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Sample Format of Crime Report
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE
CRIME REPORT
NATURE OF CASE :
COMPLAINANT/VICTIM :
(NAMES, PERSONAL CIRCUMSTANCES OF COMPLAINANT)
(IN RAPE CASES, ENCLOSE THE MEDICAL FINDING)
DATE/TIME/PLACE : OF OCCURENCE : SUSPECTS :
(NAMES, PERSONAL CIRCUMSTANCES)
ADDRESS, IF KNOW N, AND PHYSICAL
DESCRIPTION, IF AT-LARGE
EVIDENCE :W ITNESSES : (NAMES AND ADDRESS)
FACTS OF THE CASE:
NAME OF OFFICER-ON-CASE
RANK PNP
DESIGNATION
NOTED AND FORWARDED:
CHIEF OF GOUP/UNIT
RANK PNP
DESIGNATION
Sample Format of Coordination Report
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE__
COORDINATION FORM
UNIT: ____
DATE/TIME:
PLACE OF OPERATION:_
TEAM LEADER:_
MEMBERS: __
____
__
__
__
__
VEHICLE USED:
_
_
_
___
___
RECEIVED BY:
Sample Format of Lifting Of Alarm
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE
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 Number :
In connection with my request. I hereby submit the following:
( ) 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 MV was 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 motor vehicle is not registered in the name of the applicant/ present owner) ( ) Release of claim/subiogation/Deeds of Sale (if the applicant is an insurance company.( ) Special Power of Attorney (if applicant is a representative)() Affidavit of requesting Party/Owner that she/he is still the registered owner and she/ he has not made any claim with any insurance company re-loss of said MV( ) If MV was submitted/cited as evidence in a case filed in court, an order of release from court/ fiscaltaking cognizance of the case. ( ) Others
||Signature
||
||PHOTO||Print Name
||
| |
Drivers License Number
Sample Format of CSI Form 1: First Responders Form
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE
FIRST RESPONDERS FORM(This Form shall be brought by the First Responder and/or Investigator at the Crime Scene and shall be accomplished by the First Responders at the On Scene Command Post (OSCP)
DateTHIS IS TO CERTIFY that the Crime Scene (CS) described hereunder was turned over by the First Responder (FR) to the Duty Investigator /Investigator-On-Case (IOC) with the following gathered information:
Primary Place of Occurrence:
Secondary Place of Occurrence:
Type/Nature of Incident:
Rank and Names of First Responders:
Time/Date Report of Incident was received by FRs:
Time FRs Arrived at the Crime Scene:
Weather Condition
Time CS Cordoned Off and Secured/Signs Posted:
Time Flash Alarm/Request for Support Relayed by FR to TOC:
A. Names of Victims and Status (Safe/Injured/Hospitalized/Deceased, etc.,):
_ _ (Note: Use the overleaf or back page for extra entries)
B. Names of Persons Found at (inside) the Crime Scene by FR (Address/Contact Nrs):
__
C. Names of Suspects and Status (Arrested/At-large, etc..) and W eapons, if any:
D. Name of Person Found Near or at the Vicinity of CS (Address/Contact Nr):
E. Names of Persons Interviewed by the FR (Address/Contact Nr):
F. Names of Persons Who Entered the CS after the Arrival of FR and Prior to Arrival ofInvestigator (Medics, Local Officials, etc) (Address/Contact Nr):
(Note: Use the overleaf or back page for extra entries)
G. List of Evidence That May Have Been Seized or Collected by the FR (If Any): Description Disposition
H. Areas where Initial Search were conducted:
On-Scene Command Post (OSCP) established at:
Time and Date of Arrival of Investigator at the CS:
This further certifies that the Crime Scene and all the evidence therein by the FRs have been properly secured and preserved and that all the information contained herein is true and correct to the best of our ability:
Name and Signature of First Responders:
--
--
CS Received By Duty Investigator/ IOC:
Time/Date:
Witnessed By:
Prepared and Submitted by:
Rank/Name/Designation of Officer/ Signature over Printed Name
(Note: Use the overleaf or back page for extra entries)
Sample Format of CSI Form 2: Request for the Conduct of SOCO
Republic of the Philippines Department of the Interior and Local Government NATIONAL POLICE COMMISSIONPHILIPPINE NATIONAL POLICE
REQUEST FOR THE CONDUCT OF SOCO(This shall be brought to the Crime Scene by the Investigator/SOCO Team and to be accomplished by the Investigator/Investigator-On-Casebefore the SOCO Team process the Crime Scene)
Time and Date
FOR : Chief, _, CLO
FROM :
