Reports Forms

.
SAMPLE FORMAT OF SPOT REPORT

Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
QUEZON CITY POLICE DISTRICT
Novaliches Police Station-4, Quirino Highway, Novaliches, Quezon
City
Tel. _________
MEMORANDUM
FOR
FROM
SUBJECT
Spot Report
DATE
:
==================================================
===================
1.
(Indicate briefly the date/time, and place of occurrence)
2.
(brief facts of the case)
3.
(Other Facts)
4.
Requested/recommended actions from Hqs.
5.
Progress report to follow
__________________________
b. SAMPLE FORMAT OF PROGRESS REPORT

City
Tel. _________
MEMORANDUM
FOR
FROM
SUBJECT
Progress Report
DATE
:
==================================================
===================
1.
Reference: (Previous related Memos)
2.
(Indicate briefly the date/time and place of occurrence)
3.
(Brief facts of the Case)
4.
Requested/Recommended actions from Hqs.
5.
Disposition/Action Taken
6.
Final Report will follow
__________________________
c. SAMPLE FORMAT OF FINAL REPORT

City
Tel. _________
MEMORANDUM
FOR
FROM
SUBJECT
Final Report
DATE
:
==================================================
===================
1.
Reference: (Pervious related matter)
2.
(Indicate briefly the date/time and place of occurrence)
3.
Background/Brief Facts of the Case
4.
Sequence of Events
5.
Summary of Action
6.
Recommendation/Conclusion
7.
Disposition/findings
8.
For your information
_____________________________
d. SAMPLE FORMAT OF AFTER OPERATION REPORT
. Republic of the Philippines

Novaliches Police Station-4, Quirino Highway, Novaliches, Quezon City
Tel. _________
MEMORANDUM
FOR
FROM
SUBJECT
After Operation Report
DATE
:
==================================================
===================
I
Authority
II
Mission
III
Period Covered
IV
Area of Operation
Participating Elements
VI
Chronologic Events
a.
Background
b.
Intelligence Build-up
c.
Narrative account of operational activities

VII
Comments.
VIII
Assessment
__________________________________
Sample Format of Case Referral

(Regular Filling and Inquest)
Department of the Philippines

Novalcihes Police Station-4, Novaliches, Quezon City
Tel. No. _________
Date_______
The Honorable City Chief Prosecutor
Office of the City Prosecutor
Justice Hall, Quezen City
(Attn: Duty Inquest Prosecutor)
Greetings
I have the honor to refer to your Office, the records of investigation relative to
the case of (crime), committed at about __________of________, at_______________.
COMPLAINANT/S
(Name, age, nationality, civil status and current address)
VICTIM/S
SUSPECT/S (ARRESTED/DETAINED)
:
WITNESSES
PIECES OF EVIDENCE:
(specify if RECOVERED or UNRECOVERED)
FACTS OF THE CSE:
(Five (5) Ws and one (1) H).
ENCLOSURES
a.
b.
c.
d.
e.
f.
g.
h.
i.
Subscribed NPS Investigation Data Form

SS of the complainant
SS of the witness/es
Joint Affidavit of Arrest
Medico-Legal Report/Certificate Issued by____ on____.
As Stated Evidence Recovered
Death Certificate of the Victim
Anatomical Sketch of the Victim
Booking and Information of the Suspect
And others to be presented later.
This Case will be presented to you by (Name of the Investigator on-case) of
this Office during the course of inquest proceedings. Further, request furnished this
Office copy of resolution of the case and other proceedings.
For appropriate action and disposition.
______________________________
Chief of Police
Another Sample Format of Case Referral

Tel. No. _________
Date_______
Hon. Chief, State Prosecutor
Department of Justice,
Justice Hall, Quezon City
Sir/Madam:
Respectfully referred to your good office for inquest proceedings are the
herein record of investigation relative to a case of Robbery committed as follows:
VICTIMS/COMPLAINANTS:________________________________
RESPONDENTS: (Specify if AT LARGE or UNDER CUSTODY/APPREHENDED)
WITNESSES:______________________________________________
Date/time and Place of Occurrence:
On or about ________of ______ at/along _________.
Piece of Evidence:
a.
b.
(Attachment of documents, e. SSs, Affidavit of Arrest, etc)

(Evidence of crime, specify if RECOVERED or UNRECOVERED)
Others to be presented later.
FACTS OF THE CASE:
(Complete brief narrative of the facts, five Ws and one H)
This case will be presented by (name of Investigator on-case).
Very truly yours,
________________________________________
(Chief of Office)
Sample Format of Complaint Sheet

(Carnapping Incident)

Tel. No. _________
Date_______
COMPLAINT SHEET
Name of Suspect: (Name, age, Nationality, civil status, place of birth and present
address)
Last Known Address:______________________.
a.
Nature of Offense:__________________________
Place where Offense was Committed:___________.
Date/Time Offense was Committed:____________.
Local Police Office First Reported:_____________.
Date Reported: ____________________________.
Witness/es:________________________________.
Brief Statement of Complaint:
_____________________________________
___________________________________________
___________________________________________
Sketch:
Description of the Motor Vehicle
Make/Type
Plate Number
MV File Number
Year Model
Chassis Number
Registered Owner
Color
Engine Number
Address
CERTIFICATION
I, ____, of legal age, etc, after having been sworn to in accordance of the
law do hereby depose and say:
That I am the complainant of the aforesaid complaint;
That I have read the essence and understand the same;
That all the allegations contained herein are true and correct to the best of
my knowledge and hereby warrant under penalty of perjury and;
That I will inform the PNP-HPG incase the above describe motor vehicle is
recovered (by us) so that alarm could be lifted.
Conformed By: ________________________
(Registered Owner)
___________________________
(Driver)
Address:__________________________
Tel/Cell No._______________________
SUBSCRIBED AND SWORN to before me this _____th day of _______., affiant

exhibited to me his/her Residence Certificate No. _____________________issued at
_____________on _______________.
_________________________
(Notary Public)
Sample Format of Complaint Sheet

(Other Crimes)
Tel. No. _________
Complaint No._____________
Date_______
COMPLAINT SHEET
1. REPORTED THRU:
[ ] In person
[ ] Telephone
[ ] Other
2. Previously Reported to Other Agency:

