...REPUBLIC OF THE PHILIPPINES ) PROVINCE OF CAVITE ) S.S. MUN. OF GEN. MARIANO ALVAREZ ) AFFIDAVIT ON CAR ACCIDENT I, RODELITO VILLANUEVA MANALO, of legal age, married, and a resident of Block 41 Lot 6, Raspberry Street, Pacific Park Place Village, Dasmariñas, Cavite, after having been duly sworn in accordance with law, hereby depose and say: 1. That I am the owner of motor vehicle “2004 Toyota Vios 1.4 E/MT” with plate no. VCE225, color Red with Engine No. 2NZ-2936861 and Chassis No. MRO53HY41-09001439; 2. That the above described vehicle was being driven by me, I am a holder of Non-Professional Driver’s License #N01-97-206062 valid until 2017-05-06 issued by LTO- Dasmariñas, Cavite; 3. That today July 24, 2014 7:30am at the Parking Lot of Discovery Suit Hotel I was backing for me to park my car properly, but suddenly the Rear Left side of my Bumper bumped the post in Parking Lot resulting to damages; 4. That I understand that my vehicle as insured with Standard Insurance Co., Inc. covers damages caused by the accident as per insurance policy; 5. That I executed this Affidavit to attest to the fact of the damage sustained by my car to support my claim with the insurance company. IN WITNESS WHEREOF, I hereunto affixed my signature this 24th day of July, 2014 at Gen. Mariano Alvarez, Cavite. RODELITO VILLANUEVA MANALO ...
Words: 348 - Pages: 2
...___________________ VS. ___________________ CIVIL CASE NO. ___________________ HON. ___________________________ RTC-_______________, BRANCH ___ JUDICIAL AFFIDAVIT OF PETITIONER ___________________ I, ___________________, of legal age, married, and living at ___________________, petitioner in this case, state under oath as follows: PRELIMINARY STATEMENT The person examining me is Atty. ___________________ with address at ___________________. The examination is being held at the same address. I am answering his questions fully conscious that I do so under oath and may face criminal liability for false testimony and perjury. PURPOSE: This affidavit/testimony of petitioner ___________________ is being offered to prove that the respondent ___________________ contracted marriage twice, ___________________ on ___________________, and later with the petitioner ___________________ on ___________________ while the respondent’s previous marriage with ___________________ was still valid and has not yet legally dissolved. Petitioner will also prove that prior to her marriage with the respondent she was previously married to ___________________ on ___________________, which marriage was still valid and subsisting at the time she contracted marriage with the respondent. The petitioner’s testimony is also offered to prove the legal basis for the declaration of nullity of the petitioner’s marriage with the respondent, the same being bigamous. 1. Q. Please state...
Words: 1062 - Pages: 5
...___________________ VS. ___________________ CIVIL CASE NO. ___________________ HON. ___________________________ RTC-_______________, BRANCH ___ JUDICIAL AFFIDAVIT OF PETITIONER ___________________ I, ___________________, of legal age, married, and living at ___________________, petitioner in this case, state under oath as follows: PRELIMINARY STATEMENT The person examining me is Atty. ___________________ with address at ___________________. The examination is being held at the same address. I am answering his questions fully conscious that I do so under oath and may face criminal liability for false testimony and perjury. PURPOSE: This affidavit/testimony of petitioner ___________________ is being offered to prove that the respondent ___________________ contracted marriage twice, ___________________ on ___________________, and later with the petitioner ___________________ on ___________________ while the respondent’s previous marriage with ___________________ was still valid and has not yet legally dissolved. Petitioner will also prove that prior to her marriage with the respondent she was previously married to ___________________ on ___________________, which marriage was still valid and subsisting at the time she contracted marriage with the respondent. The petitioner’s testimony is also offered to prove the legal basis for the declaration of nullity of the petitioner’s marriage with the respondent, the same being bigamous. 1. Q. Please state...