SUBJECT : SOCO Assistance
1. Request for the availability of SOCO Team to process the crime scene located at _.
NATURE OF CASE :Time and Date of Incident: _
_
2. This request is made with the assurance that the Duty Investigator/ Investigator-On-Case, being in- charge of the Crime Scene shall remain and provide all the necessary security and support to the SOCO Team during the whole process until after the crime scene is released.
3. Further request that this Office be furnished a copy of the list of evidence gathered and the result of the examination conducted thereon.
4. For consideration and approval.
For the Chief of Police:
(Duty Investigator/Investigator-On-Case)
Sample Format of Technical Inspection for Vehicle
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE
Technical Inspection and Inventory Report for Recovered Motor VehicleAccomplished:
MOTOR VEHICLE DESCRIPTIONInside FeaturesEngineCompartment
Make/TypePlate No.Steering WheelAir-con Compressor
Engine No.FuelShifting Rod with KnobRadiator
Chassis No.ColorHand BrakeRadiator Cover
Registered Owner:AmmeterRadiator Inlet Hose
Owners AddressOil Pressure GaugeRadiator Outlet Hose
OUTSIDE FEATURES FRONTTemperature GaugeWater Bypass Hose
Bumper FrontFog LightsRPM GaugeIgnition Coil
Brand EmblemMarking
HeadlightsLRHeadlight KnobHigh Tension Wire
Radiator Grill
WindshieldwiperParking/Hazard KnobDistributor Cap
Signal Lights L/R
WindshieldGlassWiper KnobDistributor Assembly
Hazard Lights L/R
WindshieldWiper BladeDimmer SwitchContact Point
Headlights Guard
WindshieldWiper MotorDirectorial LevelCondenser
Left Side Portion:SpeedometerAir-con Condenser
Right side Portion:
Side MirrorSide MirrorFuel GaugeRotor
Wind Tunnel Glass
Wind TunnelGlassCars Seats FrontAdvancer
Window GlassFront SeatWindowGlass FrontSeatCar Seat BackOil Dipstick
Weather/Window StripCar Seat CoverAir-con Driver Belt
Rear Back Portion:Floor CarpetCarburettor Assembly
Luggage Compartment:
Rear BumperSpare TireFloor MattingAlternator
Brand EmblemMarkingSpare TireMounting- Note: no spare tirecover.Steering WheelAlternator VoltageRegulator
Computer Box
Plate LightFloorLuggageMatSeat Adjustment KnobAir Cleaner
Tail Light AssemblyMechanicalToolsACCESSORIES:Fuel Pump
TIRES:Air-condition UnitOil Filter
Brand/Make:Car StereoSteering Gear Box
Size: 235/75 R15Interceptor CableWater PumpAssembly
Condition: UsedStereo SpeakersEngine Fan
TypeTwittersAuxiliary Fan
No. of Studs:Car RadioFan Belt
General Condition of the MV:EqualizerSpark Plugs
RunningCD ChangerBattery
DeadlineLighterBattery Cable
REMARKSBarometerBattery Terminal
Fire ExtinguisherHorn Assembly
AntennaeHorn Relay
GENERAL APPEARANCE:Accelerator Cable
Newly paintedIntake Manifold
Paint DiscoloringExhaust Manifold
Good body shapeEngine Mounting
Body in Bad ShapeIgnition wiring
Body ongoing repairTransmission
For RepaintingSuspension Assembly
Beyond Economical Repair and corrosion have set in which requires a major body repair.Tie Rod End
Idler Arm
Front Coil Spring
Pitman Arm
Recovering Personnel:WITNESS/OWNER/BarangayOfficial:NOTED BY (HEAD OFOFFICE):
Rank/Name
Date:Date:Date:
8 - 31 -
Sample Format of Inventory/Receipt of Property
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE _ _ _
Date:_ _
INVENTORY SHEET/RECEIPT FOR PROPERTY / GOODS RECOVERED
Inventory Sheet of article/items seized from the premise/establishment of
8 - 39 -
__ located at _ _ _ _
_ by virtue of
ITEMS/ARTICLES QUANTITY/UNITS