[ ] Yes
[ ] No
If yes:
a. To what agency?
_____________________________________
b. By whom?
_____________________________________
c. Date/time
____________________________________
3. Nature of Complaint/info
4. Place of Occurrence
5. Date/time
6. Name of Complainant/Informer
7. Address
8. Tel No.
9. Name (s) of Victim (s)
14. Name (s) of Suspect (s)
19. Name (s) 0f Witness (es)
10. Age
15. Alias
11. Sex
12. Address
13. Tel. No.
16. Sex
17. Age
18. Address
20. Address
22. Brief Facts/Narrative of Complainant (Use back page, if necessary)
21. Tel. No.
23. Remarks of the receiving officer (especially if reporter refused to be identified):

a. Dialect ((Accent):_____________________________.
b. Female/Male:
c. Possible Age:_________________________________.
d. Possible place where the caller is:_________________.
e. Intoxicated or not:_____________________________.
f. Others:______________________________________.
24. I certify that the details of the complainant/info

stated above are true and correct to the best of my
knowledge.
_____________________________________
Printed
Name
and
Signature
Complainant/Informer
25. SUBSCRIBED AND SWORN to before me

this _____th day of __________here at____,
Quezon City.
of
26. Date/Time/Complainant/Info Received
27. Printed name/Signature of Receiving Officer
28. Assigned to:
29. Noted by:
CONFIDENTIAL
Sample format for investigation report

City
.
Tel. _________
MEMORANDUM
FOR
FROM
SUBJECT
After Operation Report
DATE
:
==================================================
===================
I
AUTHORITY
1.
Memo from that Office dated _______________ re-investigation report
on the
above subject.
2. Inherent
II
MATTERS TO BE INVESTIGATED
3.
To determine the surrounding circumstances of the killing of said
police
officer.
To possibly identify the suspects that will led to their apprehension
4.
and
possible prosecution.
III
5.
FACTS OF THE CASE

(D/T/P Occurrence and events)
IV
6.
INVESTIGATION/FINDINGS
etc.
CONCLUSION
VI
RECOMMENDATION/DISPOSITION
______________________________
Chief of Office
Sample form of Sworn Statement/Sinumpaang Salaysay)

(Question and Answer/ Tanong Sagot)
MALAYA AT KUSANG LOOB NA SALAYSAY NI (Name and address of the affiant) NA
IPINAGKALOOB/IBINIGAY SA PAGSISIYASAT NI (Name of the Investigator), DITO SA
TANGAPAN NG (Name and address of the office), NGAYONG IKA- (Month, Date and
year), GANAP NA IKA-(time) NG UMAGA/HAPON/GABI, SA HARAP NINA (Name of
Witnesses present, at least two (2) persons), SA PAMAMAGITAN NG MGA TANONG AT

SAGOT.
==================================================
==================
(Ang nagsasalaysay ay pinahiwatigan o pinaalalahanan ng lahat ng kanyang mga
karapatan alinsunod sa itinatakda ng ating bagong saligang batas).
MGA TANONG AT SAGOT
01.
: Ginoong/Ginang____________________, ikaw ba ay magsasabi ng

buong katotohanan at pawang katotohanan lamang sa
pagsisiyasat na ito?
SAGOT
: Opo. (Pangalan at pirma ng nagsalsaysay).
02.
TANONG
TANONG
SAGOT
03.
TANONG
pagkatao?
SAGOT
04.
TANONG
: Ikaw ba ay handang magbigay ng iyong malaya at kusang loob na

salaysay?
: Opo._________________________________.
: Maari mo bang sabihin sa pagsisiyasat na ito ang iyong tunay na
pangalan at iba pang mapagkikilanlan sa iyong tunay na
: Ako si (name, address, age, B-date, P-birth etc.).
SAGOT
: Ano naman ang dahilan at ikaw ay naririto sa aming tangapan at

nagbibigay ng iyong malaya at kusang loob na salaysay?
:
05.
TANONG
SAGOT
: Saan at kalian nangyari ang naturang insidente?

:
06.
TANONG
SAGOT
: Sinu-sino ang may kinalaman sa naganap na______________?

:
07.
TANONG
SAGOT
: Paano naman nangyari?

:
08
TANONG
SAGOT
: Kilala mo ba itong biktima?

:
09.
TANONG
sabihin
: Sa ikaliliwanag ng pagsisiyasat na ito, maari mo bang silaysay o
SAGOT
TANONG
at
: Sa iyong Pagkakalam, ilan sa mga ________ang may mga dalang baril
SAGOT
TANONG
naturang
: Bukod sa iyo, may mga alam ka bang mga tao na nakakita ng
SAGOT
kung ano ang tunay na nagyari sa naganap na ______________?

10.
anu-ano ang gma kalibre nito?

11.
___________?
-Pahina 1 ng 2 pahinaPahina 2.
KARUGTONG NG MALAYA AT KUSANG LOOB NA SALAYSAY NI _____________,
NGAYONG IKA-_____NG ______20-_____.
======================================================
===============
12.
TANONG
naturang
: Ano naman ang iyong ginawa matapos mong masaksihan ang
SAGOT
TANONG
: Kung muli mo silang makita at makaharap, makikilala mo ba ang mga

ito?
:
insidente?
13.
SAGOT
14.
TANONG
ibang
: Pansamantala ay wala na akong itatanong sa iyo, mayroon ka bang
SAGOT
TANONG
mo
: Ikaw ba ay tinakot, pinangakoan, o biigyan ng pabuya sa pagbibigay
SAGOT
ibig idagdag o bawasin sa salaysay mong ito?

15.
ng salaysay na ito?
16.
TANONG
: Handa mo bang lagdaan ang salaysay mong ito nabinubuo ng
(number of pages) pahina?
SAGOT
:
WAKAS NG SALAYSAY: (date and time)
______________________________
Nagsasalaysay
SUBSCRIBED AND SWORN TO before me this ___th day of ___, 20___, here at
Quezon City. I HEREBY CERTIFY THAT I have personally examined the herein affiant
under oath and that I am fully satisfied that he/she voluntarily executed his/her
statement.
______________________________
Administering Officer/Tagapanumpa
PAALALA:
Ang paghahanda ng mga tanong ay nababase dipende sa kung anong

klaseng kaso ang iniimbistigahan at kung anong klaseng tistigo o
naghahabla ng reklamo ang taong sumasailalim sa naturang
pagsisisayasat.
Huwag kakalimutan ng tagasiyasat ang mga paunang tanong na nagpapaalala at nagpapaunawa sa taong sumasailalaim sa naturang pagsisiyasat
ng kanyang mga karapatan alinsunod sa isinasaad ng batas.
Sample form of Sworn Statement/Sinumpaang Salaysay