Words: 1062 - Pages: 5
...Book)/$156(lost/damage), payable to VFS Services (USA) Inc. Prepaid Self Addressed envelope with tracking facility, should you wish your documents to be return by courier. Additional Documents Required: 10 11 If married but spouse name not endorsed in passport : Notarized Photo Copy of marriage certificate If Passport is Lost/ Damaged/ Expired for more than 6 months: “Notarized Affidavit of Lost/Damaged/Passport Expired more than Six Months” is Required. If Passport is Lost/ Damaged/ Expired for more than 3years: An Additional –Notarized- “4 Point Affidavit” is required for Applicants of HOU Jurisdiction. If Passport is expired for Less than 6 Months – a self-explanation letter is required as to “why the passport was not renewed?” If Passport is Lost: Original FIR(Police Report) is also required. If Passport is Lost/ Damaged: 7 additional copies of National Verification form with photographs. If Visa Status is Expired/Pending: “Notarized Affidavit of No Status” is required (Applicable to ATL, NYC, HOU & SFO, Not Applicable to WAS & CHI) If there is a Split in Name: “Notarized Deed poll Sworn Affidavit” If there is a Change of Name after...
Words: 774 - Pages: 4
... |Complied | |The following pertinent documents and information shall be submitted in support of Change of Business Name and Status PCAB license | | |application.(Applicant may Initially fill out the check boxes subject for final validation by PCAB/DTI-ROG pre-screener) | | |A. LEGAL |Yes |No |NA | | | | | | |1. Affidavit of Attestation / General Information (Page 3 of 17 and Page 4 of 17) |[ ] |[ ] |[ ] | |1.1 For change in address only: Business permit, or any other official document showing the | | | | |new office address of the applicant; |[ ] |[ ] |[ ] | |1.2 Certified true copy of SEC Certificate of Registration under the new / status and Articles | | | | |of Incorporation and By- laws showing that 70% of shares subscribed must belong to the ...
Words: 3660 - Pages: 15
...Republic of the Philippines ) Tacloban City ) S. S. JUDICIAL AFFIDAVIT I, XXX, of legal age, Filipino and a resident of Paseo de Legaspi, Tacloban City, after having been duly sworn to in accordance with law, hereby depose: That in accordance with A.M. No. 12-8-8-SC, which prescribes the use of judicial affidavits to serve as the direct examination testimony of a witness, on the basis of which the adverse party may conduct his cross-examination on such a witness, I hereby execute this judicial affidavit in a question and answer format; That conformably with Section 3(b) of the said A.m. No. 12-8-8-SC, I also state that it was investigator YYY of the office of the prosecutor, who conducted the examination of the undersigned affiant at Tacloban City under the supervision of XXX, also from the same office. That also pursuant with Section 3(c) thereof, I hereby state under pain of perjury that in answering the questions asked of me as appearing herein below, I was fully conscious that I did so under oath, and that I may face criminal liability for false testimony or perjury; Questions and Answers . . . Q: What is your name? A: I am XXX. Q: How old are you? A: I am 35 years of age. Q: Where do you live? A: I live at Paseo de Legaspi, Tacloban City Q: Do you swear to tell the truth, under oath, and that you may face criminal liability for falsification and perjury? A: Yes. Q: What is your purpose in coming here in my office? ...
Words: 991 - Pages: 4
...AFFIDAVIT I, ______________________________, Filipino of legal age and with principal registered clinic address at _____________________________________________________________after having duly sworn in accordance with law, do hereby depose and say that: 1. I am taxpayer registered at BIR Regional District Office No.________; 2. I am a Doctor of Dental Medicine practicing my profession in ___________________________________________________________________ 3. Pursuant to Revenue Regulation No. 4-2014 (“Guidelines and Policies for the Monitoring of Service Fees of Professionals) of the Bureau of Internal Revenue (BIR), I am formulating the following Professional Fee Menu: a) Patient Consultation Fee - PhP ______ / consultation b) Procedures PROCEDURE | PROFESSIONAL FEES * | | | | | | | | | | | | | | | | | | | | | | | * Professional fees indicated above is the commission received for every procedure which is 20% of the dental fees 4. The following are my schedule of discounts: Medical / Dental colleagues | 100% discount | Parents and parents in-law of medical / Dental colleagues | 100% discount | Children (legitimate or illegitimate) of medical / Dental colleagues | 100% discount | Legal spouse and common-law partners of medical / Dental colleagues | 100% discount | Senior Citizens | 20% discount | Persons with disability | 20% discount | Hospital co-workers...