_ _ _ _ _ ___ _ _ _ _
_ _ _ _ _ _ _ _ _ _
_
_
_ _
_
_
_ _
_ (Seizing Officer)
Witness by:
_ _
Sample Format of Impounding Receipt
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE
Date:_
IMPOUNDING RECEIPTDescription of the MV:
Make/Type :
Chassis No. :
Motor No. :
Plate No. :
Color :
CR/OR NO. :
LTO File No. :
Registered Owner:
Address :
VIOLATIONS:1.2.3.
Subject MV was apprehended by Anti-Carnapping Operatives of this office for violation/s as stated above on at about along the vicinity of and same was brought toHQS TMG, Camp Crame, Quezon City, for safekeeping 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.
APREHENDING OFFICERS:
Team Leader:
Conformed:
Owner/Driver/Possessor
Sample Format of Evidence Custodian Report
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE _ _
_
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 W arrant
No._ _
issued by 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 of Certification of Legally, Peacefully and Orderly Execution of Search Warrant
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE _ _
_
CERTIFICATION OF LEGALLY, PEACEFULLY AND ORDERLY EXECUTION OF SEARCH WARRANT:
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY that elements of
_
stationed at Camp Crame, Quezon City, have today __ _,200__conducted Search and Seizure in my residence/premises located at _ _ , _ ___ _ by virtue of SearchW arrant No. _ _ issued by Honorable Judge _ _ ,Executive/ Presiding Judge of Branch _ _, RTC, _ _ dated _ _ _:
That during the course of their search, they found and recovered the following personal properties of mine which is the subject of the Search W arrant, 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.) _ _ 2.) _ _ _ (Signature over printed name) (Signature over printed name)
SEARCHING PARTY/TEAM LEADER:
_ _ Signature over printed name)
SUBSCRIBED AND SWORN to before me this __ day of 20_
at_ _
_ _ _ ,
_ _.
_ _(Administering Officer)
Sample Format of Compliance/Return of Search Warrant
Republic of the PhilippinesREGIONAL T RIAL COURT
Branch
_
PEOPLE OF THE PHILIPPINESPlaintiff
Versus
Search Warrant no.
For violatio n of
Respondents
X - - - - - - - - - - - - - - - - - - - - - - - - X
COMPLIANCE/RET URN OF SEARCH WARRANT
Comes no w, the undersigned applicant, _
_of the and unto this
Honorable court, respectf ully return the herein original copy of the Search Warrant No. _ issued by the Ho norable
Presiding Judge _, Branch _, RTC for violatio n of
_. ( Attached hereto as annex
A is the original copy of Search Warrant No. ) and manifest the following:
Thatatabo ut of , elements of the
led bythe undersigned implemented the search warrant no.
_ at the premises of
located at _.
That as a result thereof, the following items/articles which are subjects of the search warrant were confiscated/seized under proper receipt as follo ws;
That the raid was conducted in a legally, peacefully and orderly manner and in the presence of Two (2) Barangay Officials
namely: Brgy Kagawad
and Brgy Executive Officer
both of . A correspo nding receipt of the evidence confiscated was furnished to the representative of . T he registered o wner of , was not aro und during the raid, ho wever, was represented by _ _, the office administrator. (Attached hereto as 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 Ho norable Court that the return of the Original Search Warrant No. and its annexes together with the seized items be accepted.
