NPS Investigation Form No. 01, s.
2008
Republic of the Philippines
Department of Justice
National Prosecution Service
PARAÑAQUE CITY
___________________
INVESTIGATION DATA FORM
To be accomplished by the Office
DATE RECEIVED: ________________________ NPS DOCKET NO.: ___________________
(stamped and initiated): ____________________ Assigned to: _________________________
Time Received: ___________________________ Date Assigned: _______________________
Receiving Staff: __________________________
To be accomplished by complainant/counsel/law enforcer
(Use back portion of space is not sufficient)
COMPLAINANT/S: Name, Sex, Age & RESPONDENT/S: Name, Sex, Age & Address
Address
LAW/S VIOLATED: WITNESS/ES: Name & Address
ESTAFA or Art. 315 par. 1 (B) of the
Revised Penal Code
DATE & TIME of COMMISSION: PLACE of COMMISSION:
2019 to 2020 Parañaque City
1. Has a similar complaint been filed before any other office?* YES ____ NO __X__
2. Is this complaint in the nature of a counter-charge?* YES ____ NO __X__
If yes, indicate details below.
3. Is this complaint related to another case before this office?* YES ____ NO __X__
If yes, indicate details below.
I.S. No.: ________________________________________
Handling Prosecutor: ______________________________
C E R T I F I C A T I O N*
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 of 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 thereto.
(Signature over printed name)
SUBSCRIBED AND SWORN TO before me this ______ day of Septemner, 2020, in Parañaque City.
____________________________
Prosecutor Administering Oath
*1, 2, 3 and Certification need not be accomplished for inquest cases
NPS Investigation Form No. 01, s. 2008
*1, 2, 3 and Certification need not be accomplished for inquest cases