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Iloilo Investigation Data Form

1) A complaint was filed by a female resident of Brgy. Igtuba, Miag-ao Iloilo against a male resident of Bolho, Miag-ao Iloilo. 2) The offense committed was violation of the Anti-Violence Against Women and Their Children Act through marital infidelity. 3) The date and time of commission was in Iloilo.

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EVANGELINE SAN FELIX
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223 views1 page

Iloilo Investigation Data Form

1) A complaint was filed by a female resident of Brgy. Igtuba, Miag-ao Iloilo against a male resident of Bolho, Miag-ao Iloilo. 2) The offense committed was violation of the Anti-Violence Against Women and Their Children Act through marital infidelity. 3) The date and time of commission was in Iloilo.

Uploaded by

EVANGELINE SAN FELIX
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Republic of the Philippines

PROVINCE OF ILOILO
OFFICE OF PROVINCIAL PROSECUTOR
Hall of Justice, Iloilo City
-o0o-

INVESTIGATION DATA FORM

DATE RECEIVED NPS DOCKET NO:________________


(Stamped and initialed)_____________ Assigned to:_____________________
Timed Received:____________________ Date Assigned:___________________
Receiving Staff:______________________
To be accomplished by complainants/counsel/law enforcer
(Use back portion if space is not sufficient)

COMPLAINANT/S: RESPONDENT/S:
Name, Sex, Age & Address Name, Sex, Age & Address
, female, legal age, with address at Brgy. Igtuba, male, legal age and a resident of Bolho, Miag-ao
Miag-ao Iloilo Iloilo

OFFENSE/S COMMITED: Witness: Name & Address


LAWS VIOLATED
Violence against Women and their Children 1.
Through marital infidelity 2. Others (Reserved)

DATE & TIME OF COMMISSION: PLACE OF COMMISSION:


Iloilo

1) Has a similar complaint been filed before any other office?


Yes______ No_______
If yes, indicate details below.
__________________________________________________________________
2) Is this complaint in the nature of counter-charge?
Yes______ No_______
If yes, indicate details below.
__________________________________________________________________
3) Is this complaint to mother case before this office
Yes______ No______
If yes, indicate details below.
__________________________________________________________________

NPS Docket No._______________________________________


Handing Prosecutor____________________________________

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 file 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.
___________________________
MA. MILA DINSAY NEMIADA
Affiant

SUBSCRIBED AND SWORN to before me this ____ __________, in City of Iloilo, Philippines.

_________________________
Administering Prosecutor/Officer

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