Republic of the Philippines

REGIONAL TRIAL COURT

XX Judicial Region
Branch X
XXXXXXX City

PEOPLE OF THE PHILIPPINES, Criminal Cases No. XXXXX

Plaintiff, and XXXXX

-versus- -for-

JUAN DELA CRUZ Y REYES, VIOL. OF SECS. 5 & 11,

alias “YAM-YAM”, ARTICLE II, OF RA 9165
Accused.
X---------------------------------------------------------X

APPLICATION FOR PROBATION

The accused, JUAN DELA CRUZ, by and through the PUBLIC

ATTORNEY’S OFFICE, hereby applies for probation under the provisions of
Presidential Decree No. 968, as amended by R.A. 10707 and declares:

1. THAT he is 38 years old, married, and a resident of xBarangay, xCity,

xProvince;
2. THAT he has been convicted by this court in the above-entitled cases and
sentenced to suffer the penalty of six (6) months and one (1) day to four
(4) years of imprisonment and to pay a fine in the amount of Ten
Thousand (10,000.00) pesos, with subsidiary imprisonment for
Criminal Case XXXXX.
3. THAT he has likewise been convicted by this court in the above-entitled
cases and sentenced to suffer the penalty of six (6) months and one (1)
day to four (4) years of imprisonment and to pay a fine in the amount
of Ten Thousand (10,000.00) pesos, with subsidiary imprisonment for
Criminal Case XXXXX.
4. THAT the above-mentioned penalty is within the probationable range of
not more than SIX (6) years of imprisonment;
5. THAT he has not filed, much less perfected an appeal from the judgment
of conviction;
6. THAT the crime for which he has been convicted is not an offense of
subversion or against the security of the State of the public order;
7. THAT he has not previously been convicted by final judgment of any
offense punished by imprisonment of not less than six (6) months and one
 (1) day and/or a fine of more than one thousand pesos (P1,000.00) pesos;
and
8. THAT he has not been once on probation under the provision of
Presidential Decree No. 968, as amended by R.A. 10707.
9. THAT he is sincerely remorseful and penitent of his present offenses and,
if granted probation, is willing to undergo supervision under such terms
and conditions that may be imposed by this Honorable Court.

March XXX, 2020, xCity, xProvince.

Blah Blah Law Office

xBuilding
xCity, xProvince by: Atty. Koko Kwik-kwak
Roll of Attorneys No. 1111111
IBP Dues paid, waiting for receipt
MCLE Compliance No. VI - 12345

COPY FURNISHED:

Office of the City Prosecutor

xCity, xProvince