JHCSC SCHOOL OF LAW

ETHICS REVIEW LECTURE SERIES

FORMS

Disclaimer: Some of the forms herein presented are taken from the internet with the sole
purpose of educational enlightenment.

III. Practical Exercises

1. Demand Letter
2. Deed of Sale of Real Property and Deed of Sale of Personal Property
3. Contract of Lease
4. Special Power of Attorney
5. Verification and Certificate of Non-forum Shopping
6. Judicial Affidavit
7. Notarial Certificates
a. Jurat
b. Acknowledgment
8. Motions
a. Motion for Summary Judgment
b. Motion to Dismiss
c. Motion to Declare in Default
9. Quitclaims in Labor Cases
10. Information in Criminal Cases

EXAMPLES:

Demand Letter

12 August 2013

MARIA C. SANTOS
111 Bonifacio Street, Canumay East,
Valenzuela City

Madam:

We write in behalf of our client, ABCD Financial Services, Inc., the matter of
your non-payment of your obligation.

Records disclose that you have an outstanding obligation with our client in
the amount of Php100,000.00 inclusive of interest and surcharges. Despite
repeated demands, you failed and continuously fail to pay the aforesaid
amount.

Accordingly, FINAL DEMAND is hereby made upon you to settle the amount
of Php100,000.00 within FIFTEEN (15) days from receipt of this letter.
Otherwise, we will be constrained to file the necessary legal action against
you to protect the interest of our client.

We trust that you will give this matter your prompt and preferential
attention to avoid the expense and inconvenience of litigation.

Truly yours,

ATTY. JUAN C. DELA CRUZ

Deed of Sale of Real Property and Deed of Sale of Personal Property

Real Property

DEED OF ABSOLUTE SALE

KNOW ALL MEN BY THESE PRESENTS:

This Deed of Absolute Sale is made and executed by:

PEDRO TEA, of legal age, Filipino, single and residing at Blk 1 Lot 2
Green St., Urban Subd., La Loma, Quezon City (hereinafter referred to as
the SELLER),

- AND -

JUAN DELA CRUZ, of legal age, Filipino, married to JUAN DELA

CRUZ, of legal age, Filipinos and residents of 100 Dewey Rd., W.H.O.
Village, Fairview, Quezon City (hereinafter referred to as the BUYERS).

WITNESSETH:
 That the SELLER is the registered owner of a certain parcel of land
together with all the improvements found therein, as evidenced by Transfer
Certificate of Title (TCT) No. 123-100000000 situated in Barangay Gulod,
Cabuyao Laguna, Philippines, and more particularly described as follows, to
wit:

“A parcel of Land (Lot 1 Blk. 5 of the cons. Subd. Plan Pcs-

12-100000, being a portion of cons. Lots 10 to 22 Blk. 1. Pcs-00-
10000 Lots 3 to 8 Blk 2. Pcs-01-011111 & Lots 2-B-1 & 1-A-2,
Psd-01-000000 LRC Rec. No.) situated in Barrio of Gulod, City of
Cabuyao, Province of Laguna. Island of Luzon. Bounded on the
W., Along Line 2-3 by Lot 3 Blk 6; On the NW., and NE., Along
Line 3-4-5 by Road Lot 1; On the E., Along Line 5-6 by Road Lot
4 (7.00 M. Wide) and on the S., Along Line 6-2 by Lot 4 Blk-6
XXXX containing an area of Eighty Seven (87) SQM ….including
all the existing improvements erected thereon.

That for and in consideration of the sum of ONE MILLION FIVE

HUNDRED PESOS Philippine Currency (Php1,500,000.00), receipt in
full is hereby is acknowledged to his entire satisfaction, the SELLER do
hereby SELL, TRANSFER and CONVEY, unto the said BUYERS, their heirs
and assigns, the above-described parcel of lot, with all the improvement
found thereon.

That the SELLER hereby warrants his title over the land above-
described, with full right to dispose of the same, free from all liens and
encumbrances, and that henceforth, full right of ownership and possession of
the whole property shall pertain to the buyers.

IN WITNESS WHEREOF, I have hereunto signed this deed of

absolute sale, this ___ day of ____________ , 20____, in the City of
______________.