(NARRATIVE)
Republika ng Pilipinas )
Lungsod ng Quezon,
x--------------------------x
)S.S.
SINUMPAANG SALAYSAY
Ako, si______________________________, Filipino, ___taong gulang, may

asawa/walang asawa, tubong ___________ at naninirahan
sa____________________,matapos na mabatid at makapanumpa ng naayon sa ating
saligang batas ng Pilipinas ay malaya at kusang loob na nagsasaad ng mga
sumusunod:
Na, noong _____, sa (pangalan ng lugar ng pinangyarihan), isang
nagngangalang ___________________________na taga ________________at/o may Agency
na ____________ na matatagpuan sa ___________________________ ay nagpakilala san a
may kakayahan siyang mangalap ng mga manggagawa para sa ibang bansa
partikularmente sa bansang _______
sa pamamagitan ng ___________:
Na, ako sa buong pagtitiwala ay nag-aplay sa taong naturan bilang isang
_____________.
Na, ang taong nabanggit ay pinangakoan ako ng trabaho sa ibang bansa na
bilang kapalit, ako ay pinagbibigay/pinagbabayad na akin namang ibinigay/ibinayad
ang maga sumusunod.
HALAGA/BAGAY
PETSA
LUGAR/TUMANGGAP
_________________
_________________
_________________
___________
___________
___________
___________________________________
___________________________________
___________________________________
Na, ang mga nasabing halaga/bagay ay tinaganap ni _____________________, at

ang nasabing tao noong ika-_____ sa loob ng kanyang opisina na matatagpuan sa
_______________ at ( ) NAGBIAGAY ( ) HINDI NAGBIGAY ng kaukulang resibo.
Na, sa kabuuan halaga, ako ay nahingian at/o nagbigay ng pera sa taong
naturan na umaabot sa halagang humigit kumulang sa ____________ kasama na ang
aking mga nagastos habang ako ay nag-aaplay sa kanya:
Na, noong _____________, ako ay lumuwas patungong Maynila sakay ng _______
at ako ay dumeretso sa bahay/agency na matatagpuan sa
_____________________________:
Na, habang ako ay nag-aantay ng aking pag-alis, ako ay pansamantalang
pinatira ng taong naturan sa kanyang bahay na matatagpuan sa
_____________________. Ako ay tumoly sa nasabing bahay sa loob ng ______________.
Habang ako ay nanunuluyan sa nasabing bahay, ako ay pinagbabayad ng halagang
_________ bawat araw/buwan para sa aking pagkain at iba pang gastusin para sa
aking pansamantalang panunuluyan:
Na, habang ako ay pansamantalang nanunuluyan sa nasabing bahay, ako ay
kanyang pinagawa ng mga gawaing bahay tulad ng _________. Ito raw umano ay
parte ng aking training bilang isang ______________.
-Pahina 1 ng 2 pahina-
-Phina 2Karugtong ng sinumpaang salaysay ni _________________________________.

Na, ang taong nabanggit ( ) ay nabigo na maipadala ako sa ibang bansa.
Na,ang taong nabanggit ay ay nabigo at/o ayaw ibalik ang aking mga
pera/papeles sa kabila ng aking paulit-ulit na kahilingan:
Na, aking napag-alaman/natuklasan na ang taong naturan ay walang
kaukulang lisensiya o karapatan na mangalap at magpadala ng manggagawa sa
ibang bansa.
Na, hanggang sa ngayon ang taong nabanggit ay pinapangakoan ako na
matuloy maka-alis patungong ibang bansa at ako ay kanyang hinihingian ng dagdag
nabayad na nagkakahalaga sa _____kapalit ng aking diumanoy pag-alis.
Na, ang taong naturan ay naninirhan at maaring mapasabihan sa
___________________:
Na, ginawa ko ang Sinumpaang Salaysay na ito upang ihabla si/sina
________________, __________________________________ ng kasong/mga kasong Illegal
recruitment at/o Estafa at/o Human Trafficking.
Na, aking pinatutunayan na ako ay hindi naghain ng reklamong katulad nito
sa mga taong nabanggit sa iba pang ahensiya o sangay ng pamahalaan maliban
dito.
BILANG PATUNAY, ako ay lumagda sa ibabaw ng aking pangalan ngayong ika____ng _____, dito sa lungsod ng Quezon, kalakhang Maynila.
_____________________________
Nagsasalaysay
SINUMPAAN AT PINATOTOHANAN sa harap ko ngayong ika-___ng ____ ditto sa
lungsod ng Quezon, kalakhang Maynila. Pinatutunayan ko na ang nagsaslaysay ay
aking nasiyasat at ako ay may sapat na paniniwala na siya ay kusa at malayang
nagsalaysay.
________________________________
Administering Officer/Tagapanumpa
Sample Format of Alarm Sheet

(Carnapping Incident)
Tel. _________
ALARM SHEET
Alarm No.
Date Reported
Time Reported
MOTOR VEHICLE DISCRIPTION

Make
Series
Year Model
Classification
[ ] Private
[ ] For Hire
[ ] Government
[ ] Diplomat
Plate No.
Chassis No.
Color
MV File No.
OWNERSHIP DISCRIPTION
Registered Owner
Last Name
First Name
Address
Insurer
CIRCUMSTANCES
[
]
Seized
at
Gunpoint/Intimidation
[
] Seized While Parked
Unattended
[ ] Qualified Theft
[ ] Theft
[ ] Fraud
[ ] Estafa
[
]
Others____________________
Time Lost
Body Type
[
[
[
[
[
Engine No.
Date Lost
] AUV
[ ] Jeepney
] Car
[ ] Bus
] Wagon
[ ] Utility Van
] Pick-up
[ ] Truck
] Closed Van [ ] Dropside
MVRR No.
[ ] HSPUR
[ ] 3 Wheeled
[ ] Motorcycle
[ ] Others
__________
CR No.
Tel. No.
Landline
Middle Name
#
Mobile #
Type of ID Presented ID No. Presented
Tel. No.
Classification
[ ] TPL
[ ] Comprehensive
Brief Narration:
___________________________________________________.
___________________________________________________.
___________________________________________________
___________________________________________________
___________________________________________________,
___________________________________________________
Place of Offense
Reported by:
_____________________________________
[ ] With safety device [ ] Activated

