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Republic of The Philippines Department of Justice National Prosecution Service Office of The Prosecutor Makati

The document is an investigation data form used by the Republic of the Philippines Department of Justice National Prosecution Service Office of the Prosecutor in Makati. The form collects information about complainants, respondents, laws violated, date and place of incident, and requires certification that the information is true and no similar claims have been filed elsewhere.

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Jenica
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104 views1 page

Republic of The Philippines Department of Justice National Prosecution Service Office of The Prosecutor Makati

The document is an investigation data form used by the Republic of the Philippines Department of Justice National Prosecution Service Office of the Prosecutor in Makati. The form collects information about complainants, respondents, laws violated, date and place of incident, and requires certification that the information is true and no similar claims have been filed elsewhere.

Uploaded by

Jenica
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

Republic of the Philippines

Department of Justice
National Prosecution Service
Office of the Prosecutor
Makati
INVESTIGATION DATA FORM
To be accomplished by the Office

DATE RECEIVED : NPS DOCKET NO. :


(stamped and initialed)
Timed received : ______________ Assigned to : _____________________
Receiving Staff : ______________ Date Assigned: _____________________

_________________________________________________________________
To be accomplish by the complainant/counsel/law enforcer.
(Use back portion if space is not sufficient)

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

LAW/S VIOLATED: WITNESSES: Name & Address

DATE & 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 __
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./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 thereof.

___________________________________
(Signature Over Printed Name)

SUBSCRIBED AND SWORN TO before me this _____day of ______________, 20___,


in _____________________.

_______________________________________
Administering Prosecutor/ Officer

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