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

RECOGNIZANCE

The accused JUAN DELA CRUZ having been allowed temporary liberty
upon recognizance of the undersigned, the latter hereby accepts custody of the
said accused and guarantees his appearance whenever required by the
Honorable Court.

March XXX, 2020, XCity, XProvince.

XXX Custodian
ID No.
Place of Issue

SUBSCRIBED AND SWORN to before me this March XXX, 2020, XCity,

Philippines.