Republic of the Philippines

SUPREME COURT
Manila

______________________ ,
Plaintiff-Appellant
,G.R. No. _____________
- versus - (Designation of the Pleading)

______________________ ,
Defendant-Appellee
,x - - - - - - - - - - - - - - - - - x

PETITION COMES NOW t h e P e t i t i o n e r , b y t h e u n d e r s i g n e d a t t o r n e y , a n d

u n t o t h i s Honorable Court, respectfully avers:

1 . T h a t p e t i t i o n e r _____________ i s o f l e g a l a g e , m a r r i e d a n d a
r e s i d e n t o f _____________ , Philippines, while respondent is also of legal age and may
be served with summons, writs and all orders of the Honorable Court at his office
address at_____________ , Philippines;

2 . T h a t t h e p e t i t i o n e r , _____________ , i n wh os e b eh al f t hi s a pp l i ca t i o n i s
bei n g made, is actually restrained of his liberty by the respondent_____________ who is the Chief
of Police of _____________ at the
_____________ Police Station;

3 . T h a t s o m e t i m e i n t h e m o r n i n g o f _____________ , pet i t i on e r w as t a ke n
i nt o custody by the said respondent without a warrant of arrest and detained at
the _____________ Police Station without any criminal charges being filed against him
before the proper judicial authorities despite the lapse of ________ ( ______ ).
Moreover, petitioner was taken by the respondent not under any
o f t h e circumstances where a warrantless arrest is allowed by the law or the Ru les
of Court;

4.That such restraint of liberty of the petitioner by the respondent is

t h e r e f o r e without any legal authority;
5.T h at t h e pe t i t i on e r t hr ou gh co uns el h as ex ha ust e d a l l ef fo rt s a va i l abl e at l a w
but t o n o a v ai l , a nd t ha t h e h a s no ot he r pl ai n, sp e ed y, an d ad eq u at e re m e d y
to p r o t e c t h i s p e r s o n a l r i g h t s a n d s e c u r e h i s p e r s o n a l l i b e r t y e x c e p t b y
h i s application for a Writ of Habeas Corpus.

PRAYER
WHEREFOR, petitioner most respectfully prays that a Writ of Habeas Corpus b e i s s u e d b y
this Honorable Court, directed to the
r e s p o n d e n t _____________ commanding the latter to produce the body of
_____________ before this Court at the time and place therein specified, and to summon the
respondent_____________ then and there to appear and to show cause of the detention of
said_____________ ; and that after du e pr o ce e di n gs , t h e s ai d _____________ be r est o r ed o f
hi s l i b e rt y a nd fo rt h wi t h discharged from confinement .

_____________ , Philippines, __Date__ .

(COUNSEL)

VERIFICATION AND CERTIFICATION

REPUBLIC OF THE PHILIPPINES)

Province of ____________________ ) S.S.
City/Municipalityof _____________ )
x-----------------------x

I,_____________ , of l e gal a ge, Fi l i pi n o, (si n gl e / m ar ri e d / wi d ow ), a n d a resident

of _____________ , P h i l i pp i n es , a ft e r b ei n g sw o rn i n a c co r da n c e wi t h l a w, hereby
depose and say:

That I am the(Plaintiff / Complainant / Petitioner)in the above-entitled case; That I have

caused the preparation of the above(Complaint / Petition)and I h av e r e ad t h e same and
knows the contents thereof; That the allegations contained therein are true and correct of my own
personal knowledge.
 That I further certify that: (a) I have not theretofore commenced any other action or proceeding or filed
any claim involving the same issues or matter in any court, tribunal, or quasi-judicial agency and, to the best
of my knowledge, no such action or proceeding is pending therein; (c) if I should thereafter learn that the
same or similar action or proceeding has been filed or is pending before the Supreme Court, the Court
of Appeals, or any other tribunal or quasi-judicial agency, I undertake to report such fact
within five (5) days therefrom to the court or agency wherein the original pleading and sworn
certification contemplated herein have been filed.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at _____________ ,

Philippines.

AFFIANT

SUBSCRIBED AND SWORN t o before me, t h i s _____________ ,

by _____________ w h o e x h i b i t e d t o m e (his/her) C o m m u n i t y T a x C e r t i f i c a t e
N o . _____________ issued at _____________ , Philippines on _____________ .

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of ______;