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To Be Accomplished by The Office:: Complainant/counsel/law Enforcer

The document is an investigation data form from the Republic of the Philippines Department of Justice regarding a complaint filed by Mary Zophia Rose Anne Nhielson L. Gepte against Ronald Jaime O. Alzo for physical abuse violation under RA 9262 from April 2022 to March 2024 in Guiguinto, Bulacan.

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7 views1 page

To Be Accomplished by The Office:: Complainant/counsel/law Enforcer

The document is an investigation data form from the Republic of the Philippines Department of Justice regarding a complaint filed by Mary Zophia Rose Anne Nhielson L. Gepte against Ronald Jaime O. Alzo for physical abuse violation under RA 9262 from April 2022 to March 2024 in Guiguinto, Bulacan.

Uploaded by

Roline Balapats
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Justice
NATIONAL PROSECUTION SERVICE
OFFICE OF THE PROVINCIAL PROSECUTOR
PROVINCE OF BULACAN

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:


COMPLAINANT/s: Name, Sex, Age & Address RESPONDENT/s: Name, Sex, Age & Address

MARY ZOPHIA ROSE ANNE NHIELSON L. Ronald Jaime O. Alzo male, single, 32 y/o, jobless,
GEPTE, female, single, 31 y/o, jobless, and and presently residing, Brgy. Cut-Cut, Guiguinto,
presently residing at 125 NIA ROAD , Bulacan.
Brgy.PANGINAY, Guiguinto, Bulacan.
CP Nr#: 09164175331

OFFENSE/s COMMITTED / LAW/s VIOLATED: ARRESTING OFFICER: Name & Address


Violation of RA 9262 (PHYSICAL ABUSE)

DATE & TIME of COMMISSION: PLACE OF COMMISSION:

April 2022 – March 28, 2024 125 NIA ROAD BRGY.PANGINAY, GUIGUINTO,
BULACAN
DATE & TIME Reported:

April 1, 2024/1:00PM
(Use back portion if space is not sufficient)
1. Has a similar complaint been filed before any other office? * YES ___ NO _X_
2. Is this complaint in the nature of a counter-charge? * YES___ NO _X_
If yes, indicate details below
3. Is this complaint related to another case before this office? * YES___ NO _X_
If yes, indicate details below:
I.S. / NPS Docket No.: ____________________________
Handling Prosecutor: _____________________________

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
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.

MARY ZOPHIA ROSE ANNE NHIELSON L. GEPTE


Victim/Complainant
ID #: ________________

SUBSCRIBED AND SWORN TO before me this ___ day of April 2024, in Malolos City of
Bulacan.

____________________________
Administering Prosecutor

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