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Republic of the Philippines

REGIONAL TRIAL COURT


Second Judicial Region
Branch 14
Laoag City

PEOPLE OF THE PHILIPPINES,


Plaintiff,

Crim. Case No. ________


For: Violation of ________
LOVE,
Accused.
x- - - - - - - - - - - - - - - - - - - - -x

WAIVER
It is hereby understood and made a part of the undertaking for the appearanceof the
accused that failure on the part of the accused to appear on any date set for
hearing/trial despite due notice, shall be considered as waiver of his
appearance/presence duting the said proceedings, and the court shall proceed and
continue as if the accused were present who hereby ratify/ies the same without
prejudice to the issuance of a Warrant of Arrest and/or confiscation of bail in the proper
case.

Laoag City, ___________.

___________________________
PRINT NAME AND SIGNATURE

Date of Birth:___________________________________________________________
Place of Birth:__________________________________________________________
City Address:___________________________________________________________
______________________________________________________________________
Provincial Address:______________________________________________________
______________________________________________________________________
Height: ___________Weight:________________ Complexion:____________________
Lips:___________ Eyes:______________ Nose:___________ Built:_______________
Identifying Marks:________________________________________________________
Father’s Name:_________________________________________________________
Date of Birth:________________________ Place of Birth:_______________________
Mother’s maiden Name:___________________________________________________
Date of Birth:_________________ Place of Birth:______________________________
Com. Tax Cert. No.:________________________ Issued on:_____________________
Issued at:____________________________ Voter’s ID No.:______________________
Telephone/ Phone No.:___________________________________________________

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