ESTAFA

(Caption and Title)

INFORMATION

The undersigned Assistant City Prosecutor, upon sworn complaint originally filed by the
offended party, accuses_______________ of the crime of ESTAFA, committed as follows:

That on or about ___________________ in the city of _____________ , province of

________________, Philippines, within the jurisdiction of this court, the said accused, having
received from ________________________various pieces of jewelry of the total value of
_____________________for the purpose of selling the same or commission, under express
obligation of turning over and accounting for the proceeds of said jewelry, if sold, or returning
said jewelry if not sold, to the said ________________within________________ from receipt
thereof, once in possession of the said jewelry and far from complying with her obligation
aforesaid, the said accused did then and there, willfully, unlawfully, and feloniously,
misappropriate, misapply, and covert the said amount to her own personal use and benefit to the
damage and prejudice of said ______________ in the sum of___________________ Philippine
currency.

Contrary to law.

(Venue, date)

Assistant City Prosecutor

Witnesses:

BAIL RECOMMENDED:

Certification