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Office of The City Prosecutor Quezon City Investigation Data Form | PDF | Complaint | Crime & Violence
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Office of The City Prosecutor Quezon City Investigation Data Form

The document is an Investigation Data Form from the Office of the City Prosecutor in Quezon City, Philippines, used for recording details of complaints and respondents in legal cases. It includes sections for complainant and respondent information, offenses committed, witnesses, and certification of the information provided. The form requires signatures and is administered by a prosecutor to ensure the accuracy of the information submitted.

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Thomas Vincent O. Pantaleon
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290 views1 page

Office of The City Prosecutor Quezon City Investigation Data Form

The document is an Investigation Data Form from the Office of the City Prosecutor in Quezon City, Philippines, used for recording details of complaints and respondents in legal cases. It includes sections for complainant and respondent information, offenses committed, witnesses, and certification of the information provided. The form requires signatures and is administered by a prosecutor to ensure the accuracy of the information submitted.

Uploaded by

Thomas Vincent O. Pantaleon
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
OFFICE OF THE CITY PROSECUTOR
QUEZON CITY

INVESTIGATION DATA FORM

DATE RECEIVED NPS DOCKET NO


(stamped and initiated): __________ XV-03-19-INV______-________
Time Received: ________________ Assigned to: ________________________
Receiving Staff: _______________ Date Assigned: _____________

COMPLAINANT/S: (Name/Sex/Age/ RESPONDENT/S: (Name, Sex, Age & Address/es)


Address/es)
________________________________ _________________________________
________________________________ _________________________________
________________________________ _________________________________

OFFENSE/S COMMITTED/ LAW/S WITNESS/ES: NAME & ADDRESS/ES


VIOLATED (for cases of estafa, theft,
malicious mischief and RIRIDTP indicate
amount involved)
_________________________________ _________________________________
_________________________________ _________________________________
_________________________________ _________________________________

DATE & TIME OF COMMISSION PLACE OF COMMISSION


_____________________________ _____________________________

1. Has a similar complaint filed before any officer? 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./NPS Docket No.: ________________________


Handling Prosecutor: ________________________

C E R T I FI CAT I O N

I CERTIFY, under oath, 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 quasi-judicial agency and that I should thereafter learn that a similar action has
been filed and or 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

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