Republic of the Philippines

DEPARTMENT OF JUSTICE
NATIONAL PROSECUTION SERVICE
PROVINCIAL PROSECUTION OFFICE
AGUSAN DEL NORTE
Hall of Justice, Libertad, Butuan City

PNP BUENAVISTA, AGUSAN

DEL NORTE, represented by
PSI JORGE M. FERNANDEZ FOR: Violation of RA 10591; and
Complainant Violation of RA 9516;

Complainant,

- versus -

Rodrigo R. Asistido

Respondent
X------------------ --/

REQUEST FOR PRELIMINARY

INVESTIGATION AND WAIVER
OF ARTICLE 125
REVISED PENAL CODE

I wish to avail myself of my right to a preliminary investigation and, for this purpose, I hereby
voluntarily waive my rights under the provisions of Article 125 of Revised Penal Code. Pending the
completion of the preliminary investigation proceedings, I agree to remain under police custody.

Butuan City, Philippines, September 28, 2014

Rodrigo R. Asistido
Respondent
Assisted by:

Lawyer

SUBSRCIBED AND SWORN TO before me this ___ day of ______________ at

Butuan City.