Investigation Data Form
Investigation Data Form
2008
COMPLAINANTS: Name, Sex, Age & Address RESPONDENTS: Name, Sex, Age and Address
1. Has similar complaint been filed before any other office?* YES___ NO_x_
2. Is the complaint in the nature of a counter-charge?* YES___ NO_x_ If yes, indicate the details below
3. Has similar complaint been filed before any other office?* YES___ NO_x_ If yes, indicate the details below
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 un 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)
________________________________________
Administering Prosecutor / Office