Republic of the Philippines

____________ Judicial Region

________________ TRIAL COURT

Branch _____, _____________, _____________

INFORMATION

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

That on or about _____________, in the City/Municipality of _____________, Province of _____________ and within the jurisdiction of this Honorable Court, the accused _____________ who is acting as cashier of said court, and as such accountable for the public funds collected and received by reason of his position, in the way of fees, cost and bonds, willfully, unlawfully, and feloniously, and with grave of abuse of confidence, misappropriated, misapplied, and embezzled and converted to his own personal use and benefit, from said funds, the sum ____________________, Philippines currency, to great detriment of public interest.

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