Sample Affidavit Money Claim 3e6j5h
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Republic of the Philippines REGIONAL TRIAL COURT 11th Judicial Region Branch ___ Davao City Rene C. Rodrigo, Plaintiff, - versus – Maria T. Oxillo, Defendant. x- - - - - - - - - - - - - - - - - - - - - - - x
CIVIL CASE No. _______________
FOR: Money Claim, Moral damages and Attorney’s Fees. COMPLAINT COMES NOW, plaintiff, Rene C. Rodrigo, by counsel, and unto this Honorable Court, most respectfully avers THAT: 1. Plaintiff is a Filipino, of legal age, married, and residing at Phase II, Ledesma Subdivision, Davao City, where he may be served with summons, papers and other process of this Honorable Court. 2. Defendant Maria T. Oxillo is a Filipino, of legal age, widow, and residing at Upper Ledesma Subdivision, where he may be served with summons, papers and other process of this Honorable Court. 3. On November 21, 2012, Defendant obtained a loan of money amounting to THIRTY THOUSAND PESOS (P 30,000) with the interest of 10% per month payable in 15 months from the time the money was loaned. 12. At about April 21, 2013 and May 5, 2013, Defendant loaned another sum of money amounting to FIVE HUNDRED PESOS (P500) and THREE HUNDRED PESOS (P300) respectively 13. In driving back from the beach, Aurelio Laxa lost control of the vehicle while negotiating a curve causing it to turn turtle resulting in the death of one of its engers Romeo Tuadles. 14.
A demand letter for indemnification for damages was by plaintiff to defendants.
15. Defendant Bonifacio Cruz promptly denied liability for reason that his vehicle was used and driven without his knowledge and consent by Aurelio Tuadles at the time of the accident. 16. As a result of the death of Romeo Tuadles, his family is in financial difficulties because they depend on him as a sole wage earner in the family. Hence, they must be made to pay for damages for the death of Romeo Tuadles, in the amount equivalent to FIVE HUNDRED THROUSAND PESOS (P 500,000.00).
17. Due to the sudden death of Romeo Tuadles, his wife and children suffered mental anguish and serious anxiety. 18. Consequently, Plaintiff was constrained to engage the services of counsel to whom it obligated itself to pay as Attorney's Fees the amount equivalent to TWENTY FIVE PERCENT (25%) of the total amount to be adjudged in favor of plaintiffs, and the costs of this suit. PRAYER WHEREFORE, the above premises considered, it is respectfully prayed of this Honorable Court after hearing on the merits, that: a. Defendants be ordered to pay for damages for death in the amount of FIVE HUNDRED THROUSAND PESOS. b. Defendants be ordered to pay moral damages in the amount of FIVE HUNDRED THOUSAND PESOS (Php 500,000.00); c. Defendants be ordered to pay attorney’s fees in an amount equivalent to TWENTY FIVE PERCENT (25%) of the total amount to be adjudged in favor of plaintiffs; d.
Defendants be ordered to pay the costs of this suit.
Other reliefs just and equitable under the premises are likewise prayed for. For the Plaintiff By BALDONADO, GOGO, ROBLEDO & TORRES LAW OFFICE Counsel for the Plaintiff 7th floor, Pryce Tower, Bajada, Davao City 221-2121/22 ATTY. KATHY FLORENCE BALDONADO
ATTY. FORCRISSA GOGO
PTR No. 95784/11.29.11/Davao City
PTR No. 87541/12.21.11/Davao City
IBP No. 86984/12.15.11/Davao City
IBP No. 92175/12.21.11/Davao City
Roll No. 10214/ TIN- 111-187-521
Roll No. 9195/ TIN- 245-187-254
MCLE No. III-000231/10.15.11
MCLE No. III-0002451/10.12.11
ATTY. MICHAEL ROBLEDO
ATTY. EDGAR TORRES
PTR No. 95478/11.26.11/Davao City
PTR No. 6547/11.21.11/Davao City
IBP No. 89787/12.2.11/Davao City
IBP No. 98748/12.5.11/Davao City
Roll No. 9594/ TIN- 284-127-324
Roll No. 10214/ TIN- 115-254-249
MCLE No. III-00042154/11.5.11
MCLE No. III-0001145/10.24.11
Republic of the Philippines
)
Davao City
)s.s
x- - - - - - - - - - - - - - - - - - - - - - - -x VERIFICATION AND CERTIFICATION AGAINST FORUM-SHOPPING I Fe Tuadles, Filipino, of legal age, married and a resident of residing at 32E Jacinto St., Davao City, after having been duly sworn to in accordance with law depose and say, THAT: That I am the Plaintiff in the above-entitled case; That I have caused the preparation of the above Complaint and I have read the same and knows the contents thereof; That the allegations contained therein are true and correct of my own personal knowledge. IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of January, 2012 at Davao City, Philippines. Fe Tuadles Plaintiff SUBSCRIBED AND SWORN to before me this 23rd day of January, 2012, by Fe Tuadles, who exhibited to me her Voter’s ID No. 12345 issued at Davao City, Philippines on May 12, 2005. WITNESS MY HAND AND SEAL.
