CT-MCF-SP No.

7-B-3
Permanent Dismissal Following Provisional Dismissal

Original – Court, 1st Copy – Prosecutor, 2nd Copy – Accused, Other copies as needed
Enter information in block letters in all parts of the Form except when reserved for Court use, which shall be
completed by the Clerk.

__________________ For Court Use Only

(Judicial Region)

 METC/MTCC/MTC/MCTC Case No.

 RTC _________________
______________________________
(Municipality/City/Province)

BRANCH __________________________________

People of the Philippines , v.

_________________________,
Accused.

ATTORNEY OR PARTY WITHOUT ATTORNEY

Name ___________________________________________
Firm Name ______________________________________
Address _________________________________________
Email Address ____________________________________
Tel./Cel./Fax Nos. _________________________________
PTR No. ________________ Date/Place
Roll No. ________________ of Issuance ______________
IBP No. ____________ ☐ Lifetime
☐ Date/Chapter
_______________
MCLE ☐ Compliance ☐ Exemption No. ____________________
Other Compliances _______________________________

Attorney for
 Prosecution ☐ Public Prosecutor ☐ Private Prosecutor
 Defense ☐ Public Attorney ☐ Private Counsel
 Other

ORDER

On _______, the Court issued an Order of Provisional Dismissal.

☐ Upon motion of the accused with the conformity of the public prosecutor,
☐ Considering the failure to revive within the period allowed,

let this case be permanently DISMISSED.

ORDER PERMANENT DISMISSAL FOLLOWING PROVISIONAL Page 1 of 2

 CT-MCF-SP No. 7-B-3
Permanent Dismissal Following Provisional Dismissal

SO ORDERED.

ORDER PERMANENT DISMISSAL FOLLOWING PROVISIONAL Page 2 of 2