[ ] Not Activated
[ ] Manual [ ]
Electronic
[ ] GSP
[ ] Without Safety Device
Investigated By:
______________________________________
______________________________________
2x2/2x3
PICTURE
With Signature and
Thumb mark
Approved By:
______________________________________
Sample Format of Alarm Sheet

(Missing Person)
Tel. _________
MISSING/WANTED PERSON ALARM SHEET
1. ALARM NO.
2. NATURE OF ALARM
3. PLACE WHERE LAST
[ ] MISSING [ ] WANTED
SEEN
4, NAME OF SUBJECT
6. ALIAS (ES)
8. DESCRIPTION
SEX
NATIONALITY
AGE
COMPLEXION
HEIGHT
WEIGHT
BUILD
HAIR
PECULIARITIES
OTHER IDENTIFICATION DATA
4. DATE/TIME
7. ADDRESS
9, PHOTO
10. ADDITIONAL INFO ON SUBJECT

11.
COMPLAINNANT/INFORMANT
14. RELATIONSHIP OF
COMPLAINANT/INFORMANT
TO SUBJECT
12. ADDRESS
13. TEL. NO.
15. REP[ORTED TO OTHER

AGENCY
[ ] YES
[ ] NO
16. DATE/TIME REPORTED
If Yes, what Agency?

____________________
17. REPORT RECEIVED BY:
18. DATE/TIME
20. THIS TO CERTIFY that the above report/data

are true and correct to the best of my knowledge.
22. SUBSCRIBED AND SWORN TO before me
this __th day of __ here at Quezon City
19. POSITION/ DESIGNATION
21. SIGNATURE OF COMPLAINANT/INFORMER

23. SIGNATURE OF ADMINISTERING OFFICER
24. ISSUANCE OF ALARM

25. DATE/TIME
REQUESTED
27. ALARM ISSUED BY
28. DATE/TIME
30. LIFTING OF ALARM
31. DATE/TIME
REQUESTED BY
33. ALARM LIFTED BY
34. DATE/TIME
36. REASON FOR LIFTING OF ALARM
[ ] PERSON RECOVERED
[ ] FALSE ALARM
26. POSITION/DESIGNATION
29. POSITION/ DESIGNATION
[ ] PERSON RETURNED
[ ] PERSON ARRESTED
37. SIGNATURE OF
SUPERVISOR
38. DATE/TIME
[ ] OTHERS
_____________
39. DESIGNATION/POSITION
Sample Format of Advance Information

Tel. _________
ADVANCE INFORMATION
NATURE OF CASE
VICTIM
:
:
______________________________________________________
______________________________________________________
(NAMES, PERSONAL CIRCUMSTANCES OF VICTIM)
______________________________________________________
(IF INJURED, DIAGNOSIS OF THE ATTENDING PHYSICIAN AND NAME OF HOSPITAL)
DATE TIME PLACE
OF OCCURRENCE
:
:
______________________________________________________
______________________________________________________
SUSPECT/S
______________________________________________________
(NAMES, PERSONAL CIRCUMSTANCES)
______________________________________________________
(RESIDENCE AND STATUS-WETHER
EVIDENCE
WITNESS/ES
:
:
______________________________________________________
______________________________________________________
--------------------------------------------------------------------------------------------------------------------FACTS OF THE CASE:
______________________________
NAME OF OFFICER-ON-CSE
______________________________
RANK
PNP
______________________________
DESIGNATION
NOTED AND FORWARDED:
_________________________________
CHIEF OF GROUP/UNIT
_________________________________
RANK
PNP
_________________________________
DESIGNATION
Sample Format of Crime Report

Tel. _________
CRIME REPORT
NATURE OF CASE
____________________________________________________
COMPLAINANT/VICTIM
:
____________________________________________________
(NAMES, PERSONAL CIRCUMSTANCES OF
COMPLAINANT)
DATE/TIME/PLACE
OF OCCURRENCE
:
:
____________________________________________________
____________________________________________________
SUSPECT/S
____________________________________________________
(NAME, PERSONAL CIRCUMSTANCES)
____________________________________________________
(ADDRESS, IF KNOWN, AND PHYSICAL DESCRIPTION, IF AT-LARGE).
EVIDENCE
____________________________________________________
WITNESS/ES
____________________________________________________
(NAMES AND ADDRESS)
-----------------------------------------------------------------------------------------------------------------------------FACTS OF THE CASE

:
_______________________________________
(NAME OF OFFICER-ON-CASE)
_______________________________________
RANK
PNP
_______________________________________
DESIGNATION
NOTED AND FORWARDED:
____________________________________
CHIEF OF GROUP/UNIT
____________________________________
RANK
PNP
____________________________________
DESIGNATION
Sample Form of Coordination Report

Tel. _________
COORDINATION REPORT
==================================================
==================
UNIT
________________________________________________
DATE/TIME
________________________________________________
PLACE OF OPERATION
________________________________________________
TEAM LEADER
________________________________________________
MEMBERS
1. ______________________________________________
2. ______________________________________________
3. ______________________________________________
VEHICLE USED
________________________________ ___________________________________
________________________________ ___________________________________
________________________________ ___________________________________
RECEIVED BY:____________________________________
Sample Format of Lifting of Alarm

Tel. _________
REQUEST FOR LIFTING OF ALARM
Name of applicant
________________________________________________
Address
________________________________________________
Registered Owner
________________________________________________
Address
________________________________________________
Description of Motor Vehicle

Make/Type/Yr Model
:_______________________________________________
Color
:_______________________________________________
Motor Number
:_______________________________________________
Chassis Number
:_______________________________________________
Plate
:_______________________________________________
In connection with my request, I hereby submit the following:
[
[
[
[
MV was
]
]
]
]
Motor vehicle for macro-etching examination

Alarm Sheet
Spot Recovery Report
Turn-over/Release Receipt of MV to owner by the covering PNP van. (If
recovered by other PNP Units)
[ ]
Original Official Receipt (OR) & Certificate of Registration (CR) if Xerox/Photo
copy, it
must be authenticated by C, Inves-OADI, investigator,/processing officer.
[ ]
Deeds of Sale (If MV is not registered in the name of the applicant/present
owner)
[ ]
Release of claim/subiogation/Deeds of Sale (If applicant is an insurance
company)
[ ]
Special Power of Attorney (If applicant is representative)
[ ]
Affidavit of Requesting Party/Owner that she/he is the registered owner and
she/he has
not made any claim with any insurance company re-loss of said MV
[ ]
If MV is submitted/cited as evidence in a case filed in court, an order of
release from
court/fiscal taking cognizance of the case.
[ ]
Others
__________________________________________________________________________
__________________________________________________________________________
________________
l
l
l PHOTO
l
l
i_____________
l
l
l
l
l
l
__________________________________
Signature
___________________________________
Print Name
___________________________________
Drivers License Number
Sample Format of Turn-over of Crime Scene