Words: 333 - Pages: 2
...Republic of the Philippines] Province of Bohol] Municipality of Getafe] COMPLAINT-AFFIDAVIT I, GENU SOCIAS TORREFIEL, of legal age, fisherman, with postal address at Barangay Nasingin, Getafe, Bohol, after having been duly sworn on oath in accordance with law hereby voluntarily depose and say: 1. That sometime on October 17, 2011or about 4:00 P.M., Monday, October 17, 2011, I was playing basketball in the basketball court of Nasingin, Getafe, Bohol; 3. That upon arrival at the SB COA gate I noticed that there was no sentinel on the said post. I proceeded to the front gate and saw two (2) silhouttes (sentinels) posted at the lobby. Without attracting their attention I walked back to the COA gate which was ajar. I saw the motorcycle of Renato Zamboanga-Process Server of this court parked infront of the Security Office at the basement and saw SG2 Elberto Q. Bautista holding the telephne on his ears staring blankly and tinkering with the keypad of the same. He smelled of liquor /alcoholic breath. 4. That I noticed SG3 Ferdinand Gurtiza together with an unidentified female person later alleged to be the paramour of the former, also inside the security office, having a drinking spree. I smelled stench air inside the security office that I felt nauseating. Upon my cursory look at the floor, I saw two (2) empty bottles of Red horse Beer; and two (2) tin caps of Ginebra San Miguel marked LTDI. The floor is messy, and so is the middle office table...
Words: 2479 - Pages: 10
...THE PHILIPPINES } Province of Agusan del Norte }s.s. Municipality of San Miguel } AFFIDAVIT COMPLAINT of Lady Empedrad ------------------------------------------------- PRELIMINARIES: The Affiant was reminded that each question and every answer shall be submitted and can be used for and against him as a matter of right and requisites of judicial processes provided under our 1987 Constitution, such as: Investigator : You have the right to have a counsel that you can confer with and if you cannot afford the services of a lawyer, one will be provided by the government for free, that you can confer with during this investigation, do you understand this right? Affiant : Yes sir. Investigator : After knowing your right, what can you say? Affiant : I voluntarily waive my right to counsel, but submit myself for investigation and willing to give my free and voluntary statement based on my personal knowledge on the incident. Investigator : Are you still willing to give your voluntary statement under the penalty of perjury as provided under the law? Affiant : Yes sir. QUESTION AND ANSWER 1. Question : Can you state your name, address and other personal circumstances? Answer : I am Lady Empedrad 31 years old, married and a resident of Purok 1, Barangay 8, Buenavista, Agusan del Norte. 2. Question : What is your purpose in executing this affidavit? Answer : 1. To file a formal complaint for the case of Violation of Art. 315 of Revised...
Words: 1863 - Pages: 8
...UNCLASSIFIED SECURITY BULLETIN SECURITY BULLETIN Office of the Assistant Secretary of Defense – Reserve Affairs Employer Support of the Guard and Reserve (ESGR) 1555 Wilson Blvd., Suite 200 Arlington, VA 22209 (703) 696-1171 x 548 Robert Tizon, Force Protection Officer roberto.tizon@osd.mil October 27, 2011 Photocopying of Military Identification Cards Recent incidents regarding the photocopying of military identification cards and common access cards (CAC), by commercial establishments to verify military affiliation or provide government rates for service, have been reported. Personnel are reminded that the photocopying of US Government Identification is a violation of Title 18, US Code Part I, Chapter 33, Section 701 and punishable by both fine and/or imprisonment. Many military members, family members and DoD employees are unaware of this law. Please pass to the lowest level and include in training for force protection, information security and OPSEC. FPO COMMENTS: Criminal elements and terrorist organizations place U.S. government identifications as a high value logistical element when planning acts against the U.S. military. Although commercial establishments are not prohibited from asking for military/government identification, many government personnel and commercial establishments are unaware of the prohibition on duplication of government identification. Unfortunately...