PEDRO TEA JUAN DELA CRUZ

SELLER BUYER

With my marital consent:

JUANA DELA CRUZ

 Signed in the presence of:

_______________________ _________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

_________________________ ) SS.

BEFORE ME, a Notary Public in the City of _________, this ___day of

__________,2020 personally appeared the following:

Name Proof of Identity Date/Place Issued

Pedro Tea
Juan Dela Cruz
Juana Dela Cruz

known to me to be the same persons who executed the foregoing

instrument and they acknowledged to me that the same is their free and
voluntary act and deed.

This instrument, consisting of 3 page/s, including the page on which this

acknowledgment is written, has been signed on the left margin of each and
every page thereof by the concerned parties and their witnesses, and sealed
with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand the day, year

and place above written.

Notary Public

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.

Personal Property
 DEED OF SALE OF MOTOR VEHICLE

KNOW ALL MEN BY THESE PRESENTS:

This Deed of Sale of Motor Vehicle is made and executed by:

PEDRO TEA, of legal age, Filipino, single and residing at Blk 1 Lot 2 Green St., Urban
Subd., La Loma, Quezon City (hereinafter referred to as the SELLER),

- AND -

JUAN DELA CRUZ, of legal age, Filipino, single, and a resident of 100 Dewey Rd.,
W.H.O. Village, Fairview, Quezon City (hereinafter referred to as the BUYER).

-WITNESSETH-

That the SELLER is the registered owner of a motor vehicle, more particularly
described as follows:

MAKE : MOTOR NO:

SERIES : SERIAL/CHASSIS NO. :
TYPE OF BODY : PLATE NO. :
YEAR MODEL : FILE NO. :
C.R. No.:

That for and in consideration of the sum of SIX HUNDRED THOUSAND PESOS
(Php600, 000.00) PESOS, Philippine Currency, receipt of which is hereby acknowledged
to his entire satisfaction, the SELLER has sold, transferred and conveyed by way of
absolute sale unto the BUYER, his heirs and assigns, the above described motor vehicle free
from all liens and encumbrances.

IN WITNESS WHEREOF, the parties have hereunto affixed their signature this
________st day of September 2020, at _________________, Philippines.

PEDRO TEA JUAN DELA CRUZ

SELLER BUYER

SIGNED IN THE PRESENCE OF:

______________________________ ________________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

____________________________________ ) SS.

BEFORE ME, a Notary Public in the City of _________, this ___day of __________, 2020
personally appeared the following:

Name Proof of Identity Date/Place Issued

Pedro Tea
Juan Dela Cruz

known to me to be the same persons who executed the foregoing instrument and they
acknowledged to me that the same is their free and voluntary act and deed.

This instrument, consisting of 2 page/s, including the page on which this acknowledgment
is written, has been signed on the left margin of each and every page thereof by the
concerned parties and their witnesses, and sealed with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand the day, year and place above
written.

Notary Public

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.

With Pacto de Retro

DEED OF ABSOLUTE SALE WITH PACTO DE RETRO

KNOW ALL MEN BY THESE PRESENTS:

This Deed of Absolute Sale with Pacto de Retro is made and executed by:
 PEDRO TEA, of legal age, Filipino, single and residing at Blk 1 Lot 2 Green
St., Urban Subd., La Loma, Quezon City (hereinafter referred to as the SELLER),

- AND -

JUAN DELA CRUZ, of legal age, Filipino, married to JUAN DELA CRUZ, both
of legal age, Filipinos, and residents of 100 Dewey Rd., W.H.O. Village, Fairview,
Quezon City (hereinafter referred to as the BUYERS).

WITNESSETH:

That the SELLER is the registered owner of a certain parcel of land together
with all the improvements found therein, as evidenced by Transfer Certificate of
Title (TCT) No. 123-100000000 situated in Barangay Gulod, Cabuyao Laguna,
Philippines, and more particularly described as follows, to wit:

“A parcel of Land (Lot 1 Blk. 5 of the cons. Subd. Plan Pcs-

12-100000, being a portion of cons. Lots 10 to 22 Blk. 1.
Pcs-00-10000 Lots 3 to 8 Blk 2. Pcs-01-011111 & Lots 2-B-1
& 1-A-2, Psd-01-000000 LRC Rec. No.) situated in Barrio of
Gulod, City of Cabuyao, Province of Laguna. Island of
Luzon. Bounded on the W., Along Line 2-3 by Lot 3 Blk 6;
On the NW., and NE., Along Line 3-4-5 by Road Lot 1; On
the E., Along Line 5-6 by Road Lot 4 (7.00 M. Wide) and on
the S., Along Line 6-2 by Lot 4 Blk-6 XXXX containing an
area of Eighty Seven (87) SQM ….including all the existing
improvements erected thereon.

