NPS Investigation Form No. 01 s.
2008
Republic of the Philippines
Department of Justice
NATIONAL PROSECUTION SERVICE
OFFICE OF THE PROVINCIAL PROSECUTOR
TARLAC CITY
INVESTIGATION DATA FORM
To be accomplished by the 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
JENYBEE G. PASTRANA CATHERINE MANITI and VIRGINIA NATINO
Femal, of legal age, No. 1095 Villa San Jose Both female, of legal age, and residents of Brgy. Sto.
Cut-Cut 1st, Capas, Tarlac Domingo 1st, Capas, Tarlac
OFFENSE/s COMMITED / LAW/s VIOLATION: WITNESS/es: Name & Address
Estafa, continuing offense JANETH B. DIAZ, JUDY ANN DATU, MARJORIE SUAREZ,
JOSEFINA Q. REYES, CELIA GENERAL
Sto. Domingo 1st, Capas, Tarlac
DATE & TIME of COMMISION: PLACE of COMMISION:
From May 2016 Concepcion and Capas, Tarlac
1. Has a similar complaint been filed before any other office? * 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:
I.S. / NPS Docket No.: _______________________
Handing Prosecutor: ________________________
C E R T I F I C A T 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 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.
JENYBEE G. PASTRANA
SUBCRIBED AND SWORN TO before me this 1st day of August, 2017 in Tarlac City, Tarlac.
_____________________________________
Administering Prosecutor / Office
*1, 2, 3, and CERTIFICATION need not to be accomplished for inquest cases