INVESTIGATION DATA FORM Blank
Uploaded by
Olive FaustinoINVESTIGATION DATA FORM Blank
Uploaded by
Olive FaustinoREPUBLIC OF THE PHILIPPINES
Department of Justice
NATIONAL PROSECUTION SERVICE
Office of the City Prosecutor
City of Muntinlupa
INVESTIGATION DATA FORM
DATE RECEIVED: ________________________ NPS DOCKET NO.:
(stamped and initiated): _____________________ XV-08-INV-______________________
Time Received: ___________________________ Assigned to: ______________________
Receiving Staff: ___________________________ Date Assigned:_____________________
_________________________________________________________________________________________
Complainant/s: Name, Sex, Age &Address Respondent/s: Name, Sex, Age & Address
RUBEN SIMUNDAC
___________________________________ __________________________________
___________________________________ __________________________________
___________________________________ __________________________________
Offense/s Committed/Law/s Violated: Witness/es: 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-charge? Yes ______ No ______
3. Is this complaint related to another case before this office Yes ______ No ______
I.S./NPS Docket No.: __________________
Handling Prosecutor: ___________________
CERTIFICATION
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 or filed any claim involving the same issues in
any court, tribunal, or quai-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.
_______________________________________
SUBSCRIBED ANS SWORN to before me this ______ day of __________________ in
____________________.
___________________________________
Administering Prosecutor/Officer
NOTE : The above should be filed up by complaint of his attorney.
Investigation set on :____________________________
Postponement :____________________________
On Petition of :____________________________
ACTION TAKEN
NOTE: Sufficient copies of the affidavit of complainant/s and witness/es and other supporting
documents should be submitted.
