Republic of the Philippines

[COURT]
Manila
[NAME]__________,
Petitioner,
-

Case No. ___________

versus -

[NAME]__________,
Respondent(s).
x ----------------------------------- x
PETITION FOR WRIT OF HABEAS CORPUS
PETITIONER, by counsel, respectfully states that:
PARTIES
1. Petitioner or is [STATE THE RELEVANT PERSONAL/PROFESSIONAL
CIRCUMSTANCES. IF PETITIONER IS A QUALIFIED PERSON, INDICATE HIS
RELATIONSHIP TO THE AGGRIEVED PARTY. PROVIDE THE FACTUAL
STATEMENTS RELEVANT TO THE ILLEGAL CONFINEMENT OR
DEPRIVATION OF LIBERTY. PROVIDE THE CONTACT DETAILS AND OTHER
RELEVANT DETAILS]
2. Respondent is/are [STATE THE RELEVANT PERSONAL/PROFESSIONAL
CIRCUMSTANCES, CONTACT DETAILS AND OTHER RELEVANT DETAILS]
STATEMENT OF FACTS
3. [DETAIL THE CHRONOLOGY OF EVENTS RELEVANT TO THE ILLEGAL
CONFINEMENT OR DETENTION OR DEPRIVATION OF LIBERTY
4. [STATEMENT ON THE JUDICIAL AFFIDAVITS OF WITNESSES, IF ANY]
5. [STATE THE EFFORTS MADE TO VINDICATE THE RIGHTS OF THE
AGGRIEVED PARTY AND THE RESULT OF THOSE EFFORTS]
6. [STATE MATERIAL FACTS RELEVANT TO ANY OTHER INTERIM RELIEF, IF
ANY]
7. [STATE MATERIAL FACTS RELEVANT TO FINAL RELIEF/S]
WHEREFORE, petitioner respectfully prays that [INDICATE THAT THE COURT
GRANT THE INTERIM RELIEFS IMMEDIATELY, THE FINAL RELIEFS TO BE GRANTED,
INTERIM RELIEFS TO BE MADE PERMANENT]
Other forms of relief just and equitable under the premises are likewise prayed for.

[CITY] ___________; [DATE] _________________________.

[SIGNATURE]
[NAME OF COUNSEL] ___________
Counsel for Petitioner
[ADDRESS] ______________

IBP Lifetime No. ____________; [CITY] _____________

PTR No. _______________; [DATE], [CITY]
Roll of Attorney No. _______________________
MCLE Compliance No. ____________________

VERIFICATION & CERTIFICATION AGAINST FORUM SHOPPING

I, [NAME] _____________________, of legal age, do hereby state that: I am the
plaintiff in the pleading/document entitled [PLEADING/DOCUMENT BEING VERIFIED]
___________________ and in such capacity, caused this Complaint to be prepared; I have
read its contents and affirm that they are true and correct to the best of my own personal
knowledge; I hereby certify that there is no other case commenced or pending before any
court involving the same parties and the same issue and that, should I learn of such a case, I
shall notify the court within five (5) days from my notice.
IN WITNESS WHEREOF, I have signed this instrument on [DATE]_____________.
[SIGNATURE]
[NAME] _________________

SUBSCRIBED AND SWORN TO before me in the City of _______________ on this

day of [MONTH AND YEAR]_________________, affiant exhibiting before me his
Government Issued ID no. _______________ issued on [DATE}__________________ at
[PLACE OF ISSUANCE]_____________________.
[SIGNATURE]
[NAME]_______
Notary Public
Until [DATE]__________________
PTR No. [NUMBER] ____________
Issued at [PLACE]______________
On [DATE] ___________________
Doc. No.
Page No.
Book No.
Series of [YEAR] ___________.

Copy furnished through personal service:

[NAME OF COUNSEL] __________________
Counsel for the Defendant
[FIRM NAME] _______________
[ADDRESS] ________________
[USE THE FOLLOWING IF SERVICE IS NOT MADE PERSONALLY]
Copy furnished through registered mail:
[NAME OF COUNSEL] __________________

Counsel for the Defendant

[FIRM NAME] _______________
[ADDRESS] ________________
Registry Receipt No. ________
Post Office ________________
Date _____________________
EXPLANATION
The
foregoing
[DESIGNATION
OF
PLEADING,
MOTION,
ETC]
_______________and its attachment were served on [NAME OF COUNSEL]
________________ by registered mail instead of personal service as counsel for petitioner
[STATE REASON] ___________________.
[SIGNATURE]
[NAME] _________________

Republic of the Philippines

City of _______________

)
) s.s.
AFFIDAVIT

I, [NAME] ____________ , a messenger of [NAME OF COUNSEL FOR PLAINTIFF],

with office address at [ADDRESS] __________________, after being duly sworn, deposes
and states:
That on [DATE] ______________________, I served a copy of the following
pleadings/papers by registered mail in accordance with Section 10, Rule 13 of the Rules of
Court:
Nature of Pleading/Paper
[STATE PLEADING/PAPER SENT]
________________________
in Case No. [CASE NUMBER] _________________ entitled [TITLE OF CASE]
____________________ by depositing a copy in the post office in a sealed envelope, plainly
addressed to [NAME OF PARTY/ATTORNEY] _______________ at _______________ with
postage fully paid, as evidenced by Registry Receipt No. _____________________ attached
and with instructions to the post master to return the mail to sender after ten (10) days if
undelivered.
TO THE TRUTH OF THE FOREGOING, I have signed this Affidavit on [DATE]
________________, in the City of [CITY] _____________, Philippines.
[SIGNATURE]
[NAME] __________
Affiant
SUBSCRIBED AND SWORN TO before me in the City of _______________ on this
day of [MONTH AND YEAR]_________________, affiant exhibiting before me his
Government Issued ID no. _______________ issued on [DATE}__________________ at
[PLACE OF ISSUANCE]_____________________.
[SIGNATURE]
[NAME]_______

Notary Public
Until [DATE]__________________
PTR No. [NUMBER] ____________
Issued at [PLACE]______________
On [DATE] ___________________
Doc. No.
Page No.
Book No.
Series of [YEAR] ___________.