This sample java program uses jPDFWriter to create a new PDF file, add a page to it and draw an image and text on the page.

// create document
PDFDocument pdfDoc = new PDFDocument ();
// create a PageFormat of standard letter size 
// with no margins
Paper p = new Paper ();
p.setSize(8.5 * 72, 11 * 72);
p.setImageableArea(0, 0, 8.5 * 72, 11 * 72);
PageFormat pf = new PageFormat ();
// create a new page and add it to the PDF (important!)
PDFPage page = pdfDoc.createPage(pf);
// get graphics from the page
// this object is a Graphics2D Object and you can draw anything 
// you would draw on a Graphics2D
PDFGraphics g2d = (PDFGraphics) page.createGraphics();
// read an image (could be png, jpg, etc...)
BufferedImage image = File("C:\\photo.jpg"));
// draw the image on the page
g2d.drawImage(image, 0, 0, null);
// set the font and color
g2d.setFont (PDFGraphics.HELVETICA.deriveFont(24f));
// draw text on the graphics object of the page
g2d.drawString("NEW TEXT", 200, 30);
// Save the document
pdfDoc.saveDocument ("C:\\output.pdf");

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