Complaint Affidavit
Complaint Affidavit
Complaint Affidavit
I, KRUL ACOSTA, of legal age, Filipino citizen, single and resident of 123
Benitez Street, Manila, after having been duly sworn to in accord Nance with law do
hereby depose and say:
1. That I am the plaintiff in the above-entitled case;
2. That I have caused the preparation of the foregoing complaint and have read
the allegations contained therein;
3. The allegations in the said complaint are true and correct of my own
knowledge and authentic records; 4. I hereby certify that I have not commenced any
other action or proceeding involving the same issues in any court, tribunal or quasi-
judicial agency and, to the best of my knowledge, no such other action or claim is
pending therein;
5. That if I should learn thereafter that a similar action or proceeding has been
filed or is pending, I hereby undertake to report that fact within five (5) days therefrom to
the court or agency where the original pleading and sworn certification contemplated
herein have been filed;
6. I executed this verification/certification to attest to the truth of the foregoing
facts and to comply with the provisions of Adm. Circular No. 04-94 of the Honorable
Supreme Court. IN WITNESS WHEREOF, I have hereunto affixed my signature
this 24th of September 2012, in the City of Manila.
KRUL ACOSTA
SUBSCRIBED AND SWORN to before me this _______ day of September,
2012, in the City of Manila, affiant exhibiting to me his Driver’s License No. 12345 issued
by the Land Transportation Office on April 8, 2012 at the City of Manila.
ATTY. NO CASE
Notary Public
My Commission Expires Dec. 31, 2012
Roll of Attorney No. 34567
IBP No. 12345/2-5-12/Manila
PTR No. 87654/12-22-11/Manila