Republic of the Philippines

____________ Judicial Region

________________ TRIAL COURT

Branch _____, _____________, _____________

INFORMATION

The undersigned, _____________, accuses _____________ of the crime of FRUSTRATED HOMICIDE, committed as follows, to wit:

That on or about _____________, at about _________ (a.m./p.m.), in the City/Municipality of _____________, Province of _____________ and within the jurisdiction of this Honorable Court, the said accused, armed with a jungle knife, and with evident intent to kill, did then and there willfully, unlawfully, and feloniously assault, attack and wound one _____________ inflicting mortal wounds in different parts of his body, which would have directly caused the death of said _____________, thus performing all acts of execution which would have produced the crime of homicide as a consequence, but nevertheless did not produce the same by reason of caused independent of his will, that is, because of the timely medical assistance rendered on the said _____________.

Contrary to law.

_____________, Philippines, __Date__.

___________________________________

ASSISTANT PROSECUTOR

(Certification of Preliminary Investigation)

C E R T I F I C A T I O N

This is to certify that as shown by the records the undersigned,an authorized officer, that there is a reasonable ground to believe that a crime has been committed and that the accused is probably guilty thereof; that the accused was informed of the complaint and of the evidence submitted against her and was given an opportunity to submit controverting evidence.

___________________________________

ASSISTANT PROSECUTOR

SUBSCRIBED AND SWORN to before me this July 19, 2010 in the City of Cagayan de Oro, Philippines