REPUBLIC OF THE PHILIPPINES

1 Municipal Circuit Trial Court of

st

_______________________________
____________________________

PEOPLE OF THE PHILIPPINES,

Plaintiff,
CRIM. CASE NO. 19-CR-________-B
-versus-

________________________________ For: THEFT OF MINERALS

Accused.
x-----------------------------------------/
APPLICATION FOR PROBATION
I, ______________________, hereby apply for probation under the provisions of
Presidential Decree No. 968 (Probation Law of 1976), as further amended by Republic
Act No. 10707, and declare:
1. That I am ____ years old, Filipino, married, indigent, and presently residing at
__________________________;

2. On January 1, 2022, I was charged of the above-cited and voluntarily pleaded

guilty to the crime of Theft of Minerals with a lesser penalty of straight six (6)
months of imprisonment;

3. That the crime for which I was convicted is not an offense against the national
security;

4. That I have not been previously convicted by final judgment of any offense
punished by imprisonment of more than six (6) months and one (1) day
and/or fine of more than one thousand pesos (P1,000);

5. That I have not been once on probation under the provisions of this Decree;

6. That I am sincerely remorseful and penitent of the offense I committed and if

granted probation, I am willing to undergo supervision under such terms and
conditions that may be imposed by the Honorable Court;

______________________________, January 20, 2022.

_______________________________
Applicant
ID No. ______________________
Mobile Number: ____________________

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