OMB Form 3-Request for Copy of Case Documents

Republic of the Philippines C O N T A C T U S:

Office of the Ombudsman Records Division : Local 2222 & 2223
Agham Road, Diliman, Quezon City Trunkline : 479-7300
Website : www.ombudsman.gov.ph

REQUEST FOR COPY OF CASE DOCUMENTS

CONFORME:
By signing below, I am agreeing to the Ombudsman Privacy Policy and giving my consent to the collection and processing
of my personal data in accordance thereto.

______________________________________
Signature of Client Over Printed Name
TO BE ACCOMPLISHED BY THE REQUESTING PARTY

Date:

Requesting Party: Sex: Male Female

Please Check One: Complainant Respondent/ Counsel OMB Official/ Others, please specify
Accused (Copy of Entry Investigator/
of Appearance) Prosecutor

OMB Case Number/

Signature:
Reference Number:

Case Title:

Documents Requested (Put a check for details of documents requested)

Certified Certified
Number of Plain Number of Plain
Documents True Documents True
Copies copy Copies copy
Copy Copy

Complaint Affidavit Resolution

Exhibits/Annexes Decision

Counter-Affidavit Order
Reply Motion for Reconsideration

Position Paper

Others, Specify
Purpose of Request

For filing in court (Please select below) For Reference Misplaced copy Others, please specify
RTC/MTC Court of Appeals
Sandiganbayan Supreme Court

TO BE ACCOMPLISHED BY THE RECEIVING CLERK

Valid Identification Card presented by the REQUESTER Valid Identification Card presented by the REPRESENTATIVE
Type ID Number Issuing Agency/Company Type ID Number Issuing Agency/Company

APPROVED/DISAPPROVED:

Chief, Central Records Division Date

RELEASED BY: RECEIVED BY:

Official Receipt No. :

O.R. Date :

Amount Paid : ₱ Signature over Printed Name of Requesting Party

Date of Release :

Released by :
Date
Signature over Printed Name
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