Republic of the Philippines

MUNICIPAL TRIAL COURT

________________ Judicial Region
BRANCH ____, City/Municipality

PEOPLE OF THE PHILIPPINES,

Plaintiff, CRIM. CASE NO.__________
- versus - (NPS No. ________________)
FOR: ACTS OF LASCIVIOUSNESS
(complete name of accused)
(Address: _______________/
Detained at _____________)
Accused.
x- - - - - - - - - - - - - - - - - - - - - -x

INFORMATION

The undersigned Assistant State/Provincial/City Prosecutor accuses (complete

name of accused) of the crime of ACTS OF LASCIVIOUSNESS, committed as follows:

That on or about the 29th day of August, 2016, in the Barrio of ____,
Municipality of _____, Province of ______, Philippines and within the
jurisdiction of this Honorable Court, the above-named accused with the
deliberate intent to satisfy his lust, did then and there willfully, unlawfully
and feloniously commit an act of lasciviousness on the person of
(Complete Name of the victim), a public school teacher, by then and there
placing himself close to her, embracing and kissing her against her will
and by means of force, and as a consequence thereof said offended party
fell to the floor resulting to her injury which caused her pain and
tenderness on the right side of the trunk on the posterior surface of the
right arm which injuries may require 3 to 4 days to heal; that the crime
was committed with the aggravating circumstance that the same was
perpetrated inside the public school building and during class hour.

Contrary to law.

(Name of Investigating Prosecutor)

(designation)

_________________________
Issued on __________________

APPROVED:

(Name)
(designation)
__________________________
 CERTIFICATION

This is to certify that a preliminary investigation has been conducted in this case; that
based on the evidence submitted by the private complainant, there is sufficient ground to
engender a well-founded belief that acts of lasciviousness has been committed, and that the
accused is probably guilty thereof and should be held for trial; and that the accused was
afforded due process of law.

(Name of Investigating Prosecutor)

(designation)
_________________________
Issued on __________________

SUBSCRIBED AND SWORN to before me this ___ day of (month) (year) at (place)

WITNESSES:

1.
2.
3. Others.

BAIL RECOMMENDED: _________________