REPUBLIC OF THE PHILIPPINES

_______________ TRIAL COURT

___ Judicial Region

Branch __, __________ City

THE PEOPLE OF THE PHILIPPINES

Plaintiff, CRIMINAL CASE NO._____________

-versus- FOR: VIOLATION OF REPUBLIC ACT

NO. 10591

_____________________________

Accused.

x-------------------------------x

APPLICATION FOR PROBATION

The undersigned accused ____________________, hereby applies for probation

under the provisions of Presidential Decree No. 968, as amended and declares
that:

1. The accused received a copy of the judgment from this honorable court on
_____________________.

2. He is of legal age and a resident of _______________________.

3. He has been convicted for Violation of Republic Act No. 10591

(Comprehensive Firearms and Ammunition Regulation Act) and sentenced to serve
the term of imprisonment of not more than six (6) years and one day and has
not yet started serving the same.   

4. The crime for which he was convicted is not an offense against security of
the state; 

5.  He has not previously been convicted by final judgment of any offense

punished by imprisonment of not less than six (6) months and one (1) day
and/or fine of not less than two (2) Thousand Pesos(P2,000.00) and.

6. He has not been on Probation under the provision of P.D. 968, as amended.

______________, _______________, Philippines.

_____________________________

Assisted by:

Atty. _______________________

Copy Furnished:

Office of the City Prosecutor