PSIR RE:___________________________ Inv. Docket No.

_____

Criminal Case Number_ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Republic of the Philippines
Department of Justice
PAROLE AND PROBATION ADMINISTRATION
_________________________________________
_________________________________________
_________________________________________

POST-SENTENCE INVESTIGATION REPORT

I.

IDENTIFYING DATA

PETITIONER:___________________________________________________________________
(Last Name)

(First Name)

(Middle Name)
True Name:___________________________________Source of Info:______________________
Alias(es):______________________________ Height (meters):_______ Weight (kilos):________
Age:_______ Sex:_______ Citizenship:_______________ Religion:________________________
Identifying Marks/Unusual Features:_________________________________________________
Present address:________________________________________________________________
Permanent Address:_____________________________________________________________
II. PETITIONERS CRIMINAL HISTORY
A. PRESENT OFFENSE
Charged with
Date:
Convicted of
Date:
Sentence
Judge
Court
Defense Counsel
Address
Offended Party
Address ______________
Custody Status: ( ) On Bail ( ) On Detention Period of Detention: ______________________
( ) ROR - Custodian:
Address :
Manner of Commission (Narrative)
Age at time of commission: ___ Extent of Participation:( ) Principal ( ) Accomplice ( ) Accessory
I.

Offenders Statement

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________
II.
Victims Statement
___________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
REMARKS/ADDITIONAL INFORMATION:
______________________________________________________________________________

Confidential

PSIR RE:___________________________ Inv. Docket No._____

Criminal Case Number_ _ _ _ _ _ _ _ _ _ _ _ _ _ _

______________________________________________________________________________
_______________________________________________________________________
B. PRIOR RECORDS
Agency

CC No. / Date

Offense

Disposition/Date

NBI
RTC
MTC
PNP
Prosecutor
Barangay
CMRD
C. OTHER DEROGATORY INFORMATION
Source/Position

Particulars

______________________________
______________________________
______________________________

______________________________
______________________________
______________________________

III. PERSONAL AND SOCIAL HISTORY

A. PETITIONERS BIRTH DATA
Date of Birth: __________ Place of Birth: _____________ Birth Order:____________
B. FAMILY BACKGROUND
1. PARENTS:
Father:
Age: ___ Occupation: __________
Last Name
First
Middle
Mother: ___________________________________ Age: ___ Occupation: __________
Maiden Name
First
Middle
Status of Marriage: ( ) Married
( )Annulled
( )Separated: __Legal __ Estranged
( ) Common-Law/Live-in ( ) Others_________________________
2. SOCIO-ECONOMIC BACKGROUND
Family Relationship

Major Family Problems

Family Reputation in the

Community

(
(
(
(

(
(
(
(
(
(
(
(

(
(
(
(

) Very Satisfactory
) Satisfactory
) Fair
) Poor

) No Apparent Problem
) Economic
) Mental/ Physical Illness
) Marital Problem
) One-Parent-Family
) Parent-Child Conflict
) Sibling Conflict
) Others

) Very Satisfactory
) Satisfactory
) Fair
) Poor

Family Economic Status

Physical Home Conditions

Stability of Residence

(
(
(
(

(
(
(
(

(
(
(
(

) More than Adequate

) Adequate
) Inadequate
) Below Poverty Level

) Very Satisfactory
) Satisfactory
) Fair
) Poor

) Stable
) Occasional Change
) Frequent Change
) No Stability

REMARKS/ADDITIONAL INFORMATION:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Confidential

PSIR RE:___________________________ Inv. Docket No._____

Criminal Case Number_ _ _ _ _ _ _ _ _ _ _ _ _ _ _

______________________________________________________________________________
_____________________________________________________________________________
C. PETITIONERS PRESENT SITUATION
Civil Status: ( ) Single ( ) Married ( ) Widow/Widower ( ) With Common-Law/Live-in partner
Status of Marriage: __Annulled __Separated: __Legal __ Estranged ( ) Others__________
Remarks:_______________________________________________________________________
1. Domestic Partner/Spouse ________________________________________________
(Full Name)
Last/Maiden Name
First
Middle
Age:____ Gender: ( )Male ( ) Female Occupation: _________________________
Home Address: _________________________________________________________
Work Address: _________________________________________________________
2. Children: Total No. of Children : _____
Age

In/Out of School

Educational Attainment

Relationship with Children:

Legitimate

Very Satisfactory
Fair

Illegitimate

Satisfactory
Poor

REMARKS/ADDITIONAL INFORMATION
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. Residence

(
(
(
(

Dwelling

Stability of Residence

) Owned: Yrs of Stay____

) Rented: Yrs of Stay____
) Informal Settler
) Others

(
(
(
(

) Stable
) Occasional Change
) Frequent Change
) No Stability

Physical Home Conditions

(
(
(
(

) Very Satisfactory
) Satisfactory
) Fair
) Poor

4. Economic Condition
Family Economic Status

Family Breadwinner

Petitioners Role in the

Family

(
(
(
(

(
(
(
(

( ) Income Contributor
( ) Total
( ) Partial
( ) Primary Care-giver
( ) Dependent

) More than Adequate

) Adequate
) Inadequate
) Below Poverty Level

) Petitioner
) Spouse
) Petitioner and Spouse
) Others

5. Major Problems in the Family

( ) No Apparent Problem
( ) Economic
( ) Husband-Wife Conflict

( ) Mental Illness
( ) Physical Illness
( ) Parent-Child Conflict

( ) Sibling Conflict
( ) Others______________

REMARKS/ADDITIONAL INFORMATION:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Confidential

PSIR RE:___________________________ Inv. Docket No._____

Criminal Case Number_ _ _ _ _ _ _ _ _ _ _ _ _ _ _

______________________________________________________________________________
______________________________________________________________________________
_______________________________________________________________________

Confidential