REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT

JUDICIAL REGION
_, BRANCH

PEOPLE OF THE PHILIPPINES,

Plaintiff, CRIMINAL CASE No.

-versus-

, FOR:
Accused.
x ---------------------------------------------- x

APPLICATION FOR RELEASE ON RECOGNIZANCE

The undersigned accused, , hereby applies for release

on recognizance pursuant to section 7, Presidential Decree No. 968, as amended, and
declares:

1. That he filed an application for probation to this

Honorable Court; (Date)

2. That he is presently confined at

for and failed to post the required bail bond;

3. That a responsible member of the

PAO Code Book 80 of 375

 Community and a resident of is
willing to accept the custody of the undersigned accused and guarantee
his appearance whenever told to do so by the Court or the Probation
Administration.

(Place) (Date)

(Accused/Ap

plicant) C O N F O R

ME:

Name:

Address:
Barangay No. Zone:

Copy furnished: (Personal

service) Prosecutor’s Office

PAO Code Book 80 of 375