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Investigation Data Form

This investigation data form provides details of a complaint filed against Madison Bank, Inc. and respondent Madison . for the crime of estafa. The complainant is C Bank, Inc., represented by Peter Conde. The complaint alleges estafa occurred between May 2018 and January 2019 in Pangasinan province. No similar complaints have been filed. The complainant certifies the information is true and correct.

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316 views

Investigation Data Form

This investigation data form provides details of a complaint filed against Madison Bank, Inc. and respondent Madison . for the crime of estafa. The complainant is C Bank, Inc., represented by Peter Conde. The complaint alleges estafa occurred between May 2018 and January 2019 in Pangasinan province. No similar complaints have been filed. The complainant certifies the information is true and correct.

Uploaded by

Legalsec Unitop
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 Prosecution Service
Office of the Provincial Prosecutor
________________________________

INVESTIGATION DATA FORM

To be accomplished by the Office

DATE RECEIVED_______________ NPS DOCKET NO._____________


(stamped and initialed)________ Assigned to:_________________
Time received:_______________ Date Assigned:_______________
Receiving Staff:______________

To be accomplished by the complainant/counsel/law enforcer


(Use back portion if not sufficient)

COMPLAINANT/S: Name, Sex, Age, Address RESPONDENT/S: Name, Sex, Age, Address

C Bank, Inc., Represented By: , Male Madison


PETER CONDE, Male, ., Batino Calamba City, Laguna
20 M. Paulino St., Cor. Burgos St.,
San Jose City, Laguna

LAW/S VIOLATED WITNESS/ES: Name and Address


Estafa , Pugaro, Manaoag,

, Baritao, Manaoag, Pangasinan

DATE AND TIME OF COMMISSION PLACE OF COMMISSION


May 2018 - January 2019 Pangasinan

1. Has a similar complaint been filed before any other offices? Yes __ No / if yes,
indicate details below
2. Is this complaint in the nature of a counter-charge? Yes___ No / if yes,
Indicate details below
4. Is this complaint related to another case before this office? Yes___ No / if yes,
Indicate details below
I.S./NPS Docket No. _______________________
Handling Prosecutor _______________________

CERTIFICATION

I CERTIFY under oath, that all the 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 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.

Peter Conde
(Signature Over Printed Name)

SUBSCRIBED AND SWORN to before me this ________day of _______________, 2019 at


__________________________.

____________________________
Administering Officer

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