SAN PEDRO MEDICAL HOSPITAL

San Pedro, City, Laguna

MEDICAL CERTIFICATE

I, the undersigned Dr. Samsong James, Doctor of Medicine,

Certify that the examination of Mr. Pedro Buhay Date of birth: May 2
1979, Age: 39.Reveals that he suffer from bodily injuries that caused of
his medical required to attend for a period of 25 days from and incurred
the amount of P53,000,00 as hospitalization expense. And he undergoing
of operation of his right shoulder.

Medical certificate issued in (place): San Pedro Medical Hospital

Operation amount: P 85,000,00 to P 100,000,00

Date: June 1, 2010,

Patient sign:_____________ Doctors sign: _________

 SPL DIAGNOSTIC CENTER INC.
San Pedro, City, Laguna

MEDICAL CERTIFICATE

___________________________________________________________

Name: Juancho Mahusay Date Examined: June 13 2010

Address: #666 Villa Angeles Age/Sex: Male

San Pedro Laguna

Birth Date: April 29, 1889 Civil Status: Sinlge

I. Physical examination

Height:156 cm. Weight: 63 kg. Blood Pressure: 90/60 mmHg

Pulse Rate: 72 bpm. Respiratory Rate: 16 cpm

___________________________________________________________

II. Laboratory and diagnostic examination.

FINDING/ REMARKS

Urinalysis: Normal

Chest X ray: Normal

Drug test: Negative

Alcohol: Negative

___________________________________________________________

III. Remarks/ Recommendation

 Class A – medical test

Signature of applicant:________

JONATHAN C. MOLETA

Internal Medical Lic. N. 92006

 Republic of the Philippines
National Prosecution Service
OFFICE OF THE PROVINCIAL PROSECUTOR
San Pedro City

PEDRO BUHAY
Complainant
-versus- IS No. 123456
For Reckless
Imprudence Resulting
To serious Physical
Injury and Damage to
property
JUANCHO MAHUSAY
Respondent.
x-------------------------------x

COUNTER AFFIDAVIT

I, JUANCHO MAHUSAY, of legal age, single, and with postal and

residence number at #666, Villa Angeles, San Pedro Laguna, after having
duly sworn in accordance with law, hereby depose and state that:

1.I stands charge with the above-captioned case;

2.It is true Honda CRV with plate number WXY-789 collided with the
gate of the house of a certain PEDRO BUHAY;

3.That it was not true that I am drunk and was driving fast

4.That the truth of the matter is the gate of the house in front of PEDRO
BUHAY suddenly swung open and blocked the lane that I’m driving in

5.That in order to avoid greater injury, I maneuvered the vehicle away but
I was unlucky that I hit the gate of PEDRO BUHAY;

6. That, I am attaching the Sworn Affidavit of RIZA OLIVARES who

was with me inside my car when the accident happened to prove the
truth of the allegations herein;

7. That I am executing this affidavit to attest the veracity of facts

mentioned above.

JUANCHO MAHUSAY
Affiant

SUBSCRIBED AND SWORN to before me this 14th day of June 2010 at

city of San Pedro. I likewise certify that I examined the affiant and I am
satisfied that the foregoing is executed freely and she/he understood the
same.

JULIO VALIENTE
Assistant City Prosecutor
 Republic of the Philippines
OFFICE OF THE PROVINCIAL PROSECUTOR
San Pedro City

REPUBLIC OF THE PHILIPPINES……...) s. s.

CITYOF SAN PEDRO………………..)

SWORN STATEMENT

I ,Carla Azul married, of legal age and a resident of #61 brgy. San Vicente, San
Pedro City, Laguna after having been sworn to in accordance with law, hereby
depose and state that:

1. That I i’m the house maid of Mr. PEDRO BUHAY , that the time I was
cleaning the dishes after his child and waiting to his from his job to open the
gate when he arrive. In few Minute I heard the horn of his car.

2. That on or about 11:00 PM, On June 10, 2010, when I going to

Outside the house of the of Mr.Pedro Buhay to open the gate. I saw
the car heading on the Primera st. The car was so fast and the car
was going to bump the car of Mr. Pedro Buhay.

3. The car of my boss is bump the gate of his house because of the
strong impact when the other car collide. Mr. Buhay suffered
bodily injuries.

4. I call to the police officer to rescue and see what happen in the
collision of two car and the ambulance came a few minute to give
first aid of Mr. buhay. And he brought to the nearest hospital

5. After the incident I saw the driver of gray honda CVR car bearing
with plate number. WXY 789 inside his car he was drunk and his
faces was red.
 6. There willfully, unlawfully and feloniously drive, manage and
operate the same in a reckless, careless, negligent and imprudent
manner, without regard to traffic laws, rules and regulations and
without taking the necessary care and precaution to avoid damage
to property , causing by such negligence, carelessness and
imprudence the said vehicle to bump/collide that cause of
incident .

I executed this affidavit to attest the truthfulness of the foregoing facts and to support
thefiling of Criminal Cases against Mr. Juancho mahusay for violations of reckless
imprudence resulting to serious physical injury and damage to property.

AFFIANTS SAYETH NAUGHT.

IN WITNESS WHEREOF, I hereunto affixed my signature this 11th day of June

2010 at , OFFICE OF THE PROVINCIAL PROSECUTOR

CARLA AZUL
Affiant

SUBSCRIBED AND SWORN

to before me this 11th day of June 2010 at San Pedro city I HEREBY
CERTIFY that I have personally examined the herein affiants and I am satisfied that
they voluntarily executed and understood their given affidavit.

