Republic of the Philippines

____________ Judicial Region

________________ TRIAL COURT

Branch _____, _____________, _____________

COMPLAINT

The UNDERSIGNED,__________________________, accuses _________, of _____________, committed as follows, to wit: That on or about _________, at about _____________ in the _________________, ______________, Philippines, the said accused did then and there willfully, unlawfully, feloniously, committed BRIBERY, upon the undersigned directly by overt acts to wit: by means of corrupt solicitation, demanded, accepted and agreed to accept cash bribery payments from a confidential informant intending to be rewarded in connection with business a series of transactions in the city of Pasay involving a thing of value P100,000.00. The undersigned executed this affidavit to attest the truthfulness of the foregoing facts and to support the filing of Criminal Cases against _______________________________ for violations of ______________________. ___________, this _____ day of __________, ____.

___________________________________

COMPLAINANT

SUBSCRIBED AND SWORN to before me this ___ day of _______ at _______________. I HEREBY CERTIFY that I have personally examined the here in offended party and I am satisfied that they voluntarily executed and understood their given affidavit.

___________________________________

Judge

WITNESSES:

__________________________

__________________________