Sample Complaint

Republic of the Philippines
SUPREME COURT
Eighth (8th) Judicial Region
Regional Trial Court- Branch 9
Bulwagan ng Katarungan
Magsaysay Blvd., Tacloban City
JUAN de la CRUZ, CIV. NO. R-TAC-2016-0127-01

Plaintiff, For: BREACH OF CONTRACT
OF CARRIAGE WITH
DAMAGES
-versus-
PEDRO RAMOS, & VICENTE JOSE,

Defendant
x-----------------------------------------x
COMPLAINT
COMES NOW, the plaintiff thru the undersigned counsel
unto this most Honorable Court, hereby files the foregoing
complaint and avers that:
THE PARTIES
1. The Plaintiff Juan dela Cruz, is a Filipino, of legal age, single and a
resident of #115, Real St., Brgy. 34, Tacloban City. He may be served
with summonses and other court processes at his address or at the
address of the undersigned counsel;
2. Defendant Pedro Ramos is a Filipino, of legal age, single and a

resident of Brgy. Guindapunan, Palo, Leyte, while defendant
Vicente Jose is likewise of legal age, single, a resident of Brgy.
Arado, Palo, Leyte. They may be served with summonses and other
court processes at their respective addresses;
3. All the parties have the capacity to sue and be sued;
STATEMENT OF FACTS AND CAUSE OF ACTION
4. Defendant Vicente Jose is the owner of a passenger jeepney with

Plate No. HVI 1234, with route from Tacloban City downtown area
going to Phase 4 V & G Subdivision, while defendant Pedro Ramos
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is the driver of the said passenger jeepney and under the employ of
defendant Jose;
5. The Plaintiff is a 3rd Year BS Nursing student currently enrolled at

Remedios Trinidad Romualdez Medical Foundation (RTRMF). On
September 20, 2016 at about 3 o’clock in the afternoon, plaintiff was
on his way to school when he took a ride on the passenger jeepney
(HVI 1234) owned by defendant Jose and driven by defendant
Ramos. He sat at the rear portion of the jeepney near the entrance
thereof;
6. When the said passenger jeepney reached the corner near Market
Savers (corner of National Highway and Calanipawan Road), some
passenger halted the vehicle and excused themselves to alight
therefrom. However, due to the number of passengers and baggage
making it difficult to alight from the vehicle, plaintiff decided to
alight as well to make way from the other passenger;
7. However, as he was just about to step off from the platform of the
vehicle, the jeepney suddenly moved and accelerated causing the
plaintiff to fall on the ground. Because of carelessness and
negligence of defendant Ramos which led to the foregoing incident,
plaintiff suffered a fracture of the “distal third of the left tibia-fibula
with severe necrosis of the underlying skin”, as well as other serious
bruises and bodily injuries. A copy of the medical certificate of the
attending physician is hereto attached as ANNEX-“A”. Likewise, a
copy of the excerpt of the Police Blotter recorded before the
Philippine National Police- San Jose Police Station regarding the
said incident is hereto attached as ANNEX-“B”;
8. Due to the injuries suffered by the plaintiff, he was admitted at the

Remedios Trinidad Romualdez hospital for two (2) months and had
to undergo several surgeries and operation in order to repair his
broken bone and his other injuries. Because of this, plaintiff
incurred expenses in the amount of THREE HUNDRED FIFTY
THOUSAND PESOS (PHP 350, 000.00). A copy of the pertinent
receipts for plaintiff’s medication and other hospital bills are hereto
attached as ANNEX-“C AND SERIES”;
9. Because of the injuries suffered by the plaintiff due to defendants’

negligence, plaintiff was unable to attend his classes and was thus
dropped therefrom; thus, defendants should reimburse the plaintiff
in the amount of TWENTY THOUSAND PESOS (PHP 20,000.00)
2
representing his tuition and school fees for the semester. A copy of
Page
the Official Receipt issued by RTRMF to herein plaintiff is hereto
attached as ANNEX-“D”;
10. On December 01, 2016, plaintiff engaged the services of the

