Investagation Data Form: To Be Accomplished by The Office

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Republic of the Philippines

Department of Justice
National Prosecution Service
OFFICE OF THE PROSECUTOR
DAVAO CITY

INVESTAGATION DATA FORM


To be accomplished by the Office
DATE RECEIVED NPS DOCKET NO.:
(stamped and initiated): MARCH 12, 2020 XV-03-INV-14 45553-88385
Timed received: 2:30 PM Assigned to: Chalm Alviado
Receiving Staff: Benedict Ontal Date Assigned: March 12, 2020

To be accomplish by the complainants/ Counsel, Law Enforcer


(Use back portion if space is not sufficient)

COMPLAINANT/S: Name, Sex, Age & RESPONDENT/S: Name,Sex,Age, &


Address Address
LEBRON R. JAMES , male, of legal age, Filipino KOBE B. BRYANT , male, of legal age, residing
citizen, and residing at 118 Yellowbell st, San at 23 Ham St, Haram Ave, Davao City
Pedro Village, Buhangin, Davao City

OFFENSE/S COMMITTED/ LAW/S VIOLATED: WITNESS/ES: Name & Adress


MICHEAL JORDAN and STEPHEN CURRY
KOBE B. BRYANT: for ESTAFA, for Malicious who are both residing at No. 5 Lot 3 Piattos St,
Mischief . Jack Subd, Matina, Davao City

DATE & TIME OF COMMISSION: PLACE OF COMMISSION


January 2020 Davao City

1. Has a similar complaint been filed before any other office?* Answer: NO
2. Is this complaint is in the nature of a counter- affidavit?* Answer: NO
If yes, indicated details below.
3. Is this complaint related to another case before this office?* Answer: NO
If yes, indicate details below.

I.S./NPS Docket No.:4433-3344-4444422


Handling Prosecutor: ATTY. ERICK JAY N. INOK

CERTIFICATION

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 of filed any claim involving the same issues in any court, tribunal, or quasi-judicial
agency, and that I should thereafter learn that qa 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.

LEBRON R. JAMES
(Signature Over Printed Name)

SUBSCRIBED AND SWORN TO before me this 14th day of March, 2020, in Davao City,
Philippines.

ATTY. ERICK JAY N. INOK


Administering Prosecutor/ Officer

*1,2,3 and CERTIFICATION need not be accomplished for inquest cases.

You might also like