Republic of the Philippines )

Province of Masbate………..)
City of Masbate ……………….) s.s

COMPLAINT

The undersigned,_______________, accuses ___________________of ATTEMPTED RAPE,

committed as follows, to wit:

That on or about ____________, at about ____________in the barrio of _____________________,

municipality of _____________, province of _____________, Philippines, the said accused did then
and there willfully, unlawfully, feloniously, and by means of force and intimidation,
commence the commission of rape upon the undersigned directly by overt acts, to wit: That
while the undersigned was alone in her house in the said barrio of __________, the accused,
without permission if anyone, entered said house and embraced, kissed and touched the
breasts of the undersigned, and lifted her skit with the intent of having carnal; knowledge
of her by means of force and threats, and if the accused did not accomplish his purpose,
that is, to have carnal knowledge of her, it was not because of his voluntary desistance but
because the undersigned succeeded in resisting criminal attempt of the said accused and
because of the opportune intervention of her neighbors who responded who responded to
her cries for help.

___________, this_____day of ______________, 20__.

_____________________________
(Offended Party)

SUBSCRIBED AND SWORN to before me this __________ day of __________________, 20___,

by _________________________offended party.

___________________________________
Municipality Judge of ___________

WITNESSES:
_____________________________
_____________________________
COMPLAINT –
A sworn written statement charging a person with an offense subscribed by the
offended party, any peace officer or other officer of the government or governmental
institution in charge of the enforcement or execution of the law violated.

In case of Rape, Abduction, Seduction, Acts of Lasciviousness