That the SELLER, for and in consideration of the amount of ONE

MILLION FIVE HUNDRED THOUSAND PESOS (Php1,500,000.00),
Philippine Currency, receipt in full is hereby is acknowledged to his entire
satisfaction, hereby SELL, TRANSFER and CONVEY under PACTO DE
RETRO unto the said BUYERS, their heirs and assigns, the above described
property with all the improvements found thereon, free from liens and
encumbrances whatsoever.
 That the SELLER, in executing this instrument, hereby reserves the right to
REPURCHASE, and the BUYER, in accepting the same, hereby obligates
himself to RESELL the property herein conveyed within a period of THREE (3)
years from and after the date of this instrument for the same price of ONE
MILLION FIVE HUNDRED THOUSAND PESOS (Php1,500,000.00),
Philippine Currency: Provided however, that if the SELLER fails to exercise his
right to repurchase as herein granted within the period stipulated, then
this instrument shall become absolute and irrevocable, without the necessity of
drawing up a new deed of absolute sale, subject to the requirements of the law
regarding consolidation of ownership of real property.

IN WITNESS WHEREOF, the parties have hereunto set their hands this
___________th day of September 2020 in ______________, Philippines.

PEDRO TEA JUAN DELA CRUZ

SELLER BUYER

With my marital consent:

JUANA DELA CRUZ

Signed in the presence of:

_______________________ _________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

_________________________ ) SS.
 BEFORE ME, a Notary Public in the City of _________, this ___day of
__________,2020 personally appeared the following:

Name Proof of Identity Date/Place Issued

Pedro Tea
Juan Dela Cruz
Juana Dela Cruz

known to me to be the same persons who executed the foregoing instrument and
they acknowledged to me that the same is their free and voluntary act and deed.

This instrument, consisting of 3 page/s, including the page on which this

acknowledgment is written, has been signed on the left margin of each and every
page thereof by the concerned parties and their witnesses, and sealed with my
notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand the day, year and
place above written.

Notary Public

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.

Contract of Lease

CONTRACT OF LEASE

This Contract of Lease made and entered into by and between:

_____________, of legal age, Filipino, (single / married / widow), and

a resident of _____________, Philippines, (hereinafter referred to as the
"LESSOR");

- and -
 _____________, of legal age, Filipino, (single / married / widow), and
a resident of _____________, Philippines, (hereinafter referred to as the
"LESSEE");

WITNESSETH That:

WHEREAS, the LESSOR is the owner of a certain parcel of land situated

at _____________, Philippines, more particularly described as follows:

(Technical Description of Property)

WHEREAS, the Lessor desires to lease the afore-described property

in favor of the LESSEE and the LESSEE accepts the lease subject to the
terms and conditions herein set forth.

NOW, THEREFORE, for and in consideration of the terms

and conditions mutually agreed upon by the parties, the LESSOR hereby
lease unto the LESSEE, his heirs, successors and assigns, the above-
described parcel of land subject to the following terms and conditions, to
wit:

1. That the term of this lease shall be for a period of _____________

(_____) (years/months) to commence upon the signing of this
Contract and shall be renewable for another _____________ (_____)
(years/months) at the option of the LESSEE, and thereafter renewable
upon mutual agreement of the parties;

2. That the monthly rentals on the leased premises above-mentioned

shall be __________________________ (P___________),
Philippine Currency for the first _____________ (_____)
(years/months) of this agreement, which shall be increased by
______________________ (P___________) every _____________
(_____) (years/months) thereafter.

