REPUBLIC OF THE PHILIPPINES)

CITY OF ___________ ) S.S.

AFFIDAVIT FOR PRELIMINARY ATTACHMENT

I, _________________________________, Filipino, of legal age, __________, residing at _________________________________, after being sworn to in accordance with law, deposes and say:

1. That I am the plaintiff above-entitled case;

2. That a sufficient cause of actions exists against the defendant named therein;

3. That this action is one of those specifically mentioned in Sec. 1 of Rule 2 of the Rules of Court, whereby a writ of preliminary attachment may lawfully issue, namely: “in an action against a party who has removed or deposed of his property, or is about to do so, with intent to defraud his creditors;”

4. That there is no sufficient security for the claim sought to be enforced by the present action;

5. That the amount due to the plaintiff in the above-entitled case is as much as the sum for which an order of attachment is proper.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________, 20____, in ___________, ___________, Philippines

_________________________________

Affiant

SUBSCRIBED AND SWORN to before me this ____ day of ___________, 20____, in ___________, ___________, Philippines, affiant having exhibited to me his License No. ___________ issued until ___________, 20____.

Doc. No. : ________;

Page No. : ________;

Book No. : ________;

Series of 20____.