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Legal Case Filing Form

This document is an investigation data form from the Department of Justice National Prosecution Service regarding a frustrated murder and illegal possession of weapons case. It provides information about the complainant, Antony Salcedo Tajale, and the respondent, Michael Ganade Gregorio. The offense is alleged to have occurred on January 1, 2020 in Barangay Camayahan, Butuan City. Witnesses listed are Ronald M Ubo and Daniel Bajao Tulop. The complainant certified that the information provided is true and correct.

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Stace Diane Deane Stefan
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212 views2 pages

Legal Case Filing Form

This document is an investigation data form from the Department of Justice National Prosecution Service regarding a frustrated murder and illegal possession of weapons case. It provides information about the complainant, Antony Salcedo Tajale, and the respondent, Michael Ganade Gregorio. The offense is alleged to have occurred on January 1, 2020 in Barangay Camayahan, Butuan City. Witnesses listed are Ronald M Ubo and Daniel Bajao Tulop. The complainant certified that the information provided is true and correct.

Uploaded by

Stace Diane Deane Stefan
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
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Department of Justice

NATIONAL PROSECUTION SERVICE


OFFICE OF THE CITY PROSECUTOR
Butuan 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, Age, Sex & RESPONDENT/s: Name, Age, Sex&
Address Address
Antony Salcedo Tajale, 20 years old, 1st Michael Ganade Gregorio, 27 years
year college student of Caraga State old, single, laborer and a resident of P-3,
University (CSU) and a resident of Brgy. Camayahan, Butuan City
transpired on in P-4B, Brgy. Camayahan,
Butuan City, 09482180947.

OFFENSE/s COMMITTED /LAW WITNESS/s: Name, Age, Sex& Address


VIOLATED
Ronald M Ubo, 17 years old, single,
Frustrated Murder, RA 10591 Grade 10 student of Taligaman National
High School and a resident of P-4B, Brgy.
Comprehensive Law on Camayahan, Butuan City, assisted by his
Firearms and father Carlito Valdueza Ubo and;
Ammunition and Illegal Daniel Bajao Tulop, 18 years old, single,
jobless and a resident of P-4B, Brgy.
Possession of Deadly Camayahan, Butuan City.
Weapon
DATE & TIME of COMMISSION PLACE OF COMMISSION
On January 1, 2020 at about 2:00AM P-4B, Brgy. Camayahan, Butuan City
1. Has a similar complaint been filed before any other office? YES ___ NO _X__
2. In this complaint in the nature of counter charge? YES ___ NO X_ if yes, indicate
the details below
3. In this complaint related to another case before this office? YES ___ NO X__ if yes, indicate
the details below
I.S./NPS Docket No: _______________________________
Handling 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 filed any claim involving the
same issues in any court, tribunal, or quasi-judicial agency, and 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.

Antony Salcedo Tajale


(Affiant)

SUBSCRIBED AND SWORN to before me this 2nd day of January 2020 Butuan
City, Philippines.

______________________
Administering Officer

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