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PJP - Investigation Data Form

This document is an investigation data form from the Office of the Provincial Prosecutor in Cavite, Philippines. It collects information about a complaint including the complainant and respondent's names, addresses, the alleged laws violated, witnesses, and date and place of the incident. The complainant certifies that the information is true and correct and that they have not filed any similar claims in other courts. It provides a docket number and space to note if a similar complaint was previously filed.

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PJPLAW
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508 views

PJP - Investigation Data Form

This document is an investigation data form from the Office of the Provincial Prosecutor in Cavite, Philippines. It collects information about a complaint including the complainant and respondent's names, addresses, the alleged laws violated, witnesses, and date and place of the incident. The complainant certifies that the information is true and correct and that they have not filed any similar claims in other courts. It provides a docket number and space to note if a similar complaint was previously filed.

Uploaded by

PJPLAW
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Justice
National Prosecutor Service

OFFICE OF THE PROVINCIAL PROSECUTOR


Province of Cavite
Imus, Cavite

INVESTIGATION DATA FORM


To be accomplished by the Office

DATE RECEIVED:______________________
(Stamped and initiated)
Time Received: ________________________
Received Staff: ________________________

NPS DOCKET NO:IV-03-IN __-11____ - _______


Assigned To: ______________________________
Date Assigned:_____________________________

_______________________________________________________________________

To be accomplished by complainant/counsel/ Law Enforcer


(Use back portion if space is not sufficient)
COMPLAINANT/S:Name, sex, age and address
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________

RESPONDENT/S: Name, sex, age and address


_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________

LAW/S VIOLATED:
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________

WITNESS/ES: Name and address


_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________

DATE/ TIME OF COMMISSION


________________________________
________________________________

PLACE OF COMMISSION
_______________________________________
_______________________________________

1.
2.
3.

Has a similar complaint been filed before any office? Yes ___ No ____
Is the complaint in the nature of counter-affidavit? Yes ___ No ____ If yes, Indicate below
Is this complaint related to other case before this Office? Yes ____ No ____ If yes, Indicate below

I.S No. _______________________________________


Handling Prosecutor ____________________________

CERTIFICATION *
I CERTIFY, under oath, that all information on this sheet are true and correct to the best of my knowledge and belief,
That I have not commenced any action or filed any claim involving the same issues in any court, tribunal, or quasi-judicial
agency, and that if I should thereafter learn that a similar action has been filed and/or is pending, I shall report that fact to this
Honorable Office within five (5) days from knowledge thereof.

___________________________________

(Signature over printed name)


SUBSCRIBED AND SWORN to before
________________________________________________.

me

this

___

day

of

________2011,

__________________________________

Prosecutor/ Administering Officer


*1, 2, 3 and Certification need not be accomplished for inquest cases

in

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