AFFIDAVIT OF DENIAL

Affidavit of denial may be submitted to clear one’s name when there are other records bearing the same name with pending case or derogatory information.

Below is a sample affidavit:

Affidavit of Denial (of Identity who has a Pending Case / Derogatory Record)

REPUBLIC OF THE PHILIPPINES)
City of ___________________) S.S.

AFFIDAVIT OF DENIAL

I, ALUH D. AKOYAN, of legal age, single, and a resident of Unit 452525252 MET 2, Cityland Brgy. Pio Del Pilar, Makati City, after having been duly sworn to in accordance with law, do hereby depose and state that:

1. I went to the Bank of XYZ to open an account. However, I was told that there is another person by my name who has a pending case;

1. I mentioned that I am not that person;

1. I have no pending case whatsoever and I have no existing account with the Bank of Makati. The alleged person having the same name as me is probably a different individual as this is my first time to open an account with said bank;
2. Any person with the same name as ALUH D. AKOYAN, ALUH DAKOYAN, or ALUH DILI AKOYAN who has existing case, is not the same person or individual as the ALUH D. AKOYAN who is the affiant in this undertaking and as shown by my proof of identity;

1. I am executing this affidavit for purpose of opening the checking account with the Bank of XYZ at Gil Puyat Ave., and to attest to the truth of the foregoing statements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1st day of September 20__ at Makati City, Philippines.

ALUH D. AKOYAN
Affiant
ID: ________________

SUBSCRIBED AND SWORN TO BEFORE ME, this 1st day of September 20___ personally appeared the above, exhibiting to me his competent evidence of identity his shown above.

Doc. No. _______________:
Page No. ______________:
Book No. ______________:
Series of 20___.