REPUBLIC OF THE PHILIPPINES

SUPREME COURT
Manila

___________________,
Petitioner,

- versus - G.R. No. ___________

[CA G.R. CR No. _________]
__________________, (Homicide)
Respondent.
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PETITION FOR REVIEW ON CERTIORARI

COMES NOW, Petitioner, by counsel, to this
Honorable Court, most respectfully elevates for review on
certiorari under Rule 45 of the 1997 Rules of Civil Procedure,
the Decision of the Court of Appeals dated ____________.

STATEMENT OF MATERIAL DATES

On October 4, 2019, Petitioner, through counsel,

received a copy of the Court of Appeals’ Decision
promulgated on _____________.

Thus, Petitioner has until _______________ (compute:

15 days from receipt of decision) within which to file the
instant Petition.

THE PARTIES

Petitioner Juan Dela Cruz, a resident of Sitio Lucky,

Makadatu City, is represented by Atty. __________, (insert
your name and address) where he may be served with
notices and other processes of this Honorable Court.
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Respondent People of the Philippines is being

represented by the Office of the Solicitor General and may
be served with notices, orders, decisions and other papers
through the latter’s office address at 134 Amorsolo St.,
Legaspi Village, 1229 Makati City.

The Court of Appeals, which rendered the assailed

Decision, is not made a party respondent in this case
pursuant to Section 4, Rule 45 of the 1997 Rules of Civil
Procedure. Nonetheless, it is being served with a copy of
the petition at Midway Building, P. Abella St., Labangon,
Cebu City.

STATEMENT OF THE MATTERS INVOLVED

Petitioner __________________ was charged in an

Information for the crime of Homicide, the accusatory
portion of which reads, viz:

“(insert Information; see Court of Appeals’

Decision)”

Upon arraignment, Petitioner pleaded NOT GUILTY to

the crime charged.

EVIDENCE FOR THE PROSECUTION

The Prosecution presented __________ and

_________ as its witness. (insert summary of witnesses’
testimony based on Court of Appeal’s Decision)

EVIDENCE FOR THE DEFENSE

To refute the allegations of the prosecution, the

defense presented ___________ and _____________.
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RULING OF THE REGIONAL TRIAL COURT

On _________, the Regional Trial Court, ___________

rendered a Decision convicting herein Petitioner. The
dispositive portion of which reads as follows:

“(insert dispositive portion of the RTC

Decision)”

RULING OF THE COURT OF APPEALS

Dissatisfied by the said Decision, the Petitioner

interposed an appeal before the Court of Appeals.

On ______________, the Court of Appeals rendered a

Decision affirming with modification the Decision of the
Regional Trial Court. The decretal portion of which reads:

“(insert dispositive portion of Court of

Appeals’ Decision)”

A copy of the aforesaid Decision was received by the

Petitioner, through counsel on October 4, 2019.

Hence, the filing of the instant Petition.

GROUNDS FOR THE ALLOWANCE

OF THE PETITION

The Court of Appeals gravely erred in affirming the

Petitioner’s conviction. The assailed Decision is not in
accordance with facts, law and applicable jurisprudence
which, if not corrected, would work grave injustice to herein
Petitioner and cause him irreparable damage. Although the
present Petition involves questions of fact, it is submitted
that this Honorable Court has the authority to review and
reverse the factual findings of the lower court if it finds that
they do not conform to the evidence. 1

1
Philippine National Bank v. Court of Appeals, et al., 187 SCRA 735.
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ISSUE PRESENTED FOR RESOLUTION

“___________________________”
(insert assignment of error/issue
presented for resolution)”

ARGUMENTS AND DISCUSSIONS

________________________________________________
________________________________________________
________________________________________________
____________________________________________
(insert arguments and discussion)

PRAYER
WHEREFORE, premises considered, it is most
respectfully prayed of this Honorable Court that the instant
Petition be GIVEN DUE COURSE and accordingly, the
Decision dated ____________ rendered by the Court of
Appeals be REVERSED and SET ASIDE and a new one be
rendered ACQUITTING Petitioner _______________ of
the crime charged.

Other reliefs just and equitable under the premises are

likewise prayed for.

Respectfully submitted.
________________. Cebu City for Manila, Philippines.

By:

Atty. _____________
Roll No. ___________
IBP No. ____________
MCLE Compliance No. VI______
PTR No. ___________
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EXPLANATION

Pursuant to Sec. 11, Rule 13 of the 1997 Rules of Court

a copy of the foregoing PETITION is being served by
registered mail due to distance and lack of office personnel
to effect personal service.

Atty. _____________

Copy furnished:

OFFICE OF THE SOLICITOR GENERAL Reg. Rec. No. ______

134 Amorsolo St., Legaspi Village Date: __________
1229 Makati City

COURT OF APPEALS Reg. Rec. No. ______

Midway Bldg., P. Abella St., Date: ___________
Happy Valley Subdivision
Labangon, Cebu City 6000
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VERIFICATION / CERTIFICATION
OF NON FORUM SHOPPING

I, ________________, of legal age, Filipino, and a

resident of ______________, under oath, hereby depose
and state that:

1. I am the Petitioner in the above-entitled case;

2. I have caused the preparation of the foregoing Petition

for Review on Certiorari;

3. The allegations stated therein are true and correct

according to my personal knowledge and are based on
authentic records;

4. Furthermore, (a) I have not commenced any other

action or proceeding involving the same issues in the
Supreme Court, the Court of Appeals, or any other
tribunal or agency, (b) to the best of my knowledge, no
such action or proceeding is pending in the Supreme
Court, the Court of Appeals, or any other tribunal or
agency and (c) if should I learn that a similar action or
proceeding has been filed or is pending in the Supreme
Court, the Court of Appeals, or any other tribunal or
agency, I undertake to report such fact within five (5)
days therefrom to this Honorable Court.

IN WITNESS WHEREOF, I have hereunto set my hand

this ____ day of _________________, 2019, in
_____________________________, Philippines.

______________
Affiant

SUBSCRIBED AND SWORN to before me, this _____

day of ____________________, 2019, in
_____________________________, Philippines.
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Notary Public
(insert details)