LIKEWISE, it is respectf ully prayed that the undersigned be authorized by this Ho norable Court or grants the
purposes.
_ to conduct Forensic Examinatio n on the seized computers and other electronic devices for evidentiary
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 at City of Manila, Philippines.
Presiding Judge
Sample Format of Booking and Arrest R eport
Republic of the PhilippinesDepartment of the Interior and Local GovernmentPHILIPPINE NATIONAL POLICE__
BOOKING AND ARREST REPORT
Picture2x2
_(Last Name) (First Name) (Middle Name)
DATE:
ADDRESS :PLACE & DATE OF BIRTH : OCCUPATION : NATIONALITY :
SEX : _
Tel No. __
MARITAL STATUS :_ WEIGHT : _
_ _
_ HEIGHT:
AGE : _
EDUCATIONAL ATTAINMENT : _
NAME OF SCHOOL: _ SCARS AND MARKS : _NAME & ADDRESS OF FATHER: _ NAME & ADDRESS OF MOTHER: NAME & ADDRESS OF RELATIVES: _
_LOCATION OF SCHOOL:_ OTHER IDENTIFYING MARKS:
__
OFFENSE CHARGE:
_(NATURE OF OFFENSE) (CRIM/IS NO.)
ARRESTED BY: WHERE ARRESTED: _ BOOKED BY : _
_ UNIT: _ _ DATE/TIME ARRESTED: _ BRANCH/SECTION:
SIGNATURE OF PERSON ARRESTED: _ NAME OF ARRESTING OFFICER:
RIGHT HAND
THUMB INDEX MIDDLE RING LITTLE
LEFT HAND
w. Sample Format of Explosive-Related Incident Report
(With Evidence Recovery Log and Custody Log)
Republic of the Philippines
Department of the Interior and Local GovernmentNATIONAL POLICE COMMISSIONPHILIPPINE NATIONAL POLICE INTELLIGENCE GROUPPHILIPPINE BOMB DATA CENTER
2nd Floor Maritime BuildingCamp Crame, Quezon CityTel. Nos. (02) 4120065 / 7230401 loc 4496 Email: [email protected]
EXPLOSIVE-RELATED INCIDENT REPORT FORM
BDC Incident NumberDate Received
Police Blotter Case Number
Reporting PNP Unit
Chief of Office
Investigator-on-Case
Unit Contact DetailsAddress
Phone
Bomb Squad Unit
Team Leader
Unit Contact DetailsAddress
Phone
SOCO Unit
Unit Contact DetailsAddress
Phone
Date/Time of Incident
Location
Incident CategoryBombingAttempted BombingTheftRecoveryOther
CasualtiesYesNoNumber:
DeathsYesNoNumber:
Pre-Incident ThreatYesoMethod of Threat:
Post-Incident ThreatYesoMethod of Threat:
Delivery MethodDeliveredDropped Thrown Placed SuicideBuriedOther
Details
Initiation MethodTime
Victim
Environmental
Command
Other
Details
Power SourceBatteryMains
Details
Explosive TypeCommercialMilitary / OrdnanceImprovisedOther
Details
Detonator TypeCommercialMilitary Improvised Other
Details
Container TypePlasticMetal Carton Bag ClothWoodOther
Details
MotiveVandalismTerrorist Criminal ReligiousDomestic DisputeExperimentationExtortionOther
Details
TargetGovernmentCommercial Private Other
Details
Suspected Group: Details:
Device/Component DescriptionThis box needs to include a device description and a components list. This requires as much information as possible.
Incident DetailsInclude information on injuries, property damage, motive and incident description, device location and any other relevant information.
Render Safe ProcedureList action taken by reporting unit and any information considered urgent for promulgation to other law enforcement agencies and first responders. e.g. Device rendered safe by remote approach utilizing disruptor.
Photographs/Media
List and describe any photos, diagrams attached to the report.
Signature _
Date: / /
Name:
Note: Please transmit to PBDC-IG through fax or Email.
