REPUBLIC OF THE PHILIPPINES )

MUNICIPALITY OF SAN ISIDRO )S.S

PROVINCE OF NUEVA ECIJA )
X - - - - - - - - -X

COMPLAINT-AFFIDAVIT

I, XXXXXXX, of legal age, Filipino, married, and a resident of

Bayanihan, Gapan City, After having been duly sworn in accordance with
law hereby depose and state:

1. That I am the General Manager of D Corporation with office address

at xxxxx, Gapan City;

2. That I am formally charging:

a) xxx, former Office Manager of D. Corporation of legal age,

Filipino and a resident of Sto Cristo Norte, Gapan City.

b) bbbb, former Purchasing Officer of D Corporation, of legal age,

Filipino and a resident of 180 Rizal St., Malapit, San Isidro, Nueva
Ecija.

c) cccc former Cashier of D. Libunao Gas, of legal age, Filipino, and

a resident of Barangay Entablado, Cabiao, Nueva Ecija.

3. That on January 4, 2017, more or less, i was informed by Mr. hhhh,

Office Manager of D corp regarding the discrepancy in the quantity of
drums of acetone as appearing in the inventory report against the PDEA
Report;
4. That I instructed hhhh to reconcile the aforesaid discrepancy and we
found out later on that there were 5 drums of acetone, which respondents
made it appear that PDLUB Trading on August 15, 2016 and September
13, 2016 delivered 10 drums of acetone to our company;

5. That respondents succeeded in the commission of qualified theft

because they were then in position of manipulating documents in our
office due to grave abuse of trust and confidence we reposed upon them;
5.1 That respondents thru the used of falsified delivery receipts of
PDLUB trading on two occasions were able to release, obtain and
misappropriate for themselves an aggregate amount of P 183,000.00 from
the funds of D Corporationn, as evidence by the hereto attached
Delivery Receipt, Payment Order Form, Check Vouchers and RCBC
Checks, marked as Annexes A, B, C, D E and F;

5.2 That our employees particularly Jerwin executed an Affidavit in

support of my complaint against the respondents. Copies of said
Affidavits are hereto attached and marked as Annexes G, ;

6) That I am executing this affidavit to formally change the respondents

for the crime of Qualified Theft and Falsification of Public Documents.

IN WITNESS WHEREOF, I have affixed my signature this 27 th day

of June, 2017 hereat Gapan City.

Xxxxxx
Affiant
ID NO. CO5-79-002721
Issued by LTO
 SUBSCRIBED AND SWORN TO BEFORE me this 27th day of June
2017 hereat Gapan City, by XXXXX, who satisfactorily proven his
identity to me through his identification card no. 0117261 issued by PRC,
that he is the same person who personally signed in the foregoing
verification/certification before me and acknowledge that he executed the
same.

ATTY. B BBBBB
Notary Public
Until December 31, 2018
PTR NO. ####### 1-1-17
At Gapan city