FORM NO.

51 -- ESTAFA
          
               INFORMATION

    The undersigned accuses .............................................................of the crime of

ESTAFA defined and penalized under ART.315., par .4, 1 (a) of the Revised Penal Code
committed as follows

    That on or about the …………......day of .............129…………………....in the

Municipality of ....................................................................Province of     and within the
jurisdiction of this Hon. Court the said accused in deceitful performance of a  previous
contract to deliver one hundred (100) bags of monosodium glutamate, commonly known
as "Vetsin and after having received in advanced the amount of P500.00 from
one ........................................................................... did then and there willfully ,
unlawfully and feloniously deliver 100 bags under the pretense that they contained the
commodity agreed upon when in fact , on examination, only 20 bags contained the
monosodium glutamate  as the rest contained a mixture of sugar and flour , to the damage
and prejudice of the said .......................................................... in the amount of……

Contrary to law.
..........19…………

                              .......................................
                           Provincial Fiscal

WITNESSES:
........................................
........................................