undersigned counsel and sent a demand letter to each of the
defendants, asking the latter to reimburse plaintiff for his medical
expenses and school fees, within a period of fifteen (15) days from
the date of receipt. A copy of the said demand letter is hereto
attached as ANNEX-E” & “F”;
11. Based on the registry return card of the Postal Office- Tacloban City,
defendants each received their respective demand letters on
December 3, 2016; thus, they had until December 18, 2016 within
which to comply with plaintiffs’ demand. A copy of the respective
registry return cards are hereto attached as ANNEX-“G” & “H”;
12. However, even up to this date defendants have not yet

communicated with the plaintiff of their desire, if there be any, to
accede to plaintiff’s demand for reimbursement;
13. Due to defendants’ refusal, to accede to plaintiff’s demands, the

latter was forced to engage the services of the undersigned counsel
for the filing of the instant case for FORTY THOUSAND PESOS
(PHP 40, 000.00) representing his retainer’s fee and TWO
THOUSAND FIVE HUNDRED PESOS (PHP 2, 500.00) as
appearance fee per hearing;
14. Plaintiff was likewise compelled to pay the amount of TWENTY

THOUSAND PESOS (PHP 20, 000.00) as docket fees for the filing
of the instant case before the Honorable Court, and would likewise
incur additional litigation expenses in the amount of TEN
THOUSAND PESOS (PHP 10, 000.00). A copy of the Official
Receipt issued by the Office of the Clerk of Court for the docket fees
is hereto attached as “I”;
15. Due to the neglect and imprudence of the defendants, plaintiff

suffered anxiety, sleepless nights, and hurt feelings, which if
monetized would be equivalent to TWENTY THOUSAND PESOS
(PHP 20, 000.00);
16. To set an example to the public so that drivers and operators alike
observe prudence in the conduct of its business and its obligations,
defendants should be made to pay to plaintiff exemplary damages
3
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in the amount of FIFTY THOUSAND PESOS (PHP 50, 000.00);

PRAYER
WHEREFORE, FOREGOING PREMISES CONSIDERED, it

is most respectfully prayed for that the instant complaint be GIVEN
DUE COURSE, and upon hearing and trial, that a Decision be
rendered in favour of the plaintiff and ORDERING the defendants
to pay the plaintiff, solidarily, the following amounts, to wit:
1. THREE HUNDRED FIFTY THOUSAND PESOS (PHP 350,

000.00) representing plaintiff’s medical and hospital
expenses;
2. TWENTY THOUSAND PESOS (PHP 20, 000.00) representing

plaintiff’s tuition and school fees;
3. FORTY THOUSAND PESOS (PHP 40, 000.00) for the

undersigned counsel’s retainer’s fee and TWO THOUSAND
FIVE HUNDRED PESOS (PHP 2, 500.00) per appearance;
4. TWENTY THOUSAND PESOS (PHP 20, 000.00) representing

the docket fees, and TEN THOUSAND PESOS (PHP 10,
000.00) as additional litigation expenses; and
5. TWENTY THOUSAND PESOS (PHP 20, 000.00) as moral

damages, and FIFTY THOUSAND PESOS (PHP 50, 000.00) as
exemplary damages;
Other reliefs just and equitable under the circumstances are

likewise prayed for.
Tacloban City, Philippines, this 27th day of January 2017.
BERNARDO, ECALDRE, IBAÑEZ, OPINIANO & SABELLANO

LAW OFFICES
Counsel for the Plaintiff
Rm. 101, 1st Floor, Law Building
DVOREF College of Law
Calanipawan Road, Brgy. 96
Tacloban City 6500
4
Page
BY:
ATTY. DONA LIZA SABELLANO

Atty’s Roll No. 51447/ May 10, 2006
PTR No. 18909595:1-04-17, Palo, Leyte
IBP No. 693095:1-04-17, Leyte Chapter
MCLE Compliance No. IV-0004453, 11-12-2014
Valid Until April 14, 2019
ATTY. SUZANNE IBAÑEZ

