REOUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

NATIONAL CAPITAL JUDICIAL REGION
BRANCH ,MANILA CITY
Plaintiff,
Versus
respondent

JUDICIAL AFFIDAVIT
OF WITNESS JUAN DELA CRUZ
I, JUAN DELA CRUZ, of legal age, single, Filipino and a residence of 05 CMLI compound
Pag asa, Quezon City, state and dispose under oath as follows.

Preliminary Statement
The Judicial Affidavit was taken at the office of Atty. _______________ at
________________________.
Question were propounded by Atty. ___________________________ and this question are
numbered consecutively and each question is followed by the answer of witness.
I am answering his question fully conscious that I do so under oath, and may face criminal liability for
false testimony and perjury.
OFFER OF TESTIMONY: the testimony of the witness is being offered to prove that he was the one
who repaired the TOYOTACamry with the shattered windshield.
According to its owner Norberto Somera who showed an O.R. C.R. which proved that he was the owner
of the Toyota Camry with plate no. AAA789.
His testimony will proved that the car brought by the plaintiff suffered damages up to the extent of two
hundred thousand pesos (P 200,000.00).
EXAMIANTION PROPER
Q1. Do you swear to tell the truth and nothing but the truth?

A1. I do
Q2. are you aware that you will face criminal liability for false testimony and perjury if you will not tell
the truth?
A2. I am
Q3. Please state your name, age, address and occupation.
A3. I am Juan Dela Cruz, 30 years old, single, Filipino and residing at Pag asa, Quezon City. I am an auto
mechanic of Toyota Service Center, Quezon City Branch.
Q4. How many years have you been as an auto mechanic?
A4. I been an auto mechanic for 10 years
Q5. How many years have you been working as mechanic at Toyota Service Center?
A5. Ive been employed as auto mechanic for 8 years.
Q6. Can you tell us how many cars did you repair in the past?
A6. More or less a thousand cars.
Q7. Have you encountered repairing shattered windshield windows?
A7. Yes, Sir
Q8.How many times did you repair a shattered windshield?
A8. Ive repaired 80 cases of shattered windshield.
Q9. What was the condition of the Toyota Camry when it was delivered in your service center?
A9. The windshield of the Toyota Camry was shattered when it was delivered in our service center.
Q10. Do you have proof that the Toyota Camry was really under your service center?
A10. I have the work order sir for the repair of the shattered windshield of the Toyota Camry
(Exhibit____)
Q11. how much did it cost in repairing the vehicle?
A11. The repair cost two hundred thousand pesos (P 200,000.00)
Q12. Do you have proof of the repair cost?

A12. Yes Sir. I have the receipt issued by the Toyota Service Center (exhibit D)
Q13. is the cost of the repair reasonable?
A13. Yes, Sir. Because the windshield of the car was shattered into pieces that it needed to be replace a
new.
Affiant further sayeth naught.

JUAN DELA CRUZ

AFFIANT

SUBSCRIBED AND SWORN to before me this ________________at__________________,

affiant exhibiting to me her ___________________
Issued on_______________
Doc. No.________
Page no._________
Book no.__________
Series no.________

SWORN ATTESTATION
I hereby state, under oath, that I faithfully recorded the question I
asked and the corresponding answers that the witness gave and that neither
I nor any other person present or assisting me has coached the witness
regarding the letters statement.
ATTY. ______________________
SUBSCRIBED AND SWORN to before me this _______________
at _____________, affiant exhibiting to me his ________________ bearing
the no.__________________ and will
Expire on ______________________.
Doc no._____
Page no. _____
Book no.____
Series of._____

Toyota Service Center

Quezon City
Branch ___
NAME:______________
ADDRESS:______________________
MAKE AND MODEL: TOYOTA CAMRY

DATE:_______________
PHONE:______________
LICNESE NO. ___________

MOTOR NO._____________
LABOR DESCRIPTION:

AMOUNT:

SHATTERED WINDSHIELD CHANGE NEW ONE

200,000.00

QUANTITY:

NAME OF PART:

BRAND NEW WINDSHIELD

AMOUNT:

LABOR:

VAT

TOTALCOST

200,000.00

I HEREBY AUTHORIZED THE ABOVE REPAIR WORK TO BE DONE ALOGN WITH THE
NECESSARY MATERIAL AND HEREBY GRANT YOU AND YOUR EMPLOYEES
PERMISSION TO OPERATE THE VEHICLE HEREIN DESCRIBED FOR THE PURPOSE OF
TESTING AND INSPECTION..AN EXPRESS MECHANIC
LEIN IS HEREBY
ACKNOWLEDGED ON ABOVE VEHICLE TO ENSURE THE AMOUNT OF REPAIR
THERETO
WORK AUTHORIZED BY:_______________
DELIVERED TO:___________________
DELIVERED:______________

DATE PROMISED:__________
DATE