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Investigation Data Form

This document is an investigation data form from the National Prosecution Service of the Philippines Department of Justice. It collects information about a complaint including the complainant and respondent's names and addresses, the alleged offense, date and location of the incident, and any witnesses. The complainant certifies that the information is true and correct and that they have not filed a similar complaint in another court or agency.

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Chanine Mae Cruz
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1K views1 page

Investigation Data Form

This document is an investigation data form from the National Prosecution Service of the Philippines Department of Justice. It collects information about a complaint including the complainant and respondent's names and addresses, the alleged offense, date and location of the incident, and any witnesses. The complainant certifies that the information is true and correct and that they have not filed a similar complaint in another court or agency.

Uploaded by

Chanine Mae Cruz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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NPS Investigation Form No. 01 s.

2008

Republic of the Philippines


Department of Justice
NATIONAL PROSECUTION SERVICE
OFFICE OF THE CITY PROSECUTOR
OF _______________
Hall of Justice, ___________

INVESTIGATION DATA FORM

To be accomplished by Office:

DATE RECEIVED: NPS DOCKET NO.:


(stamped and initialed): ___________________ ____________________________________
Time Received: _________________________ Assigned to: __________________________
Receiving Staff: _________________________ Date Assigned: _______________________

To be accomplished by complainant/counsel/law enforce:


(Use back portion if space is not sufficient)

COMPLAINANT/s: Name, Sex, Age & Address RESPONDENT/s: Name, Sex, Age, & Address
_________________________ ____________________________________
__________________________ ______ __________________________ _________ ___
_________________________________ _________________________________________
______________________________________ _______________________________
_______________________________ _____ _____________ _________________________

OFFENSE/s COMMITED / LAW/s VIOLATION: WITNESS/es: Name & Address


__________________________ _ ___________________ _____________
___ defined and penalized under Art. par. , ___ __________________________________
_in relation to Art. __ par. 2 ___________________________________
of The Revised Penal Code ___________________________________

DATE & TIME of COMMISION: PLACE of COMMISION:


____________
_______________________________________ _______________________________________

1. Has a similar complaint been filed before any other office? * YES ___ NO ___
2. Is this complaint in the nature of a counter-charge? * YES ___ NO ___ If yes, indicate details below:
3. Is this complaint related to another case before this office? * YES ___ NO ___ If yes, indicate details below:
I.S. / NPS Docket No.: _______________________
Handing Prosecutor: ________________________

C E R T I F I C A T I O N*
I CERTIFY, under oath, 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 quasijudicial 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)

SUBCRIBED AND SWORN TO before me this ____________ day of ___________________ ,20 _______ ,
In ___________________________________________.

_____________________________________
Administering Prosecutor / Office

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

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