Monday, November 16, 2015
City of Mandaue ) S.S.
AFFIDAVIT OF DENIAL
I, MEDIO Y. SUERTE, of legal age, Filipino, married, and a resident of Cabangcalan, Mandaue City, Cebu, Philippines, after being sworn to in accordance with law, depose and state - THAT:
1. I am applying for a Philippine Passport and one of the requirements is to submit a clearance from the National Bureau of Investigation (NBI);
2. To comply with this requirement I submitted my application for NBI clearance;
3. The NBI Office in Cebu City has informed me that they could not issue me a clearance because a name similar to my name appeared in the NBI files involving in Multiple Rape, docketed as Criminal Cases No. 1234 & 5678 pending before Branch 69 of the Regional Trial Court of Quezon City, against said person bearing a name similar to mine;
4. I am executing this affidavit to attest to the foregoing facts and to deny categorically and specifically under oath that I am not the same person mentioned in the docket/files of NBI with the said derogatory/civil/criminal record/s, nor am I in any way involved in any case proceeding as either plaintiff/complainant or defendant/accused in the Philippines and abroad;
5. I was born on July 28, 1990 in Mandaue City, and I have established my permanent residence in Mandaue City;
In view of the foregoing, I am requesting the NBI Office to issue the appropriate clearance in my favor for compliance with the certain requirements for the issuance of a Philippine Passport;
IN WITNESS WHEREOF, I hereby affixed my signature this 16th day of November 2015 in Mandaue City, Cebu, Philippines.
MEDIO Y. SUERTE
SUBSCRIBED AND SWORN TO before me this _____________ in ______________, Philippines, affiant exhibiting to me his competent evidence of identity by way of ______________ issued at _____________ on ______________.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2015.
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