The rentals shall be paid by the LESSEE to the LESSOR on a monthly

basis payable on or before the _______th day of the every month;

3. That upon the signing of this Contract, the LESSEE agrees to pay
advanced rentals for _____________ (_______) months;

4. That the LESSOR shall pay the real property taxes levied of the
leased premises corresponding to the aforementioned parcel
 of land while the LESSEE shall pay the real property taxes levied
on the building and other improvements that shall be introduced by
the latter;

5. It is expressly agreed by the parties herein that any fixed

improvements or renovations that will be introduced in the subject
stall shall become the property of the LESSOR after the expiration of
the term of this Contract.

IN WITNESS WHEREOF, the parties have hereunto affixed their

signatures this _____________ at _____________, Philippines.

LESSOR LESSEE

SIGNED IN THE PRESENCE OF:

__________________ __________________

ACKNOWLEDGMENT

Special Power of Attorney

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS, that I, [Your Name], of legal age, a resident
of [Your Address], Philippines, do hereby appoint [Recipient's Name], of legal age, a resident of
[Recipient's Address], Philippines, as my true and lawful attorney-in-fact, with full power and
authority to act on my behalf and in my name, to perform the following specific act:
1. Purpose: The attorney-in-fact is authorized and empowered to perform the following specific
act on my behalf:
[Describe the specific act or task that the attorney-in-fact is authorized to perform.]
2. Duration: This Special Power of Attorney shall be valid and in effect from the date of
execution until [specify a specific date or event upon which it will terminate], unless earlier
revoked in writing by me.
3. Powers and Authority: In connection with the specific act mentioned above, my attorney-in-
fact shall have the power and authority to:
[Specify the powers and authority necessary to carry out the specific act, ensuring they are
clearly defined and limited to the intended purpose.]
4. General Provisions:
a) This Special Power of Attorney is limited in scope and pertains solely to the specific act
described herein.
b) My attorney-in-fact shall act diligently, faithfully, and solely in my best interest, exercising
reasonable care and skill.
c) I hereby ratify and confirm all acts and deeds lawfully done by my attorney-in-fact in
connection with the specific act mentioned above.
d) This Special Power of Attorney shall be governed by and construed in accordance with the
laws of the Republic of the Philippines.
e) This document may be executed in counterparts, each of which shall be deemed an original,
and all counterparts together shall constitute one and the same instrument.
IN WITNESS WHEREOF, I have hereunto set my hand this [day] of [month], [year], in
[City/Municipality], Philippines.
____________[Signature]____________
[Name]
ACKNOWLEDGMENT
BEFORE ME, a Notary Public for and in [City/Municipality], Philippines, this [day] of [month],
[year], personally appeared:
Name ID Presented
[Your Name] [Type of ID] __________________
known to me and to me known to be the same person who executed the foregoing instrument and
acknowledged that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL.
Doc. No. _____;
Page No. _____; Notary Public
Book No. _____;
Series of [Year].

Verification and Certificate of Non-forum Shopping

Republic of the Philippines )

IN THE CITY OF PAGADIAN) S.S.

VERIFICATION AND CERTIFICATION

OF NON-FORUM SHOPPING

I, _______________, a Filipino citizen, of legal age, single/married and a resident of

_______________, state under oath that:

1. That I am the _______________ in the above-captioned case;

2. That I have caused the preparation and the filing of the foregoing Petition;
 3. That the allegations contained therein are true and correct based on my personal
knowledge and authentic documents;

4. That the same is not filed to harass, cause unnecessary delay, or needlessly
increase the cost of litigation; and

5. That the factual allegations in the petition have evidentiary support or, if
specifically so identified, will likewise have evidentiary support after a reasonable opportunity
for discovery.

6. I further certify that:

6.1. That I have not commenced any other action or proceeding involving the
same issue in the Supreme Court, the Court of Appeals or different divisions thereof, or
any other tribunal or agency;

6.2. That should I learn thereafter that a similar action or proceeding has been
filed or is pending before the aforementioned bodies or tribunal, I undertake to report the
fact within five (5) days therefrom to the court or agency wherein the original pleading
and sworn certification contemplated herein has been filed;

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day of

__________ in _______________, Philippines.

_________________________
Affiant
ID No.:
Issued by:

SUBSCRIBED AND SWORN to before me this _____ day of __________ at

_______________, Philippines; affiant exhibiting his competent evidence of identity, written
below her/his name.

Doc. No. _____;

Page No. _____;
Book No. ____;
Series of _____.

