Chapter 10 - Sworn Statement Format
Chapter 10 - Sworn Statement Format
CHAPTER X
Sworn Statement in Question-
and-Answer Format
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Module TECHNICAL ENGLISH 1 (Investigative Report Writing and Presentation)
SWORN STATEMENT OF MR. PEDRO SANTOS Y DELA CRUZ TAKEN BY PO3 JUNE T.
ADALEM PNP AT THE OFFICE OF THE INVESTIGATION SECTION, SANTA ROSA
POLICE STATION, SANTA ROSA, NUEVA ECIJA IN THE PRESENCE OF SPO4 ROBERTO
B. NERI PNP, THIS 20TH DAY OF FEBRUARY 2004, AT ABOUT 9:00 O’CLOCK IN THE
MORNING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .x
PRELIMINARY : Mr. Pedro DC. Santos, you are being informed that you are under
investigation for your involvement in the commission of an offense.
You are reminded that under our New Constitution, you have the
right to remain silent and to be assisted by a counsel of your choice.
If you cannot afford to hire one, and you want assisted by counsel,
this office will provide you with a lawyer free of charge. Any
statement that you will make can be used for or against you in any
court of law in the Philippines. Is this clearly understood by you?
ANSWER : Yes, sir.
QUESTION : Having been informed of your rights under the constitution to
remain silent, do you wish to proceed with this investigation?
ANSWER : Yes, sir.
QUESTION : Do you also wish to be assisted by a counsel of your choice?
ANSWER : I do not need the assistance of counsel
QUESTION : You are also reminded that whatever statement you will give might
be used against you. Is this clearly understood by you?
ANSWER : Yes, sir.
QUESTION : In short, you are waiving your right to counsel in this investigation?
ANSWER : Yes, sir.
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Module TECHNICAL ENGLISH 1 (Investigative Report Writing and Presentation)
QUESTION : Are you willing to sign a waiver to that effect with the assistance of
Atty. Mark Ryan M. Mabutol, who is here present?
ANSWER : Yes, Sir.
PEDRO DC SANTOS
(Affiant)
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Module TECHNICAL ENGLISH 1 (Investigative Report Writing and Presentation)
A13 : The answer to this question should not be typed BUT should be written
handwritten answer of the affiant and the latter should be made to
write out in his own handwriting the following statement: “Yes, sir, I
have read this statement of mine consisting of ___ pages and it is the truth.
I made it of my own free will, without any threats or promises having been
made to me by anyone.
SUBSCRIBED AND SWORN to before me this 20th day of February 2004, at Santa Rosa,
Nueva Ecija. I hereby certify that I have personally examined the affiant, and I am satisfied that
he voluntary executed and understood his statement.
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Module TECHNICAL ENGLISH 1 (Investigative Report Writing and Presentation)
Example:
JOINT AFFIDAVIT
WE, PO3 Amorsolo A. Esmundo PNP and PO3 Jonathan M. Reyes PNP, both of legal age,
members of the Santa Rosa Police Station, Santa Rosa, Nueva Ecija, and presently assigned to the
Investigation Section, after having been duly sworn in oath in accordance with law, do hereby
voluntary depose and state the following:
That, we were the investigators tasked to conduct the necessary surveillance on the
proliferation of pornographic materials and sleazy tabloids in the municipality of Santa
Rosa, Nueva Ecija, exhibiting obscene language and vulgar photographs of males and
females which we believe are detestable and offensive to common decency, morals and
good customs and are therefore violative of our penal laws;
That, on the 21st day of February 2004, at around 4:00 o’clock in the afternoon, in
order to ascertain the veracity of the report on the circulation of smut publications, we
proceeded to a printing office located at Brgy. Rizal, Santa Rosa, Nueva Ecija, where we
were able to gain entry to the printing office by posing as owners of delivery vehicles
interested in hauling newspapers and magazines. While inside, we were able to see for
ourselves that this office was indeed printing pornographic materials.
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Module TECHNICAL ENGLISH 1 (Investigative Report Writing and Presentation)
IN WITNESS HEREOF, we affixed our signatures over our printed names this 21st day of
February 2004, at Santa Rosa, Nueva Ecija.
SUBSCRIBED AND SWORN to before me this 20th day of February 2004, at Santa Rosa,
Nueva Ecija. I hereby certify that I have personally examined the affiants, and I am satisfied that
they voluntary executed and understood their statement.
References:
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