Words: 320 - Pages: 2
...iSINUMPAANG SALAYSAY Ako, _____________________, nasa hustong gulang, naninirahan sa Unit C, 48-E, Philand Drive, Philand Village, Brgy. Pasong Tamo, Quezon City (unang panig). -at- Ako, _____________________, nasa hustong gulang, may-asawa, naninirahan sa Brgy. Suklayin, Baler, Aurora (ikalawang panig) ay nagsasaad ng mga sumusunod: 1. Na noong ika 6 ng Oktubre taong 2013 humigit kumulang ganap na ika-12:48 ng tanghali ay nagkaroon ng aksidente sa pagitan ng unang panig at ikalawang panig; 2. Na habang binabagtas ng unang panig ang kahabaan ng Recto Street gamit ang sasakyan nito, HONDA CITY may plaka bilang UQS 150, ay nasagi ng isang tricycle, na minamaneho ng ikalawang panig, may plaka bilang 6151OH; 3. Na ang ikalawang panig bilang namamasada lamang ng tricycle at wala nang iba pang pinagkakakitaan ay walang kakayahang magbayad ng mga pinsala na sanhi ng aksidente; 4. Na ang saksakyan ng unang panig ay mayroong comprehensive insurance mula sa Malayan Insurance (Philippines); 5. Na dahil dito, ang unang panig ay nagdesisyon na lamang na gamitin ang nasabing insurance upang maipaayos ang kanyang sasakyan; 6. Na ang unang panig na lamang ang sasagot sa lahat ng participation fees na maaaring pababayaran ng Malayan Insurance. KUSANG LOOB NAMING IGINUHIT ANG AMING LAGDA SA DOKUMENTONG ITO ngayong ika-6 ng Oktubre, taong 2013 dito sa Baler, Aurora. JULIET ROSE T. IGNACIOUnang PanigDriver’s Lic#N02-12-014438Valid until 2014-11-24 | EDDIEMAR...
Words: 270 - Pages: 2
...REPUBLIC OF THE PHILIPPINES REGIONAL TRIAL COURT NATIONAL CAPITAL REGION BRANCH 245, PASIG CITY PEOPLE OF THE PHILIPPINES Plaintiff. -versus- CRIM CASE NO. 111222-33-44-GG FOR: THEFT BOB ONG Accused. X------------------------------------------- X JUDICIAL AFFIDAVIT I, POL G. MEDINA, Filipino of legal age, married and with address at 1224 PugadBaboy St. San Andrews, Manila, after having been duly sworn in accordance with law, do hereby depose and state that: Question No. 1 (“Q1”): What is your current profession? Answer (“A”): I am currently a barangay tanod in our barangay. Q2: Where is your barangay? A: It is in PugadBaboy St. San Andrews, Manila Q3: How long have you been a barangay tanod? A: I have been a tanod for 2 years now. Q4: What are the principal duties of your profession? A: My responsibility includes keeping the security of our barangay, traffic control, making arrests if there is a crime happening and there are no police to make the arrest. Q5: Where you the one who arrested the suspect BOB ONG? A: Yes, me and some of the tanods as well Q6: What day was this? A: Sunday, January 5, 2013 Q7: At what time did you make the arrest? A: It was 2:00 in the morning Q8: Are you sure? A: Yes Q9: How can you be sure? A: I looked at my wristwatch, and because I studied law and it taught me that whenever you make arrests, you should...
