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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, respondent, alleged laws violated, date and place of incident, and a certification by the complainant. The form asks if a similar complaint was previously filed, if it is a counter-charge, and if it is related to other cases before the office. It collects contact information for witnesses and will be used to open a case file and docket for the new complaint.

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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, respondent, alleged laws violated, date and place of incident, and a certification by the complainant. The form asks if a similar complaint was previously filed, if it is a counter-charge, and if it is related to other cases before the office. It collects contact information for witnesses and will be used to open a case file and docket for the new complaint.

Uploaded by

ckldb
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
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Republic of the Philippines

Department of Justice
National Prosecution service
OFFICE OF THE PROVINCIAL PROSECUTOR
_____________
__________________

INVESTIGATION DATA FORM


To be accomplished by the Office
DATE RECEIVED:
NPS DOCKET NO:
(Stamped and initialed):___________________________ IV-03-IN -14___________________
Time Received
:______________________________
Assigned to:_________________
Receiving Staff
:______________________________
Dated Assigned:______________
To be accomplished by complainant/counsel/Law enforcer
(used back portion if space is not sufficient)
COMPLAINANT/S: Name, Sex, Age & Address
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________

RESPONDENT/S: Name, Sex, Age & Address


______________________________________
______________________________________
______________________________________
______________________________________
______________________________________
______________________________________

LAW/S VIOLATED:
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________

WITNESS/ES Name & Address


______________________________________
______________________________________
______________________________________
______________________________________
______________________________________
______________________________________

DATE & TIME of COMMISSION


_____________________________________
_____________________________________

PLACE OF COMMISSION
____________________________________
____________________________________

1. Has a similar complaint been filed before any office? YES___ NO___
2. Is this complaint in the nature of counter-charged? YES___ NO___
3. Is this complaint related to another cases before this office? YES___ NO___ if yes, indicate details
below.
I.S. NO.__________________________
Handling Prosecutor:__________________________

CERTIFICATION
I CERTIFY under oath, that all the information on this sheet are true and correct to the best of knowledge
and belief, that I have not commenced any action or filed any claim involving the same issues in any court,
tribunal, quasi-judicial agency, and that if I should thereafter learn that a similar criminal action has be filed
and/or is pending, I shall report that fact to this Honorable Office within (5) days from knowledge thereof.
___________________________
(Signature over Printed Name)
SUBSCRIBED AND SWORN to before me this _____ day of _______________________, 2013
in________________.
_____________________________
(Prosecutor Administering Oath)
*1,2,3, and Certification need not be accomplished for inquest cases.

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