Investigation Data Form: Department of Justice
Investigation Data Form: Department of Justice
Investigation Data Form: Department of Justice
2008
COMPLAINANT/S: Name, Sex, Age & Address RESPONDENT/s: Name, Sex, Age & Address
Name Name
LAW VIOLATED WITNESSE/es: Name & Address
1. Has a similar complaint been filed before any other offices? * YES ____ NO _____
2. Is this complaint in the nature of a counter-charge?* 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.
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 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.
________________________________
SUBSCRIBED AND SWORN TO before me this __Day of May , 2019 in QUEZON CITY,
Philippines.
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PROSECUTOR ADMINISTERING OATH