Republic of the Philippines

MUNICIPAL TRIAL COURT IN CITIES

Fifth Judicial Region
Branch ____
Lagazpi City
PEOPLE OF THE PHILIPPINES
Plaintiff,
-versus-

CRIMINAL CASE

NO. ____
For: Violation of Batas
Pambansa Blg. 22
MARIA CYNTHIA R. AGNABO,
Accused.
x------------------------------------------------x

JUDICIAL AFFIDAVIT
(of Carmen Monsalve)
Name of Witness :
Address
:
Examining Lawyer
Address
:
Albay
Place of Examination:
Albay

LADIE M. CHA
:

Brgy. Salvacion, Daraga, Albay

Atty. Ian Ll. Macasinag
First Park Subd.,Sagpon, Daraga,
First

Park

Subd.,Sagpon,

Daraga,

I, CARMEN L. MONSALVE, after having been duly sworn to

in accordance with the law, hereby respectfully states that I am
answering the following questions asked of me, fully conscious
that I do so under oath, and that I may face criminal liability for
false testimony or perjury, thus:
Q1: Do you swear to tell the truth, the whole truth and
nothing but the truth?
A1: Yes, I do.

Q2: Please state your full name and other personal

circumstances.
A2: I am Carmen L. Monsalve, of legal age, Filipino citizen
and a resident of Brgy. Pandan, Daraga Albay.
Q3: Do you know the accused in this case?
A3: Yes.
Q4: How were you able to know her?
A4: I was able to know the accused because she loaned
money from me.
Q5: Why are you executing this judicial affidavit?
A5: I am executing this judicial affidavit to attest to the truth
of the foregoing facts relative to the case for BP 22 I have filed
against Maria Cynthia R. Agnabo before this court.
Q6: Why did you file a case for BP 22 against herein
accused?
A6: Because sometime in Naga City, the said Accused issued
in my favor Philippine National Bank Check No. 0750298 dated
September 4, 2015 in the amount of SIX HUNDRED THOUSAND
PESOS (Php 600,000.00) which was drawn against the account of
the Accused with Philippine National Bank-Naga Branch with
Account No. 46-567-440004-4 as supposed payment for the loan
accommodation which I extended to her.
Q7: I will mark the check you have given me as Annex A
to make it an integral part hereof. Do you confirm to my action?
(At this juncture, witness hands over a copy of the check)
A7: Yes.
Q8: Can you please explain to us what happened next, if
there was any?
A8: That at the time the accused issued and delivered the
said check, she made the assurance and representation that the
said check is a good check and will be covered by sufficient funds
when presented for payment. Thus, on September 4, 2015, I

deposited said check in my Bank De Oro (BDO)-Legazpi City

Branch. However, it was dishonored and returned by the said
bank due to ACCOUNT CLOSED. If you will notice, the check has a
stamp ACCOUNT CLOSED on its face.
Q9: Do you have any other proof that says that the check
was returned to you?
A9: Yes.
Q10:
What is it?
A10: A check return advice was given to me by BDO-Legazpi
City Branch. (At this juncture, witness hands over a copy of the
check return advice)
Q11: I will mark this check return advice you have given me
as Annex B to make it an integral part hereof. Do you confirm
to my action?
A11: Yes.
Q12: What did you do then upon learning that the checks
were dishonored by the bank?
A12: On November 25, 2015, I immediately notified the
Accused of the dishonor and return of the said check by sending a
demand letter to her.
Q13: Do you have a copy of that demand letter?
A13: Yes, I have a copy with me. (At this juncture, witness
hands over a copy of the demand letter)
Q14: I will mark this copy of your demand letter as Annex
C to make it an integral part hereof. Do you confirm to my
action?
A14: Yes.
Q15: Did the accused pay you after she received your
demand letter?
A15: No, she failed and refused to pay me even after the ten
(10)-day period from the receipt of my demand letter, that I have
asked her, within which to make good the check. The demand

letter was even personally received by the Accused on December

4, 2015.
Q16: In filing this case, did you incur any damages?
A16: Yes. In fact I have paid for the filing fees and incurred
an obligation for the payment of Attorneys Fees.
Q17: How much was your agreement with your lawyer?
A17: I have agreed to pay my lawyer Twenty Thousand
Pesos (Php 20,000.00) plus Php1,500 per appearance during the
hearing of the case.
Q18: Do you have anything more to say?
A18: None.
Q19: Are you willing to narrate other relevant matters in
court should the need arise?
A19: Yes, I am willing.
AFFIANT FURTHER SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto set my hand this
____ day of February, 2016 at Daraga, Albay, Philippines.
CARMEN L. MONSALVE
Judicial Affiant

LADIE M. CHA
Judicial Affiant
SUBSCRIBED AND SWORN TO, before me this ___th day of
_______________, 2016 at Daraga, Albay, Philippines by the affiant,
who exhibited to me his ______________________________, as
competent evidence of identity, pursuant to the 2004 New
Rules on Notarial Practice, as amended.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2016.

ATTESTATION
I, IAN LL. MACASINAG, a member of the Integrated Bar of
the
Philippines,
who
conducted
the
examination
of
CARMEN L. MONSALVE, hereby respectfully attest that I
faithfully recorded the questions I asked and the corresponding
answers that the witness gave, and that neither me nor any other
person then present or assisting me coached the witness
regarding his answers.
IAN LL. MACASINAG
SUBSCRIBED AND SWORN TO, before me this ___th day of
_______________, 2016 at Daraga, Albay, Philippines.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2016.