PTR No. 18909596:1-04-17, Palo, Leyte
ATTY. JANJAN BERNARDO

PTR No. 18909597:1-04-17, Palo, Leyte
5
Page
VERIFICATION AND CERTIFICATION OF NON-FORUM
SHOPPING
I, JUAN de la CRUZ, Filipino, of legal age, single and a
resident of #115, Real St., Brgy. 34, Tacloban City, after being sworn
according to law, hereby depose and state that:
1. I am a plaintiff in the above-stated case;
2. I caused the preparation of the foregoing complaint;
3. I have read the contents thereof and the facts stated therein
are true and correct of my personal knowledge and/or on the
basis of copies of documents and records in my possession;
4. I have not commenced any other action or proceeding

involving the same issues in the Supreme Court, the Court of
Appeals, or any other tribunal or agency and to the best of my
knowledge and belief, no such action or proceeding is
pending in the Supreme Court, the Court of Appeals, or any
other tribunal or agency; and
5. If I should thereafter learn that a similar action or proceeding

has been filed or is pending before the Supreme Court, the
Court of Appeals, or any other tribunal or agency, I undertake
to report that fact within five (5) days therefrom to this
Honorable Court.
IN WITNESS WHEREOF, I have hereunto affixed my
signature, this day of ________________, in the City of Tacloban,
Leyte, Philippines.
JUAN de la CRUZ
Complainant
Driver’s License No. H02-IV-1234567
SUBSCRIBED AND SWORN TO Before me a Notary Public

for and in the City of Tacloban, Leyte, Philippines, this day of
_________________, affiant showing his competent proof of identity
to me, exhibiting the above document, and swore before me that the
same is his voluntary act and deed. Witness my hand and seal in
the place and date above-mentioned.
ATTY. JULIET OPINIANO
NOTARY PUBLIC UNTIL 12-31-2017
Doc. No.:____; Commission No. 2016-01-10
Page No.:____; Atty’s Roll No. 51451/ 5-10-06
PTR No.18909570:1-04-17, Palo, Leyte
Book No.:____; IBP No. 693080:1-04-17, Leyte Chapter
6
Series of 2017 MCLE Compliance No. IV-0004457, 11-

Page
12-2014, valid Until April 14, 2019

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Republic of the Philippines

JUAN de la CRUZ, CIV. NO. R-TAC-2016-0127-01

PEDRO RAMOS, & VICENTE JOSE,

2. Defendant Pedro Ramos is a Filipino, of legal age, single and a

3. All the parties have the capacity to sue and be sued;

STATEMENT OF FACTS AND CAUSE OF ACTION

4. Defendant Vicente Jose is the owner of a passenger jeepney with

5. The Plaintiff is a 3rd Year BS Nursing student currently enrolled at

8. Due to the injuries suffered by the plaintiff, he was admitted at the

9. Because of the injuries suffered by the plaintiff due to defendants’

10. On December 01, 2016, plaintiff engaged the services of the

12. However, even up to this date defendants have not yet

13. Due to defendants’ refusal, to accede to plaintiff’s demands, the

14. Plaintiff was likewise compelled to pay the amount of TWENTY

15. Due to the neglect and imprudence of the defendants, plaintiff

in the amount of FIFTY THOUSAND PESOS (PHP 50, 000.00);

WHEREFORE, FOREGOING PREMISES CONSIDERED, it

1. THREE HUNDRED FIFTY THOUSAND PESOS (PHP 350,

2. TWENTY THOUSAND PESOS (PHP 20, 000.00) representing

3. FORTY THOUSAND PESOS (PHP 40, 000.00) for the

4. TWENTY THOUSAND PESOS (PHP 20, 000.00) representing

5. TWENTY THOUSAND PESOS (PHP 20, 000.00) as moral

Other reliefs just and equitable under the circumstances are

Tacloban City, Philippines, this 27th day of January 2017.

BERNARDO, ECALDRE, IBAÑEZ, OPINIANO & SABELLANO

ATTY. DONA LIZA SABELLANO

ATTY. SUZANNE IBAÑEZ

ATTY. JANJAN BERNARDO

1. I am a plaintiff in the above-stated case;

2. I caused the preparation of the foregoing complaint;

4. I have not commenced any other action or proceeding

5. If I should thereafter learn that a similar action or proceeding

SUBSCRIBED AND SWORN TO Before me a Notary Public

Series of 2017 MCLE Compliance No. IV-0004457, 11-

12-2014, valid Until April 14, 2019

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