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Form No. 1--Complaint
Affidavit for Filing of BP 22 Case
(Complaint Affidavit for Filing of BP 22 Case)
COMPLAINT-AFFIDAVIT
I,
_____________, Filipino, of legal age,
(single / married / widow), and a
resident of _____________,
Philippines, after being sworn to in accordance with law, depose and
state:
That I know
the person of __Respondent__,
who is a resident of _____________,
Philippines;
That sometime in the morning of
__date of issue__, at
__place of issue__,
Philippines, the said
__Respondent__
issued in my favor a __Name of Bank__
Check No. _____________ in
the amount of P_____________ as
supposed payment for the loan accommodation of P_____________,
which I have extended to (him/her);
That the said check is drawn against the account
of the said __Respondent__
at
__Name of Bank__ with Account
No. _____________;
That at the time the said
__Respondent__
issued the delivered the said check to me,
(he/she) made the assurance and
representation that the said check is a good check and would be
covered by sufficient funds when presented for payment;
However, when the above-mentioned check was
deposited, the same was dishonored and returned by the bank on the
ground that the same was drawn against a "CLOSED ACCOUNT." A true
and faithful machine reproduction of the said check is hereto
attached as Annex "____";
As such, I immediately notified said
__Respondent__
of the dishonor and return of the said check and demanded
from (him/her) that
(he/she) make good the said check
within _____________ (____)
days from receipt thereof. A true and faithful machine reproduction
of my demand letter to (him/her) is
hereto attached as Annex "____";
When said
__Respondent__
failed to heed my demands, I endorsed the said check to
my legal counsel who immediately sent a formal demand letter through
registered mail with return card on
_____________, which was received by the said
__Respondent__
on
_____________. As of date however,
__Respondent__
has unjustifiably ignored all these demands to pay the
said account and/or to redeem the said returned check. A true and
faithful machine reproduction of my demand letter to
(him/her) is hereto attached as
Annex "____";
I am therefore executing this Complaint-Affidavit
in support of the charges for Violation of Batas Pambansa Bilang
22 against the said
__Respondent__,
who may be served with subpoena and other processes of this
Honorable Office at (his/her) last
known address at
_____________,
Philippines;
IN WITNESS WHEREOF, I have hereunto set my
hand this _____________ at
_____________, Philippines.
COMPLAINANT
SUBSCRIBED AND SWORN to before
me this _____________ at
_____________. I hereby certify
that I have examined the Affiant and that I am fully satisfied that
(he/she) has voluntarily executed
and understood the contents of (his/her)
Complaint-Affidavit.
Administering
Officer
Form
No. 2--Complaint
for Acts of Lasciviousness
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