Atty. Brent Sanchez

Notary Public
 Republic of the Philippines
National Prosecution Service
OFFICE OF THE PROVINCIAL PROSECUTOR
San Pedro City

PEDRO BUHAY
Complainant

-versus- IS No. 123456

For Reckless Imprudence
Resulting to serious
Physical Injury and Damage
to Property
JUANCHO MAHUSAY
Respondent.
x-------------------------------x

COMPLAINT-AFFIDAVIT

I, PEDRO BUHAY, of legal age, single, and with postal and residence
number at # 12 Primera St., San Pedro Laguna, after having duly sworn in
accordance with law, hereby depose and state that:

1.That on or about 11:00 PM of June 10, 2010, JUANCHO MAHUSAY

were driving his Gray Honda CRV with plate number WXY-789 along
Primera St., San Pedro Laguna; there willfully, unlawfully and feloniously
drive, manage and operate the same in a reckless, careless, negligent and
imprudent manner, without regard to traffic laws, rules and regulations
and without taking the necessary care and precaution to avoid damage to
property , causing by such negligence, carelessness and imprudence
the said vehicle to bump/collide bearing plate no. WXY-789
driven by me, thereby causing damage to my car.

2. As further consequence due to the strong impact, I suffered bodily

injuries which required medical attendance for a period of 25
days, from , and incurred the amount of P53,000.00 as hospitalization
expense. Furthermore, I was advised by my attending physician, Dr.
Samsong to undergo operation on my right shoulder which would cost
between P85,000.00 to P100,000.00, and not to mention the fact that I
have become incapacitated from performing my customary labor since the
accident;

3.That the total amount of damage to my gate and my car amounts to

Php.500,000.006.

4. That during the incident, it was proven that he was drunk beyond the
legallimit;

5. The report from the San Pedro City Police Station clearly
establishes the recklessness of accused. A copy of which is attached as
ANNEX “A” and made an integral part of this complaint. As contained in
said report and going back to what had transpired, I was then cruising in a
motorcycle as described above on its proper lane along the stretch of
Laguna Sta. Rosa Road heading west when suddenly the vehicle driven by
the accused coming from the opposite direction (east) encroached the
motorcyle’s lane in a vain attempt to overtake another vehicle and to
avoid collision I in fact even tried to swerve the motorcycle to the
right shoulder of the road to give much room for the accused’s vehicle to
pass, notwithstanding the collision was not avoided;

6. The collision flung the motorcycle off the road southward from the
point of impact while throwing me off my seat and knocking me
seemingly lifeless. Accused’s vehicle skidded southward evidencing
his irresponsible and reckless act of overtaking and over speeding.
Photos of the actual collision of the subject vehicles are attached as
ANNEX “B” and made an integral part of this complaint;

7. Therefore, the accused’s overtaking and the speed in which he drove

his car appear to be the main causes for his inability to stop his car and
avoid the collision. Indeed, accused, being the driver of an overtaking
vehicle, should have ensured that the conditions were such that an
attempt to pass is reasonably safe and prudent, and in passing
should have exercised reasonable care, which he failed to do so, thus,
he should be made liable for the resulting damages to the motorcycle and
for the injuries I sustained;

8. I am therefore executing this Complaint-Affidavit in support of the

charges for Reckless Imprudence Resulting in Serious Physical Injuries
and Damage to Property against the said Accused.

That we voluntary executed this complaint for purposes of filing a

criminal charges against JUANCHO MAHUSAY.

PEDRO BUHAY
Affiants

SUBSCRIBED AND SWORN to before me this 11th day of June 2010 at

City of San Pedro.

JOSE E. SALAS
Assistant Provincial Prosecutor
 Republic of the Philippines
OFFICE OF THE PROVINCIAL PROSECUTOR
San Pedro City

REPUBLIC OF THE PHILIPPINES……...) s. s.

CITYOF SAN PEDRO………………..)

SWORN STATEMENT

I ,Riza Olivares, single, of legal age and a resident of #69 Brgy. Laram San Pedro
City, Laguna after having been sworn to in accordance with law, hereby depose and
state that:

1. That on or about 10:30 PM. June 10 2010, I just waiting to Mr Mahusay. To my

office after I finish in my office work in the Sta. Rosa. He Arrived at exactly
10:30 and drive me along the highway of san pedro laguna sent me to my house.
He was in good condition of his driving.

2. When they arrived in Primera st. he saw the car stopping in the middle of the
highway without any signal light of his car. And the gate was blocking in that
way.

3. They not faster because I totally said them to minimize the speed because there
was night and they have many motorcycle passing. The driver shock when there
was a car stop in his front and there was a motorcycle in our side the driver was
panic because they did know how to avoid those car at motorcycle.

4. He decide to bump the car to less incident and less cause of date . the collision of
two car cause of damage of the gate.

5. Is not true that the statement of Mr. Buhay and Carla azul that my driver has
drunk. Because I never ride my driver when he was drinking alcohol.

IN WITNESS WHEREOF, I hereunto affixed my signature this 14th day of June

2010 at , OFFICE OF THE PROVINCIAL PROSECUTOR

RIZA OLIVARES
Affiant
SUBSCRIBED AND SWORN to before me this 14th day of June 2010 at
city of San Pedro. I likewise certify that I examined the affiant and I am
satisfied that the foregoing is executed freely and she/he understood the
same.

JULIO VALIENTE
Assistant City Prosecutor