7/25/2019 NPS Investigation Form No. 01, s. 2008

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Republic of the Philippines

Department of Justice

National Prosecution ServiceProvince of Misamis Oriental

OFFICE OF TE PRO!INCI"# PROSEC$TOR%&F I'P 'uil(in)* Capitol Roa(* Ca)a+an (e Oro Cit+

IN!ESTI,"TION D"T" FORM

To be accomplished by the Office

D"TE RECEI!ED - ./&./&%./0 NPS DOC1ET No2- 34.54IN64/0"4.....

7stampe( an(

initialle(8-

"ssi)ne( to-

Time Receive(- Date "ssi)ne(- ./&./&%./0

Receivin) Staff-

To be accomplishe( b+ complainant&counsel&la9 enforcer

7$se bac: portion if space is not sufficient8

COMPLAINANT/S: RESPONDENT/S:

Name- Name-

")e- Se;-

")e- Se;-

"((ress-

"((ress-

LAW/S VIOLATED: WITNESS/ES:

Name-

")e- Se;

-

"((res

s-

D"TE < TIME of COMMISSION-

Time-

Date-

/2 as a similar complaint been file( before an+ other office= >?es @@@ No @@@%2 Is this complaint in the nature of a counter4char)e=> >?es @@@ No @@@

If +es* in(icate (etails belo92

A2 Is this complaint relate( to another case before this office=> >?es @@@ No @@@If +es* in(icate (etail belo9

I2S2 No2-an(lin) Prosecutor-

C E R T I F I C " T I O N>

I Certif+* un(er oath* that all the information on this sheet are true an(

correct to the best of m+ :no9le()e an( belief* that I have not commen( an+

action or file( an+ claim involvin) the same issues in an+ court* tribunal* or Buasi4u(icial a)enc+* an( that if I shoul( thereafter learn that I similar action has been

7/25/2019 NPS Investigation Form No. 01, s. 2008

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file( an(&or is pen(in)* I shall report that fact to this onorable Office 9ithin five

758 (a+s from :no9le()e thereof2

Subscribe( an( s9orn to before me this @@@ (a+ of @@@@@@@@@@@* %.@@* in@@@@@@@@@@@@@@@@@@2

"(ministerin) Prosecutor&Officer