(From First Responder to the Investigator)
Tel. _________
TURN-OVER OF CRIME SCENE
____________
Date
This is to certify that the crime scene (State the particular incident and the
date, time, place of occurrence) was turned over by the first responder to the duty
investigator.
This further certifies that all physical evidence found by the first responder at
the crime scene are properly secured and preserved. (List all the pieces of evidence
to be turned over).
Received By : __________________________
Time/date
: __________________________
Turned over By: __________________________

Time/Date
: ___________________________
Witnessed By
___________________________
Sample Format of Turn-over of Crime Scene

(From Investigator to SOCO Team Leader)
Tel. _________
TURN-OVER OF CRIME SCENE AND PHYSICAL EVIDENCE
____________
Date
This is to certify that the crime scene and all physical evidence (State the
particular incident and the date, time, place of occurrence) were turned over by the
duty investigator to the SOCO Team Leader.
This further certify that ell the physical evidence found and initially marked
and inventoried by the investigator at the crime scene are properly listed and
recorded in the investigators Evidence Log Book.
Received By : __________________________
Time/date
: __________________________
Turned over By: __________________________

Time/Date
: ___________________________
Witnessed By
___________________________
Sample Format of Technical Inspection for Vehicle

Tel. _________
Technical Inspection and Inventory Report for Recovered Motor Vehicle
Accomplished By._______________________________________
MOTOR VEHICLE DESCRIPTION
INSIDE FEATURES
ENGINE
Make/Type
Plate No.
Steering Wheel
COMPARTMENT
Air-con Compartment
Engine No.
Fuel
Shifting Rod Knob
Radiator
Registered Owner:
Hand Brake
Radiator Cover
Owners Address
Oil Pressure Gauge
Radiator Outlet Hose
OUTSIDE FEATURES FRONT

Bumper Front
Fog Lights
Brand
Emblem
Headlights
Making
L/R
Radiator Grill
Windshield
Wiper
Signal Lights L/R
Windshield
Glass
Hazard Lights L/R
Windshield
Temperature Gauge
RMP Gauge
Headlight Knob
Water Bypass Hose

Ignition Coil
High Tension Wire
Parking/Hazard Knob
Distributor Cap
Wiper Knob
Distribution Assembly
Dimmer Switch
Contact Point
Wiper Blade
Windshield
Wiper Motor
Left Side Portion: Right Side Portion
Side Mirror
Side Mirror
Wind Tunnel Glass
Wind
Tunnel
Glass
Window
Glass
Window Glass
Front Seat
Front Seat
Weather/
Window Strip
REAR BACK PORTION:
LUGGAGE COMPARTMENT:
Rear Bumper
Spare Tire
Brand
Emblem
Spare
Tire
Markings
Mounting-Note:
no spare tire
cover.
Plate Light
Floor
luggage
Mat
Tail
Light
Mechanical
Assembly
Tools
TIRES
Brand/Make:
Size: 235/75 R15
Condition: Uses
Type
No. of Studs:
General Condition of the MV
Running
Deadline
REMARKS
Headlights Guard
RECOVERING PERSONNEL:
Directorial Level
Condenser
Speedometer
Fuel Gauge
Car Seats Front
Air-con Condenser
Rotor
Advancer
Car Seats Back
Oil Dipstick
Car Seat Cover
Air-con Driver Belt
Floor Carpet
Carburetor Assembly
_ Floor Matting_______
_ Steering Wheel_____
Computer Box
_ Alternator_____________
_ Alternator Voltage Regulator
Seat Adjustment Knob
Air Cleaner
ACCESORIES
Fuel Pump
Air-Condition Unit
Car Stereo
Interceptor Cable
Stereo Speakers
Twitters
Car Radio
Equalizer
CD Changer
Lighter
Barometer
Fire Extinguisher
Antennae
GENERAL
APPEARANCE
Newly Painted
Paint Discoloring
Good Body Shape
Body in Bad Shape
Body ongoing repair
For repairing
Beyond economic repair
and corrosion have set
in which requires a
major body repair
Oil Filter
Steering Gear Box
Water Pump Assembly
Engine Fan
Auxiliary Fan
Fan Belt
Spark Plugs
Battery
Battery Cable
Battery Terminal
Horn Assembly
Horn Relay
Accelerator Cable
WITNESS
/
OWNER/
BARANGAY OFFICIALS
Intake Manifold
Exhaust Manifold
Engine Mounting
Ignition wiring
Transmission
Suspension Assembly
Tie Rod End
Idler Arm
Front Coil Spring
Pitman Arm
NOTED BY: (HEAD OF
OFICE)
______________________
RANK/NAME
DATE
DATE
DATE
Sample Format of Inventory/Receipt of Property

Tel. _________
Date:____________
INVENTORY SHEET/RECEIPT FOR PROPERTY/GOODS RECOVERED
Inventory Sheet of article/items seized from the premise/establishment of
____________,
Located at _______________ by virtue of (Warrant/etc, state the issuing office,
date/time of issuance)
ITEMS ARTICLE
QUANTITY/UNITS
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
(Use extra page if necessary)
______________________________
Seizing Officer
Witness By:
____________________________________
Sample Format of Impounding Receipt

