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INVESTIGATION DATA FORM - DOJ Revision 1 V2

1) This document is an investigation data form from the National Prosecution Service of the Philippines Department of Justice. 2) It provides information about a complaint filed, including the complainant and respondent's names and addresses, the laws violated, witnesses, and details of the incident. 3) The complainant certified under oath that the information provided is true and correct and that they have not filed any similar claims in other courts.

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Jazz Tracey
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© © All Rights Reserved
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838 views

INVESTIGATION DATA FORM - DOJ Revision 1 V2

1) This document is an investigation data form from the National Prosecution Service of the Philippines Department of Justice. 2) It provides information about a complaint filed, including the complainant and respondent's names and addresses, the laws violated, witnesses, and details of the incident. 3) The complainant certified under oath that the information provided is true and correct and that they have not filed any similar claims in other courts.

Uploaded by

Jazz Tracey
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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NPS Investigation Form No. 01 s.

2008
Republic of the Philippines
Department of Justice
NATIONAL PROSECUTION SERVICE
OFFICE OF THE CITY PROSECUTOR
PUT NAME OF CITY

INVESTIGATION DATA FORM


To be accomplished by Office:

DATE RECEIVED  NPS DOCKET NO. :
(stamped and initialed):
Time Received:  Assigned to : 
________________________________ 
Receiving Staff: Date Assigned : ________________________________
======================================================================================
To be accomplished by complainant/counsel/law enforcer:
(Use back portion if space is not sufficient)
COMPLAINANT/s: Name, Sex, Age & Address  RESPONDENT/s: Name, Sex, Age, & Address

LAW/S VIOLATED: WITNESSES : Name & Address


GRAVE COERCION UNDER ARTICLE 286 OF THE REVISED
PENAL CODE
MALICIOUS MISCHIEF UNDER ARTICLE 327 OF THE REVISED
PENAL CODE

DATE & TIME of COMMISION:  PLACE of COMMISION:

Has a similar complaint been filed before any other office? *  YES ___  NO _/_


Is this complaint in the nature of a counter-charge? *  YES ___  NO _/_ If yes, indicate details below:
Is this complaint related to another case before this office? *  YES ___  NO _/_ If yes, indicate details below:
I.S. / NPS Docket No.: _________________________  
Handing 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 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, I shall report that fact to this Honorable Office within five (5) days from knowledge
thereof. 

______________________
(Signature over printed name)

SUBCRIBED AND SWORN TO before me this ____ day of ____________ ,2021, in San Juan City.

DOJ_PM_NPSO2.FO1
Revision 1

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