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Republic of The Philippines Department of Justice National Prosecution Office Provincial Prosecution Office

This document is an investigation data form from the National Prosecution Office of the Philippines Department of Justice. It collects information about a complaint including the complainant, respondent, law violated, date and place of incident, and certification that the information provided is true. It assigns a docket number, investigator, and confirms that no similar case has been filed elsewhere. The form is used to gather initial details about a complaint to facilitate the investigation.

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102 views

Republic of The Philippines Department of Justice National Prosecution Office Provincial Prosecution Office

This document is an investigation data form from the National Prosecution Office of the Philippines Department of Justice. It collects information about a complaint including the complainant, respondent, law violated, date and place of incident, and certification that the information provided is true. It assigns a docket number, investigator, and confirms that no similar case has been filed elsewhere. The form is used to gather initial details about a complaint to facilitate the investigation.

Uploaded by

AC GoldJewelries
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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 Office
PROVINCIAL PROSECUTION OFFICE
______________________

INVESTIGATION DATA FORM

To be accomplished by the Office

DATE RECEIVED: NPS DOCKET NO.: NPS-V-09-INV____________


(stamped and initialed):
Time Received: _______________________ Assigned to: _________________________________
Receiving Staff: ______________________ Date Assigned: _______________________________

To be accomplished by complainant/counsel/law enforcer


(Use back portion if space is not sufficient)

COMPLAINANT: RESPONDENT:
Name, age, address_____________________ _____________________________________
LAW VIOLATED: WITNESS:
____________________________________ _____________________________________

DATE AND TIME OF COMMISSION: PLACE OF COMMISSION:


__________________________________ _____________________________________

1. Has a similar complaint been filed before any other office? Yes ____ No ___
2. Is this complaint in the nature of a counter-affidavit? Yes ____ No ___
3. Is this complaint related to another case before the office? Yes ____ No ___

I.S. No.: __________________________________


Handling Prosecutor: _______________________

CERTIFICATION

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

_______________________________

SUBSCRIBED AND SWORN to before me this __th day of _____________ in


___________________, Philippines by _____________________________ who has satisfactorily
proven to me their identity through their _______________________________ and, that they are the
same persons who executed the foregoing and that they freely and voluntarily executed the same.

Doc. No. ___


Page No. ___
Book No. ___
Series of ____.

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