Tel. _________
Date:____________
IMPONDING RECEIPT
Description of MV
1.
2.
3.
Make/Type
____________________________________________________
Chassis No.
____________________________________________________
Motor No.
____________________________________________________
Plate No.
____________________________________________________
Color
____________________________________________________
CR/OR No.
____________________________________________________
LTO File No.
____________________________________________________
Registered Owner :
____________________________________________________
Address
____________________________________________________
Violations
:
________________________________________________________
________________________________________________________
________________________________________________________
Subjet MV was apprehended by Anti-Carnapping Operatives of this office for

violation as stated above on ____________________at about__________ along the
vicinity of _________
______________________ and same was brought to HQS TMG, Cam Crame, Quezon
City, for safe keeping subject for the investigation/verification and proper
disposition.
Note: Subject MV shall only be released upon presentation of its pertinent original
documents and upon notation/approval of the ADI.
APPREHENDING OFFICERS
Team Leader :
__________________________________
Members
:
__________________________________
__________________________________
__________________________________
Conformed :
________________________________
Owner/Driver/Possessor
Sample Format of Evidence Custodian Report
______________________________________________
______________________________________________
Date:____________
RECEIPT OF EVIDENCE CONFISCATED
THIS IS TO CERTIFY that the undersigned receiving Police Officer
seized/confiscated the following described properties/items from the custody and
control of __________________________________, by virtue of Search Warrant
No._________________ issued by the Honorable Judge_____________________________,
Executive Presiding Judge of Branch___________________, RTC,______________________
dated
____________________
for
violation
of
____________________________________________:
PROPERTIES/ITEMS CONFISCATED
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________________________.
SIGNED IN THE PRESENCE OF:
1.)
2.)
_______________________________________
_______________________________________
____________________________________
(Evidence Custodian)
Sample Format
Execution.
of
Certification
of
Legally,
Peacefully
and
orderly

______________________________________________
______________________________________________
CERTIFICATION OF LEGALLY, PEACEFULLY AND ORDERLY EXECUTION OF
SEARCH WARRANT:
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY that elements of _______________________________________
Atationed at Camp Crame, Quezon City, have today ____________________, 20___
conducted Search and Seizure in my residence/premises located at
_________________________________
_______________________, _____________ by virtue of Search Warrant No.______________
issued by Honorable Judge _____________________, Executive/Presiding Judge of
Branch____
RTC,______________________ dated ___________________________.
That during the course of search, they found and recovered the following
personal properties of mine which is the subject of the Search Warrant, to wit:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
___________________________________________.
I FURTHER CERTIFY that the search was done in peaceful, appropriate and
orderly manner and nothing were taken by the searching party aside from those
enumerated above.
==================================================
===================
________________________________
(Signature over printed name of owner)
SIGNED IN THE PRESENCE OF:

1.)______________________________________
(Signature Over Printed Name)
2.)_________________________________
SEARCHING PARTY/TEAM LEADER:
____________________________________
SUBSCRIBED AND SWORN to before me this __________ day of ________________

______________20____, here at Quezon City, Metro Manila.
__________________________________
(Administering Officer)
Sample Format of Compliance/Return of Search Warrant

REGIONAL TRIAL COURT
________________________
Branch_____________
______________________
PEOPLE OF THE PHILIPPINES
Plaintiff
Versus
Search Warrant
No.______________
For Violation of_________________
___________________________
Respondent
X---------------------------------------X
COMPLIANCE/RETURN OF SEARCH WARRANT
Comes now the undersigned applicant, ______________of the _____________ and
unto this Honorable court, respectfully return the herein original copy of the Search
Warrant No. ____
Issued by the Honorable Presiding Judge ________________, Branch_________,
RTC________
______________ for violation of ______________________. (Attached hereto as annex
A is the original copy of Search Warrant No._____________) and manifest the
following.
That at about _________of ____________, elements of the
________________________
________________________ led by the undersigned implemented the search warrant
No._____
at the premises of ______________________________________ located at _______________.
That as a result thereof, the following items/articles which are subject of the
search warrant were confiscated/seized under proper receipt as follows:
That he raid was conducted in a legally, peacefully and orderly manner in the
presence of two (2) Barangay Officials name ly: Brgy. Kagawad
____________________________ ____and
Brgy. Executive Officer _________________________________both of __________________
A corresponding receipt of the evidence confiscated was furnished to the
representative of ____
___________________________.; The registered owner of ___________________, was not
around during the raid, however, as represented by _________________________, the
office administrator. (Attached hereto annex B is a copy of receipt of
evidence confiscated and a certification of orderly execution of Search

Warrant as annex C).
WHEREFORE, it is most respectfully prayed to this Honorable court that the
return of the original Search Warrant No._________ and its annexes together with the
seized items be accepted.
LIKEWISE. It is respectfully prayed that the undersigned be authorized by this
Honorable court or grants the _____________________________ to conduct Forensic
Examination on the seized computers and any other electronic devices for
evidentiary purposes.
Other reliefs just and equitable in the premises, are likely prayed for.
Done this _____day of _____20_____, City of_____________, Philippines.
________________________________
Applicant/Team Leader
SUBSCRIBED AND SWORN to before me this ___day of____20___here at City
of___, Philippines
____________________________
Presiding Judge
Sample Format of Booking and Arrest Report
______________________________________________
______________________________________________
BOOKING AND ARREST REPORT
Picture
__________________________________________DATE____________
(Last Name)
(First Name) (Middle Name)
2x2
ADDRESS:____________________________________________________________________
______________________________________________________________________________
PLACE 7 DATE OF BIRTH:______________________________________________________
OCCUPATION:________________________________________________________________
NATIONALITY:________________SEX:__________WEIGHT:__________HEIGHT:_______
AGE:_______________EDUCATIONAL ATTAINMENT:_____________________________
NAME OF SCHOOL:___________________________________________________________
LOCATION OF SCHOOL:_______________________________________________________
SCARS AND MARKS:__________________________________________________________
OTHER IDENTIFYING MARKS:_________________________________________________
NAME AND ADDRESS OF FATHER:_____________________________________________
NAME AND ADDRESS OF MOTHER:_____________________________________________
NAME AND ADDRESS OF RELATIVES:__________________________________________
OFFENSE CHARGE:
_____________________________________________________________________________
(NATURE OF OFFENSE)
(CRIM/IS NO.)
ARRESTED BY:_______________________________________________________________
UNIT:________________________________________________________________________
WHERE ARRESTED:___________________________________________________________
DATE/TIME ARRESTED:_______________________________________________________
BOOKED BY:______________________________BRANCH/SECTION:_________________
SIGNATURE OF PERSON ARRESTED:____________________________________________
NAME OF ARESTING OFFICER:_________________________________________________
RIGHT HAND
THUMB
INDEX
MIDDLE
RING
LITTLE
LEFT HAND
Sample Format of Detainees Report
CRIMINAL INVESTIGATION DETECTION GROUP
CIDG DETENTION CENTER
Camp Crame, Quezon City
DATE:___________________________
CERTIFICATION
THIS IS TO CERTIFY that the undersigned Incoming Duty Jail Guard/s assumes
the duties and responsibilities from the Outgoing Duty Jail Guards from
_________________________to __________
______________and received the following.
DETAINEES REPORT
Name
Male
1.
2.
Offense
Arrest Unit
Date
Court
Female
1.
2.
Current Detainees= 41
Actual Detainees = 41
Female= 08
Female= 08
Total= 49
Total= 49
Remarks
INCOMING DUTY JAIL GUARDS
OUTGOING DUTY JAIL GUARDS
__________________________________ TEAM LEADER____________________________________

