, Zambales. I hereby certify that I have examined the Affiant
and that I am fully satisfied that she has voluntarily executed and
understood the contents of her Complaint-Affidavit.

Manuel M Mismanos Jr.


Assistant City Prosecutor
MCLE Compliance No. VI-0001807
March 27, 2017

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