ADMINISTRATIVE LOG
Location:Personnel Involved:
Date:
Case Identifier/Number:
Preparer/ Assistants:
TimePertinent Description / Information
NARRATIVE DESCRIPTION
Location:
Date:
Case Identifier/Number:
Preparer/ Assistants:
PHOTOGRAPHIC LOG
Location:Camera:
Date:Type of film:
Case Identifier/Number:
Preparer/ Assistants:Remarks
Photo#Description of Photograph ic SubjectCamera Settings and Lens TypeDistanceUse ofScale
Sketch (of Applicable)
CRIME SCENE DIAGRAM / SKETCH
Location:Reference
Date:Scale of Disclaimer
Case Identifier/Number:Compass Orientation
Preparer/ AssistantsEvidence
Fixed Objects
Measurements
Key / Legend
EVIDENCE RECOVERY LOG
Location:Personnel Involved:
Date:
Case Identifier/Number:
Preparer/ Assistants:
Item #Description ofItemLocationRecovered by:PhotoLog #Marking Direct = D Indirect = IPackagingMethodComm ents
CUSTODY LOG
Item #Case Number:
Delivered By:DateTime
To:
Returned To:DateTime
By
Delivered By:DateTime
To:
Returned To:DateTime
By
Delivered By:DateTime
To:
Returned To:DateTime
By
Delivered By:DateTime
To:
Returned To:DateTime
By
Delivered By:DateTime
To:
Returned To:DateTime
By
BOMB SUMMARY CHART
Incident #Incident LocationBombContainerTypeExplosivePipeMethod Initiation
BOMB SUMMARY CHART
BatteryWireTapeGlueSwitchClockContact ScrewSolder
R/C Devices #Construction SimilaritiesFingerprintsRemarks
x. Sample Format of Detainees Report
Republic of the PhilippinesDepartment of the Interior and Local GovernmentNATIONAL POLICE COMMISSION PHILIPPINE NATIONAL POLICECRIMINAL INVESTIGATION DETECTION GROUPCIDG DETENTION CENTER Camp Crame, Quezon City
C E R T I F I C A T I O N
THIS IS TO CERTIFY that the undersigned Incoming Duty Jail Guards assumes theduties and responsibilities from the Outgoing Duty Jail Guards from to and received the following to wit:
D E T A I N E E S R E P O R T
NameOffensesArrest UnitDateCourtRemarks
Male
1.
2.
Female
1.
2.
Current Detainees... = 41Female = 08Total = 49
Actual Detainees... = 41Female = 08Total = 49
INCOMING DUTY JAIL GUARDS OUTGOING DUTY JAIL GUARDS
TEAM LEADER DESK GUARD GATE GUARD
NOTED/INSPECTED: NOTED/INSPECTED:
y. Sample Format of After Case Hearing Report(During Trial)
Republic of the PhilippinesDepartment of the Interior and Local GovernmentNATIONAL POLICE COMMISSION PHILIPPINE NATIONAL POLICE _ _ _ _
MEMORANDUM FOR : FROM :SUBJECT : After Case Hearing Reports
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 a motion forreinvestigation of the case and was presented to City Prosecutor and after examining the motion, it was only approved by the court.
3. For information.
_ (CHIEF OF OFFICE)
y. Sample Format of After Case Hearing Report(During Promulgation)
Republic of the PhilippinesDepartment of the Interior and Local GovernmentNATIONAL POLICE COMMISSION PHILIPPINE NATIONAL POLICE _ _ _
_
MEMORANDUM FOR : FROM :SUBJECT : After Promulgation of Judgment Reports
DATE :
1. This pertains to the promulgation of Judgment in PP vs in CC.
2. On or about o clock in the afternoon on even 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 ofdeceased _ _ of the Decision, twelve (12) pages are hereto attached.
4. According to the Provincial Jail W arden, accused will be transferred to National Penitentiary, Muntinlupa City as soon as the commitment order issued by the Judge.
5. Information.
_ __ (CHIEF OF OFFICE)