__________________________________ DESK GUARD
____________________________________
__________________________________ GATE GUARD
____________________________________
NOTED/INSPECTED:
NOTED/INSPECTED:
__________________________________
______________________________________
Sample Format of After Case Hearing Report

(During Trial)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
After Case Hearing Report
DATE
:
==================================================
===================
1.
This has reference to the Court Hearing which was attended today
by the undersigned together with __________________________________ relative to the
case filed by ____________________________against _________________________, docketed
under CC# _______________________ is scheduled for arraignment at the sala of
____________________
________________________________________________________.
2. However, said court hearing/arraignment was set because

________________counsel
of
the
respondents
submitted/filed
motion
for
reinvestigation of the case and was presented to the City Prosecutor and after
examining the motion, it was only approved by the court.
3.
For Information.
_____________________________
(CHIEF OF OFFICE)
Sample Format of After Case Hearing Report

(During Promulgation)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
After Promulgation of Judgment Report
DATE
:
==================================================
===================
1.
This pertains to the promulgation of Judgment in PP vs CC.

2.
On or about _____ date, was found guilty beyond reasonable
doubt on the said three (3) cases, to wit:
CASE NUMBER
CRIME COMMITTED
______________
______________
_____________________
_____________________
SENTENCE
_________________
_________________
______________
_____________________
_________________
3.
In addition to the following, the accused is also directed to pay
the heirs of deceased ____________________of the Decision, twelve (12) pages are
hereto attached.
4.
According to the Provincial Jail Warden, accused will be
transferred to National Penitentiary, Muntinlupa City as soon as the commitment
order issued by the Judge.
5.
For Information.
______________________________
(CHIEF OF OFFICE)
Sample Format of Case Folder

CASE FOLDER OF ______________________________________
ENCLOSURE OF CASE REFERAL/TRANSMITTAL
(For violation of___________________________)
TABLE OF CONTENTS
1. Sworn Statement of (Name of Complainant)
A
2. Sworn Statement of (Name of Witness)
B
3. Affidavit of Arrest (Name of Arresting Officer)
C
4. Documentary Evidence
D
a. Complaint Sheet of Complainant
D-1
b. Request and Certificate of POEA
D-2
c. Request and Result of Ultra Violet Powder
d. Summary of Information
D-3
e. Coordination
f. Request and Result of Physical Examination
D-5
D-4
D-6
g. Booking/Information Sheet of Suspect
D-7
h. Copies of Photographs and sketch of agency
D-8
i. Copies of Photographs during Entrapment Operation

D-9
j. Copies of Photographs of the Suspect
D-10
k. Copies of Photographs of the pieces of Physical Evidence
D-11
l. Evidence Recovered and Seized
D-12
m. Reports about the Case
D-13
n. Others
D-
14
______________________________
Officer on Case
Noted By;
__________________________________
Chief of Office
Sample Request Format of Medico-Legal Examination

(Autopsy)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
DATE
Director, PNP Crime Laboratory
Request for Autopsy Examination
==================================================
===================
1.
Request conduct of medico-legal (autopsy) examination on the
accompanying specimen to determine the cause of death.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
SPECIMEN SUBMITTED
2.
Further Request that this Office be furnished a copy of medicolegal examination result for our reference.
3.
For consideration.
_______________________________________
(CHIEF OF OFFICE)
(Genital)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Genital Examination
DATE
:
==================================================
===================
1.
Request conduct of
_______________.
_________________residing at _____________.
Genital
examination
of
the
person
2.
In connection with para 1/above, request furnish this office a
copy of the initial result thereof for reference purpose.
3.
For consideration.
_______________________________________
(CHIEF OF OFFICE)
(Physical/Medical)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Physical/Medical Examination
DATE
:
==================================================
===================
1.
Request conduct of Physical/Medical examination of the person
____________________________residing at____________________________________.
2.
In connection with para 1/above, request furnish this office a
copy of the initial result thereof for reference purpose.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Blood Samples)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Blood Examination
DATE
:
==================================================
===================
1.
Request conducts Medico-Legal (blood) examination on the
accompanying specimen.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Semen Samples)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Semen Examination
DATE
:
==================================================
===================
1.
Request conducts Medico-Legal (Semen) examination on the
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(DNA)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for DNA Examination
DATE
:
==================================================
===================
1.
Request conducts Medico-Legal (DNA) examination on the
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
Sample Request Format of Firearms Identification Examination

(Ballistics)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Ballistics Examination
DATE
:
==================================================
===================
1.
Request conducts ballistics examination on the accompanying
specimen to determine whether the firearm described below was fired from the fired
cartridge or otherwise.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
SPECIMEN SUBMITTED
submitted firearm. Make, Cal, S#, etc)
: (state the description of the
2.
Further Request that this Office be furnished a copy of ballistic
examination result for our reference.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Cross-Matching)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Cross-Matching Examination
DATE
:
==================================================
===================
1.
Request conducts ballistics examination on the accompanying
specimen to determine whether the firearm described below was fired from the fired
cartridge or otherwise.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
SPECIMEN SUBMITTED
submitted firearm. Make, Cal, S#, etc)
2.
Further Request that this Office be furnished a copy of CrossMatching examination result for our reference.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
Sample Request Format of Chemistry examination