Atty. Forcrissa Gogo Doc No. _________
Notary Public until December 2012
Page No. ________
PTR No. 87541/12.21.11/Davao City
Book No. ________
IBP No. 92175/12.21.11/Davao City
Series of 2012
Roll No. 9195/ TIN- 245-187-254 MCLE No. III-0002451/10.12.11
CIVIL CASE No. _______________
FOR: Money Claim, Moral damages and Attorney’s Fees. COMPLAINT COMES NOW, plaintiff, Rene C. Rodrigo, by counsel, and unto this Honorable Court, most respectfully avers THAT: 1. Plaintiff is a Filipino, of legal age, married, and residing at Phase II, Ledesma Subdivision, Davao City, where he may be served with summons, papers and other process of this Honorable Court. 2. Defendant Maria T. Oxillo is a Filipino, of legal age, widow, and residing at Upper Ledesma Subdivision, where he may be served with summons, papers and other process of this Honorable Court. 3. On November 21, 2012, Defendant obtained a loan of money amounting to THIRTY THOUSAND PESOS (P 30,000) with the interest of 10% per month payable in 15 months from the time the money was loaned. 12. At about April 21, 2013 and May 5, 2013, Defendant loaned another sum of money amounting to FIVE HUNDRED PESOS (P500) and THREE HUNDRED PESOS (P300) respectively 13. In driving back from the beach, Aurelio Laxa lost control of the vehicle while negotiating a curve causing it to turn turtle resulting in the death of one of its engers Romeo Tuadles. 14.
A demand letter for indemnification for damages was by plaintiff to defendants.
15. Defendant Bonifacio Cruz promptly denied liability for reason that his vehicle was used and driven without his knowledge and consent by Aurelio Tuadles at the time of the accident. 16. As a result of the death of Romeo Tuadles, his family is in financial difficulties because they depend on him as a sole wage earner in the family. Hence, they must be made to pay for damages for the death of Romeo Tuadles, in the amount equivalent to FIVE HUNDRED THROUSAND PESOS (P 500,000.00).
17. Due to the sudden death of Romeo Tuadles, his wife and children suffered mental anguish and serious anxiety. 18. Consequently, Plaintiff was constrained to engage the services of counsel to whom it obligated itself to pay as Attorney's Fees the amount equivalent to TWENTY FIVE PERCENT (25%) of the total amount to be adjudged in favor of plaintiffs, and the costs of this suit. PRAYER WHEREFORE, the above premises considered, it is respectfully prayed of this Honorable Court after hearing on the merits, that: a. Defendants be ordered to pay for damages for death in the amount of FIVE HUNDRED THROUSAND PESOS. b. Defendants be ordered to pay moral damages in the amount of FIVE HUNDRED THOUSAND PESOS (Php 500,000.00); c. Defendants be ordered to pay attorney’s fees in an amount equivalent to TWENTY FIVE PERCENT (25%) of the total amount to be adjudged in favor of plaintiffs; d.
Defendants be ordered to pay the costs of this suit.
Other reliefs just and equitable under the premises are likewise prayed for. For the Plaintiff By BALDONADO, GOGO, ROBLEDO & TORRES LAW OFFICE Counsel for the Plaintiff 7th floor, Pryce Tower, Bajada, Davao City 221-2121/22 ATTY. KATHY FLORENCE BALDONADO
ATTY. FORCRISSA GOGO
PTR No. 95784/11.29.11/Davao City
PTR No. 87541/12.21.11/Davao City
IBP No. 86984/12.15.11/Davao City
IBP No. 92175/12.21.11/Davao City
Roll No. 10214/ TIN- 111-187-521
Roll No. 9195/ TIN- 245-187-254
MCLE No. III-000231/10.15.11
MCLE No. III-0002451/10.12.11
ATTY. MICHAEL ROBLEDO
ATTY. EDGAR TORRES
PTR No. 95478/11.26.11/Davao City
PTR No. 6547/11.21.11/Davao City
IBP No. 89787/12.2.11/Davao City
IBP No. 98748/12.5.11/Davao City
Roll No. 9594/ TIN- 284-127-324
Roll No. 10214/ TIN- 115-254-249
MCLE No. III-00042154/11.5.11
MCLE No. III-0001145/10.24.11
Republic of the Philippines
)
Davao City
)s.s
x- - - - - - - - - - - - - - - - - - - - - - - -x VERIFICATION AND CERTIFICATION AGAINST FORUM-SHOPPING I Fe Tuadles, Filipino, of legal age, married and a resident of residing at 32E Jacinto St., Davao City, after having been duly sworn to in accordance with law depose and say, THAT: That I am the Plaintiff in the above-entitled case; That I have caused the preparation of the above Complaint and I have read the same and knows the contents thereof; That the allegations contained therein are true and correct of my own personal knowledge. IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of January, 2012 at Davao City, Philippines. Fe Tuadles Plaintiff SUBSCRIBED AND SWORN to before me this 23rd day of January, 2012, by Fe Tuadles, who exhibited to me her Voter’s ID No. 12345 issued at Davao City, Philippines on May 12, 2005. WITNESS MY HAND AND SEAL.
Atty. Forcrissa Gogo Doc No. _________
Notary Public until December 2012
Page No. ________
PTR No. 87541/12.21.11/Davao City
Book No. ________
IBP No. 92175/12.21.11/Davao City
Series of 2012
Roll No. 9195/ TIN- 245-187-254 MCLE No. III-0002451/10.12.11
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