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    PCpl J.B. Mark Sanchez
    1) Rose Alain y Robis filed a complaint against four men - Edgardo Santiago, Espinoza Clark, Godoy Jomar, and Liwaliw Fronstone - for the offense of rape with homicide. 2) The incident reportedly occurred at 10:00 AM in Kalye Putol, Sitio Tagbak, Brgy. San Jose, Antipolo City. 3) Johnry Poblete y Duenas, a 49-year old taho vendor from the same area, witnessed the incident.

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    Use Back Portion If Not Sufficient

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    PCpl J.B. Mark Sanchez
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    1) Rose Alain y Robis filed a complaint against four men - Edgardo Santiago, Espinoza Clark, Godoy Jomar, and Liwaliw Fronstone - for the offense of rape with homicide. 2) The incident reportedly occurred at 10:00 AM in Kalye Putol, Sitio Tagbak, Brgy. San Jose, Antipolo City. 3) Johnry Poblete y Duenas, a 49-year old taho vendor from the same area, witnessed the incident.

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    IDF and Referral

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    1) Rose Alain y Robis filed a complaint against four men - Edgardo Santiago, Espinoza Clark, Godoy Jomar, and Liwaliw Fronstone - for the offense of rape with homicide. 2) The incident reportedly occurred at 10:00 AM in Kalye Putol, Sitio Tagbak, Brgy. San Jose, Antipolo City. 3) Johnry Poblete y Duenas, a 49-year old taho vendor from the same area, witnessed the incident.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    77 views2 pages

    Use Back Portion If Not Sufficient

    Uploaded by

    PCpl J.B. Mark Sanchez
    1) Rose Alain y Robis filed a complaint against four men - Edgardo Santiago, Espinoza Clark, Godoy Jomar, and Liwaliw Fronstone - for the offense of rape with homicide. 2) The incident reportedly occurred at 10:00 AM in Kalye Putol, Sitio Tagbak, Brgy. San Jose, Antipolo City. 3) Johnry Poblete y Duenas, a 49-year old taho vendor from the same area, witnessed the incident.

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    of 2

    Republic of the Philippines

    Department of Justice
    NATIONAL PROSECUTION SERVICE
    Antipolo City, Rizal

    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 complainant/counsel/law enforcer


    (Use back portion if not sufficient)

    COMPLAINANT/s Name, Sex, Age & Address RESPONDENT/s Name, Sex, Age & Address

    1.Rose Alain y Robis, Female, 49 y.o, a resident of No. 1. EDGARDO SANTIAGO y TADAS alyas “Tata Edgie”,
    1 Kalye Putol Sitio Tagbak Brgy. San Jose, Antipolo City Male,57 years old,a native of Brgy. Malinis, Tuguegarao
    CP number:099999999 City, Province of Cagayan, Cagayan Valley and
    presently residing at No. 20 Sitio, Buhanginan, Brgy. San
    Jose Antipolo City

    2. Espinoza, Clark y Rulloda alyas Buli 50 years old,


    Male, a native of Tuguegarao City, Province of Cagayan
    Cagayan Valley and presently residing at No. 20 Sitio,
    Buhanginan, Brgy. San Jose Antipolo City

    3. Godoy, Jomar Bancifra alyas Suob, 54 years


    old,Male a native of Tuguegarao City, Province of
    Cagayan, Cagayan Valley and presently residing at No.
    20 Sitio, Buhanginan, Brgy. San Jose Antipolo City

    4. Liwaliw, Fronstone Campilis alyas ponkan, 55 years


    old,Male, native of Tuguegarao City Province of
    Cagayan, Cagayan Valley and presently residing at No.
    20 Sitio, Buhanginan, Brgy. San Jose Antipolo City.

    OFFENSE/s COMMITTED/LAW/s VIOLATED: Witness/s: Name & Address


    Rape with Homicide Johnry Poblete y Duenas 49 years old, taho vendor, a
    resident of Kalye Putol No.8 Sitio Tagbak Brgy. San
    Jose, Antipolo City

    TIME of COMMISSION: PLACE of COMMISSION:

    transpired at about 10:00 A.M at Kalye Putol Sitio Tagbak Brgy. San Jose, Antipolo 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 – affidavit? * YES___ NO_X__
    If yes, indicate details below.
    3. Is this complaint related to another case before this office? * YES___ NO_X__

    I.S. No.:___________________________________

    Handling Prosecutor: ____________________

    CERTIFICATIONS

    I CERTIFY, under oath, that all information on this sheet are true and correct to the best of my knowledge
    and belief, that I have not commence any action or 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, shall
    report that fact to this Honorable Office within five (5) days from knowledge thereof.

    Rose Alain y Robis


    Complainant

    SUBSCRIBE AND SWORN TO before me this day of May 2013 in Antipolo City, Rizal.

    ____________________________
    Administering Office/Prosecutor

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