Judicial Affidavit

REPUBLIC OF THE PHILIPPINES

MUNICIPAL TRIAL COURT
9th Judicial Region
_____, Zamboanga del Sur
 -o0o-

CASE TITLE
x- - - - - - - - - - - - - - - - - - - - - - - - - - - - x

JUDICIAL AFFIDAVIT OF _______________

I, _______________, a Filipino citizen, of legal age, single/married and a resident of

____________________, state under oath that:

PRELIMINARY STATEMENT

This Judicial Affidavit is prepared in the English language and translated to me in the
Visayan language, which I speak and understand, with an explanation from the counsel. I am
answering the questions asked of me fully conscious that I do so under oath and that I may face
criminal liability for false testimony.

The counsel examining me is ATTY. _______________, with office address at

____________________, and the examination was conducted at the same address. Questions
were propounded by ATTY. ____________________ and these questions are numbered
consecutively; each question is followed by an answer.

I hereby warrant that should there be copies or reproductions attached to this Judicial
Affidavit the same are faithful copies or reproductions of the original thereof.

OFFER OF TESTIMONY

This Judicial Affidavit constituting the direct testimony of _______________ in this case
is offered to prove the following:

1. That he is the ___________ in this case;

2. OTHER PURPOSES

3. That he will testify on other matters relevant to the main purposes for which he is
presented as a witness in the case.
......................

1. Q. Do you swear to tell the truth and nothing but the truth?

A I do.

2. Q Will you please state your name, age, address, and other
 personal circumstances?

A I am __________, a Filipino citizen, _____ years old, and a resident of

____________________.

3. QUESTION AND ANSWER PROPER.

4. Q I have nothing more to ask. Do you have anything more to say?

A None, at the moment.

. . . . . . . . . . . . . . . . . . . . . . . ……..
Affiant further sayeth naught.

_____________________________
Affiant
ID No.:
Issued by:

SUBSCRIBED AND SWORN to before me this _____ day of __________ at

_______________, Philippines; affiant exhibiting his competent evidence of identity, written
below his name.

Doc. No. ___

Page No. ___
Book No. ___
Series of ____.

ATTESTATION

I hereby state, under oath, that I faithfully recorded the questions I asked and the
corresponding answers that the witness gave, which is in the English dialect, and that neither I
nor any other person present or assisting me has coached the witness regarding the latter’s
statement.

ATTY. _____________________________

SUBSCRIBED AND SWORN to before me this _____ day of __________ at

_______________, Philippines; affiant exhibiting her competent evidence of identity.

Doc No. ____

Page No. ___
Book No. ___
Series of ____.

Notarial Certificates
a. Jurat
b. Acknowledgment

JURAT

SUBSCRIBED AND SWORN to before me this _____ day of __________ at

_______________, Philippines; affiant exhibiting his competent evidence of identity, written
below his name/ affiant personally appeared, presenting to me her/his competent evidence of
identity bearing No. _____ valid until _____.

WITNESS MY HAND AND SEAL.

Doc. No. ___

Page No. ___ Notary Public
Book No. ___
Series of ____.

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

_________________________ ) SS.

BEFORE ME, a Notary Public in the City of _________, this ___day of

__________,2020 personally appeared the following:

Name Proof of Identity Date/Place Issued

Pedro Tea
Juan Dela Cruz
Juana Dela Cruz

known to me to be the same persons who executed the foregoing instrument and they
acknowledged to me that the same is their free and voluntary act and deed.

This instrument, consisting of 3 page/s, including the page on which this acknowledgment is
written, has been signed on the left margin of each and every page thereof by the concerned
parties and their witnesses, and sealed with my notarial seal.
 IN WITNESS WHEREOF, I have hereunto set my hand the day, year and place above
written.

Notary Public

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.

Motions
a. Motion for Summary Judgment
b. Motion to Dismiss
c. Motion to Declare in Default

Motion to Dismiss

Republic of the Philippines

____________________
9th Judicial Region
_______________
Pagadian City

CASE TITLE
x-----------------------------------------/

MOTION TO DISMISS

COMES NOW, Accused, through the undersigned counsel and unto this Honorable Court
most respectfully moves for the dismissal of the above-entitled case on all counts on the ground
that the private complainant in the said case, __________, has already become hostile for the
cause of the prosecution by his execution of an Affidavit of Desistance attached hereto as Annex
“1”.