(Dangerous Drugs)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Dangerous Drugs Examination
DATE
:
==================================================
===================
1.
Request conducts dangerous drugs examination on the
accompanying specimen to determine whether it contains dangerous drugs or
otherwise.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
Further Request that this Office be furnished a copy of
dangerous drugs examination result for our reference.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Drug Test)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Body Fluids Examination
DATE
:
==================================================
===================
1.
Request conducts Drug Test on the accompanying specimen to
determine whether it contains dangerous drugs or otherwise.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
Further Request that this Office be furnished a copy of said
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Paraffin Test)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Paraffin Test
DATE
:
==================================================
===================
1.
Request conducts Paraffin Test on the accompanying specimen
to determine the presence of gunpowder.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Explosives Test)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Explosives Test
DATE
:
==================================================
===================
1.
Request conducts explosive Test on the accompanying specimen
to determine the component explosive ignridient/s.
a.
NTURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Macro-etching Test)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Macro-etching Test
DATE
:
==================================================
===================
1.
Request conducts Macro-etching examination on the motor
vehicle described below.
a.
MAKE/TYPE :
2.
b.
PLATE NO.
c.
COLOR
d.
CHASSIS NO.:
e.
EGNINE NO. :
Subject vehicle was involved (Brief Facts of the Case)
3.
4.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Trajectory Test)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Trajectory Test
DATE
:
==================================================
===================
1.
Request conducts
specimen to determine the trajectory.
a.
NTURE OF CASE
Trajectory
on
the
accompanying
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
Test
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Ultra-Violet Test)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Ultra-Violet(Fluorescence Powder) Test
DATE
:
==================================================
===================
1.
Request conducts examination on the person of (name of the
arrested person/subject), (age, civil status, occupation, etc) who was arrested
during entrapment operation conducted at about_____, date___ at _________.
a.
NATURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Toxins Examination)
______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Toxins Examination
DATE
:
==================================================
===================
1.
Request conducts toxins examination on the accompanying
specimen to determine the poisonous ingredients.
a.
NATURE OF CASE :
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Burned Debris/Flammable/Volatile Substances)

______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Flammable/Volatile Substances Test
DATE
:
==================================================
===================
1.
Request conducts examination on the accompanying specimen
to determine the flammable/volatile substances
.
a.
NATURE OF CASE :
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Chemical Analysis)

______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Chemical Analysis
DATE
:
==================================================
===================
1.
Request conducts Chemical analysis on the accompanying
specimen to identify the component chemical substance.
.
a.
NATURE OF CASE :
b.
VICTIM
c.
SUSPECT
d.
TDPO
e.
submitted specimen)
SPECIMEN SUBMITTED
2.
3.
For consideration
_______________________________________
(CHIEF OF OFFICE)
(Sample Request Format of Fingerprint Examination)

______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Fingerprint Examination
DATE
:
==================================================
===================
1.
References:
a._________
b._________
2.
Per
above
references,
request
conduct
fingerprint
identification/latent print lifting and identification/fingerprint comparison on herein
submitted specimen to that of the standard fingerprint taken from suspect
________________to wit:
a.
Standard fingerprint specimen of ____________; and
b.
Questioned latent prints placed in __________ with

markings
_________________________....
3.
Further request furnished this Division/Office result thereof for
our investigative reference.
_______________________________________
(CHIEF OF OFFICE)
(Sample Request Format of Questioned Document Examination)

______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Questioned Document Examination
DATE
:
==================================================
===================
1.
References:
a._________
b._________
2.
Per above references, request conduct questioned document
examination/comparison on the herein submitted standard handwritings specimen
to that of alleged questioned document to determine whether it is authentic or not,
to wit:
c.
Standard handwriting specimen consist of ____ pages

with markings _______; and
d.
Alleged
questioned
document
with
markings____________.
3.
_______________________________________
(CHIEF OF OFFICE)
(Sample Request Format of Polygraph Examination)

______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for Polygraph Examination
DATE
:
==================================================
===================
1.
Request conducts polygraph examination on the person of
____________
(or the following persons):
a.
NATURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
2.
3.
For consideration.
_______________________________________
(CHIEF OF OFFICE)
(Sample Request Format for the Conduct of Soco)

______________________________________________
______________________________________________
MEMORANDUM
FOR
FROM
SUBJECT
Request for SOCO
DATE
:
==================================================
===================
1.
Request the presence of SOCO Team to process the crime scene
located at ____________________________________________.
a.
NATURE OF CASE
b.
VICTIM
c.
SUSPECT
d.
TDPO
2.
3.
For consideration.
_______________________________________
(CHIEF OF OFFICE)

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SAMPLE FORMAT OF SPOT REPORT

(Indicate briefly the date/time, and place of occurrence)

(brief facts of the case)

Requested/recommended actions from Hqs.

Progress report to follow

b. SAMPLE FORMAT OF PROGRESS REPORT

Reference: (Previous related Memos)

(Indicate briefly the date/time and place of occurrence)

(Brief facts of the Case)

Requested/Recommended actions from Hqs.

Final Report will follow

c. SAMPLE FORMAT OF FINAL REPORT

Reference: (Pervious related matter)

(Indicate briefly the date/time and place of occurrence)

Background/Brief Facts of the Case

For your information

d. SAMPLE FORMAT OF AFTER OPERATION REPORT

. Republic of the Philippines

After Operation Report

Narrative account of operational activities

Sample Format of Case Referral

Department of the Philippines

(Name, age, nationality, civil status and current address)

(Name, age, nationality, civil status and current address)

(Name, age, nationality, civil status and current address)

(specify if RECOVERED or UNRECOVERED)

FACTS OF THE CSE:

(Five (5) Ws and one (1) H).

Subscribed NPS Investigation Data Form

Department of the Philippines

(Attachment of documents, e. SSs, Affidavit of Arrest, etc)

Very truly yours,

Sample Format of Complaint Sheet

QUEZON CITY POLICE DISTRICT

SUBSCRIBED AND SWORN to before me this _____th day of _______., affiant

Sample Format of Complaint Sheet

2. Previously Reported to Other Agency:

9. Name (s) of Victim (s)

14. Name (s) of Suspect (s)

19. Name (s) 0f Witness (es)

13. Tel. No.

22. Brief Facts/Narrative of Complainant (Use back page, if necessary)

21. Tel. No.

23. Remarks of the receiving officer (especially if reporter refused to be identified):

24. I certify that the details of the complainant/info

25. SUBSCRIBED AND SWORN to before me

26. Date/Time/Complainant/Info Received

27. Printed name/Signature of Receiving Officer

28. Assigned to:

29. Noted by:

Sample format for investigation report

Republic of the Philippines

After Operation Report

Memo from that Office dated _______________ re-investigation report

To determine the surrounding circumstances of the killing of said

FACTS OF THE CASE

Sample form of Sworn Statement/Sinumpaang Salaysay)

Witnesses present, at least two (2) persons), SA PAMAMAGITAN NG MGA TANONG AT

: Ginoong/Ginang____________________, ikaw ba ay magsasabi ng

SUBSCRIBED AND SWORN to before me this _th day of ___., affiant

Ako, si____________________________, Filipino, _taong gulang, may

SUBSCRIBED AND SWORN to before me this day of ______