The undersigned, _____________, accuses _____________ of the crime of RAPE, committed as follows, to wit:
That on or about _____________, at about _________ (a.m./p.m.), in the City/Municipality of _____________, Province of _____________ and within the jurisdiction of this Honorable Court, the said accused entered the house of _____________ who was then and there alone, and did there and then, willfully, unlawfully, and feloniously, had carnal knowledge of the said _____________ against her will and by means of force, violence, intimidation and threats.
Contrary to law.
_____________, Philippines, __Date__.
(Certification of Preliminary Investigation)