Without the private complainant and main witness’s active participation and cooperation,
the prosecution will have insufficient evidence to prove the guilt of the accused beyond
reasonable doubt.

PRAYER

WHEREFORE, premises considered, it is respectfully prayed of this Honorable Court

that the above-entitled case be DISMISSED.
 Other just and equitable remedies are likewise prayed for.

Respectfully submitted this _______________ in the __________.

Atty. _________________________
Counsel for the Accused
Lawyer’s certificate and details

NOTICE

Clerk of Court
____________________
____________________

Prosecutor __________
__________ Prosecution Office
_______________

Greetings!

Please take notice that I am submitting this MOTION TO DISMISS for the
consideration and approval of this Honorable Court.

Schedule the hearing of the said motion on _____ or on a day the Court and counsels will
be available.

Thank you.

ATTY. ____________________

Copy Furnished:

Prosecutor _______________
__________ Prosecution Office
_______________
Quitclaims in Labor Cases

REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF LABOR AND EMPLOYMENT
NATIONAL LABOR RELATIONS COMMISSION
NATIONAL CAPITAL REGION
QUEZON CITY

_________________________________
Complainant,

-versus- NLRC-NCR Case No. ________________

_________________________________
Respondent.

x----------------------x

QUITCLAIM AND RELEASE

I, _________________________of legal age, with address at _______________________,
after having been duly sworn to an oath in accordance with law, depose and say:

1. I was an employee of ______________________________, with address at

_______________________________________________________________.

2. On the _____ day of ________________, I filed the instant case for illegal dismissal as
well as for the payment of underpaid benefits;

3. That after much thought, I now realize my mistake in filing the instant case. I declare
that I resigned from my work voluntary and of my own free will and design. Being so, I
have no cause of action against my said employer nor any of its officers,
representatives, successors or assigns;

4. I likewise declare that I am not entitled to any underpayment as I mentioned in this

complaint, and hereby free the respondents in this case from any liability whatsoever
from any issues arising from the subject complaint, including that which pertains to the
Social Security Service (SSS), Pag-ibig, and Philhealth.

5. Should there exist anything in the future that may entitle me to file any action against my
employer for any cause of action whatsoever, I hereby waive by these presents
whatever rights that I may have, to institute or maintain the same;

IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of

___________________ at ____________________________.

_______________________________
COMPLAINANT

SUBSCRIBED AND SWORN to before me this ______ day of ___________________ at

_____________________ by the complainant ___________________________. I hereby
certify that I have personally examined the complainant and I am satisfied that he voluntarily
executed and understood the said Quitclaim and Release.

WITNESS MY HAND AND SEAL this _____ day of _______________, 20____ at

_____________________.

_______________________________
LABOR ARBITER

Information in Criminal Cases

Republic of the Philippines

National Capital Judicial Region
REGIONAL TRIAL COURT
Branch 147
Makati City

PEOPLE OF THE PHILIPPINES,

Plaintiff,
Crim Case No. 123456
- versus - for
Homicide
AKU SADO,
Accused.
x - - - - - - - - - - - - - - - - - - - - -x

INFORMATION

The undersigned City Prosecutor hereby accuses Aku Sado of the crime of Homicide
committed as follows:

That on or about August 12, 2013, Makati City within the jurisdiction of this court, the said
accused, armed with a bladed weapon, with intent to kill, did then and there willfully, unlawfully
and feloniously attack, assault and stab one VIC TIMA, thereby inflicting upon him a fatal
wound which directly caused his death.

Contrary to law.

Makati, Philippines, August 22, 2013.

 ATTY. BEN TONG
City Prosecutor

WITNESSES:

MARIA MAKILING JUAN TAMAD

CERTIFICATION

I hereby certify that a preliminary investigation was conducted in the above-entitled case,and
there is prima facie evidence that the crime of Homicide has been committed and that the
accused is probably guilty thereof.

ATTY. BEN TONG

City Prosecutor