Republic of the Philippines Department of Justice National Prosecution Prosecution Service OFFICE OF THE PROSECTOR !E"ON CIT#
INVESTAGA INVE STAGATION TION DATA DATA FORM To be accomplished by the Office D$TE D$TE RECEI%ED NPS DOC&ET NO'( XV-03-INV-14 ,,,,,,,,,,,,-,,,,,,,,,, )stampe* an* initiate*+(,,,,,,,,,,,,,,,, initiate*+(,,,,,,,,,,,,,,,,,,,,, ,,,,, ,,,,,,,,,,,,-,,,,,,,,,, Time* receive*(,,,,,,,,,,,,,,,,,,, receive*(,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,, $ssi.ne* to(,,,,,,,,,,,,,,,,,,,,,, to(,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,, Receivin. Staff(,,,,,,,,,,,,,,,,,, Staff(,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,, Date $ssi.ne*(,,,,,,,,,,,,,,, $ssi.ne*(,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,, To be accomplish by the complainants/ Counsel, Law Enforcer (Use back portion if space is not sufficient)
CO/P0$IN$NT1S( Name2 Se32 $.e 4 $**ress LEONILA C. WATANABE, female2 of le.al a.e2 Filipino citi5en2 an* resi*in. at No' 67 Pin.8ian 92 Central2 Central2 :aran.a; :aran.a; Pason. Pason. Tamo2 Tan*an. an*an. Sora2 !ue5on Cit;
RESPONDENT1S( Name2Se32$.e2 4 $**ress JOEY L. TABBU, an* RONILA TABBU both of le.al a.es2 resi*in. at 67< /ac$rthur Street2 $rea 9-$ Pason. Tamo2 Tan*an. Sora2 !ue5on Cit;'
OFFENSE1S OFFENSE1 S CO//ITTED1 CO//ITT ED1 0$=1S 0$=1S %IO0$TED( %IO0$TED( =ITNESS1ES( =ITNESS1ES ( Name 4 $*ress Joe T!""#( for R$ >6?62 for EST$F$2 for M!'%(e) C. To''e) !$* E&%+!"e( T. De&o)!(! @ho /alicious /ischief' are both resi*in. at No' 67 Pin.8ian2 Central2 :aran.a; Pason. Tamo2 Tan*an. Sora2 !ue5on Cit; Ro$%&! T!""#( for EST$F$2 for /alicious /ischief ' D$TE D$TE 4 TI/E OF CO//ISSION( December 6A97 to Present 9' 6' 7'
P0$CE OF CO//ISSION !ue5on Cit;
Has a similar similar complaint complaint been file* file* before before an; other officeB officeB $ns@er( $ns@er( NO Is this complaint complaint is in the nature nature of a countercounter- affi*avit affi*avitB B $ns@er( $ns@er( NO If ;es2 in*icate* *etails belo@' Is this this complaint complaint relate* relate* to another another case before this officeB officeB $ns@er( $ns@er( NO If ;es2 in*icate *etails belo@' belo@'
I'S'1NPS Doc8et No'(,,,,,,,,,,,,,,,,,,,,,,,, No'(,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,, Han*lin. Prosecutor(,,,,,,,,,,,,,,,,,, Prosecutor(,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,, ,, CERTIFIC$TION I CERTIF#2 un*er oath2 all the information on this sheet are true an* correct to the best of m; 8no@le*.e an* b elief2 that I have no t commence* an; action of file* an; claim involvin. the same issues in an; court2 tribunal2 or uasi-u*icial a.enc;2 an* that I shoul* thereafter learn that a similar action has been file* an*1or is pen*in. I shall report that fact to this Honorable Office @ithin five )<+ *a;s from 8no@le*.e thereof'
,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,, )Si.nature Over Printe* Name+ S:SCRI:ED $ND S=ORN TO before me this,,,,,*a; of ,,,,,,,,,,,,,,,,,,,,,2 ,,,,,,,,,,,,,,,,,,,,,2 6A,,,,,2 in ,,,,,,,,,,,,,,,,,,,,,' ,,,,,,,,,,,,,,,,,,,,,'
,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,, ,, $*ministerin. Prosecutor1 Officer 92627 an* CERTIFIC$TION nee* not be accomplishe* for inuest cases'
