The undersigned, _____________, accuses _____________ of the crime of
CONCUBINAGE, committed as follows, to wit: That on or about _____________, in the City/Municipality of _____________, Province of _____________ and within the jurisdiction of this Honorable Court, the accused _____________ who is the husband of the undersigned Complainant, cohabited and lived together with his co-accused _____________ as husband and wife in a private dwelling, begetting out of such cohabitation, a child named _____________, the co-accused _____________ knowing fully well that accused _____________ was a very much married man. Contrary to law. _____________, Philippines, __Date__. COMPLAINANT (JURAT) Witnesses: _________________ ____________________