Words: 955 - Pages: 4
...REPUBLIC OF THE PHILIPPINES FIRST JUDICIAL REGION MUNICIPAL TRIAL COURT IN CITIES Alaminos City, Pangasinan PEOPLE OF THE PHILIPPINES, Plaintiff, -versus- Criminal Case No. _____ BILLY MENDEZ and ISAGANI MENDEZ, Accused. x---------------------------------x PANGHUKUMANG SINUMPAANG SALAYSAY Ang nasasakdal, ay gumagalang na isumiti sa Hukumang ito ang Pang-hukumang Sinumpaang Salaysay ni ISAGANI MENDEZ, sa pamamagitan ng pagtanong ni Atty. Philip N. Humilde at pagsagot ni Billy Mendez na naganap sa opisina ng naturang abogado sa Sadsaran, Poblacion, Alaminos City, Pangasinan, para sa mga sumusunod na purpose: 1. Para sa kanyang testimonya na kaugnay ng kasong ito, 2. Para ilahad ang tunay na pangyayari na naganap noong Disyembre 27, 2012, 3. Para patunayan na wala siyang kasalanan at hindi niya sinaktan si Romeo Calpo, at 4. Para patunayan ang iba pang mahahalagang allegasiyon sa kasong ito. PAGKATAPOS MANUMPA, ayon sa batas, ito ang masasabi ng testigo: 1. T.Para sa record, maari mo bang sabihin ang iyong pangalan, tirahan, edad, estado at trabaho. S. Ako po si ISAGANI MENDEZ, nasa wastong edad, walang trabaho, at kasalukuyang nakatira sa Barangay Mona, Alaminos City, Pangasinan. 2. T. Sa pagsagot ng mga tanong na itatanung ko sayo, alam mo ba na ikaw sumusumpa na naayon sa batas na pawang katotohanan lamang ang iyong sasabihin at kung ikaw ay magsinungaling ikaw ay maaring sampahan ng kaukulang kaso ng pagsisinungaling sa...
Words: 788 - Pages: 4
...Affidavit I am a witness for The Gilded Age. The time period of the Gilded Age was roughly around when the Civil War ended right up to when World War II commenced. This period was marked in American history by the massive growth of industry. The iron and steel industry grew dramatically and there was an increased demand for western resources such as lumber, gold, and silver due to the fact that it improved transportation. Railroad development dramatically grew, as trains were needed to move goods from the west to the east. This was Cornelius Vanderbilt’s area of expertise. John D Rockefeller was the founder of the Standard Oil Company, whereas Andrew Carnegie built a Steel Empire from the ground up. However all of these so-called, “geniuses” were robber barons, because they ridiculously rich through their ruthless business deals. The Gilded Age was exactly what the name means; having a pleasing or showy appearance that in all reality conceals something of little worth. Although everything seemed glitzy and glamorous on the outside that was not how it truly was. In 1890, 11 million of the nation’s 12 million families earned less the $1200 a year. From this, the average annual income was only $380, which was well below the poverty line. Many Americans and new immigrants crowded into urban areas, causing them to be teeming with crime and filth. Andrew Carnegie was the creator of the Steel Empire and is considered a Robber Baron because he rose to the top...
Words: 629 - Pages: 3
...Running head: THE ASSASSINATION OF MALCOLM X The Assassination of Malcolm X Kirston Gardner University of Phoenix HIS/145 Carole Lormand September 10, 2013 The Assassination of Malcolm X On February 21, 1965, I was among the 400 Negroes that gathered in the Audubon Ballroom at 166th Street and Broadway in Harlem to attend a regular Sunday affair of Malcolm’s Organization of Afro-American Unity. Being that Malcolm’s movement emphasized self-defense, there was no search of anyone at the rally. The rally had been scheduled for 2:30pm. It was to be held in the second-floor hall of the two-story building. I arrived early in hopes that Malcolm would name the men who fire bombed his home last Sunday. There were 400 wooden folding chairs set up with two aisles going down the side but no center aisle. There was a restful country scene mural at the back of the stage. I sat in the 12th row and waited with anticipation. The speaker that spoke prior to Malcolm X stated that: “Malcolm X is a man who would give his life for you.” As Malcolm stepped up to the flimsy plywood lectern he gave the traditional Arabic greeting, “Salaam Aleikum,” which meant peace be unto you. We responded, “Aleikum Salaam.” Malcolm proceeded to say, “Brothers and sisters…” then he was interrupted. About four rows up was a disturbance. Two men jumped to their feet, one yelling at the other: “Get your hands off my pockets, do not be messing with my pockets.” Malcolm’s bodyguards hurriedly moved toward...
Words: 837 - Pages: 4
