The undersigned, _____________, accuses _____________ of the crime of THEFT, 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, with intent to gain, did then and there willfully, unlawfully, and feloniously take, steal and carry away the following personal properties belonging to one, _____________, to wit: _____________, without the latter’s consent and against his will, with a total value of P_____________ to the damage and prejudice of the said _____________ in the cited amount.
Contrary to law.
_____________, Philippines, __Date__.
(Certification of Preliminary Investigation)