Republic of the Philippines

NATIONAL POLICE COMMISION

PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Sta. Maria, Ilocos sur
Tel No. 628-0013

January 18, 2024

The Honorable Chief City Prosecutor

Office of the City Prosecutor
Provice of Santa Maria Ilocos Sur

Sir/Madam,

Respectfully referred to your good office for Inquest proceedings are the pertinent
records of investigation relative to cases for Violations indicated after their Names on the
complaint of this station as represented by PO1 Charlie Carabot et al, Operatives of SDET,
Marikina City Police Station PCP-4. The Incident transpired at about 2:20 AM of January 18,
2024, at Maynganay Sur, Santa Maria Ilocos Sur, to wit;

A. SUSPECT/s:

DANIEL MONFORTE y AMBAS, male, 31 years old, single, tricycle driver

and presently residing at No. 27 Brgy. Maynganay, Santa Maria for Violation of section 11
(Illegal possession of dangerous drugs) of R.A 9165 Art II.

This case/s will be presented to your office by the Arresting Officers/s or

investigator-on-case for disposition and evaluation. Further, furnish this office a copy of your
resolution for our reference.

ANTONIO V. LUALHATI JAKE S. IBALLA

Police Chief Inspector Police Superintendent
Station Commander
B. ENCLOSURES/ATTACHMENT:
1. Joint affidavit of Arrest
2. Affidavit of Investigator
3. Booking Sheet and Arrest Report of the Suspect
4. Spot Report
5. Request for Laboratory Examination
6. Result of Laboratory Examination
7. Receipt of Inventory of Seized Evidence
8. Chain of Custody Form
9. Photographed while conducting marking and inventory of seized evidence
10. Photographed/Mug-Shot of the suspect
11. Medical Certificate of the Suspect
12. Pre-Operation and Coordination Form

Recommendation

Rona B. Catarin
Duty Inquest Fiscal
 Republic of the Philippines
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria, Ilocos Sur
Tel No. 628-0013

MEMORANDUM

FOR : Director, NCRPO

(Attn: Chief of DDEU)

FROM : Station Commander

SUBJECT : Spot Report re: Arrested person for Violation of Section 11 Art. II
of RA 9165

DATE : JANUARY 18, 2024

1. Reference:
a. Blotter Entry No: 19-0070

2. DANIEL MONFORTE y AMBAS, male, 31 years old, single, tricycle driver and
presently residing at No. 27 Brgy. Maynganay Sur Santa Maria for Violation of section 11
(Illegal possession of dangerous drugs) of R.A 9165 Art II.

3. Initial investigation disclosed that at about 2:20 AM, October 09, 2019, Personnel of
Marikina City Police Station PCP-4 SDET of this station led by PCI ANTONIO V. LUALHATI
conducted buy-bust operation which resulted to the arrest of the above-named suspect at
house Brgy. Maynganay Sur Santa Maria.

4. Confiscated from the possession and control of the above-named suspect are two (2)
pieces of small heat sealed transparent plastic sachet containing white cystalline substance
suspected to be “shabu” marked as CLC and CLC-1 all with date and signature of seizing
officer which were submitted to Camp Crame Crime Laboratory Office CCCLO for Laboratory
Examination.

5. A case for violation of Section 11 of Art. II of R.A 9165 is being prepared for
proceedings against the arrested suspects before the office of the City Prosecutor. The
Investigator- on-case is PO1 John David Samorio of SDET with contact number:
09095060274

6. For information and Progress report to follow.

ANTONIO V. LUALHATI JAKE S. IBALLA

Police Chief Inspector Police Superintendent
 Station Commander
Republic of the Philippines
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria, Ilocos Sur
Tel No. 628-0013

MEMORANDUM

FOR : Chief: Camp Crame Crime Laboratory Office

(Attn: Duty Chemist)

SUBJECT : Laboratory Examination, Request for

DATE : JANUARY 18, 2024

1. Respectfully request a chemical laboratory examination be conducted on herein

specimen to determine the presence of dangerous drugs.

Two (2) pieces of small heat sealed transparent plastic sachet containing white
cystalline substance subjected to be “shabu” marked as CLC and CLC-1 all with date
and signature of seizing officer

2. The aforementioned specimen was confiscated from the possession and control of
the suspect identified as DANIEL MONFORTE y AMBAS, male, 31 years old, single, tricycle
driver and presently residing at No. 27 Brgy Maynganay Sur Santa Maria for Violation of
section 11 (Illegal possession of dangerous drugs) of R.A 9165 Art II.

2. Further request, furnish this office a copy of the result of examination to support
the filling of charge/s against the arrested suspect.

ANTONIO V. LUALHATI
Police Chief Inspector
Chief, SDEU

Received and Recorded by: NUP Armina G. Calupas

Received by: PO1 ROQUE Agency/Address: Duty Desk Officer, CCCLO
Time and Date: 8:03 AM, January 18, 2024 Time and Date: January 18, 2024, 8: 15 AM
Agency/Unit: DDEU Delivered by: PO1 Charlie Carabot

CAMP CRAME CRIME LABORATORY

PHYSICAL SCIENCE SECTION
Received by: PCI Ciarra F. Cabalida
Agency/Address: Forensic Chemist, CCCLO
Time and Date: January 18, 2024, 11:50 AM
Report No. D-1017-19
 Republic of the Philippines
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria Ilocos Sur
Tel No. 628-0013

CHAIN OF CUSTODY FORM

Nature of Case: Violation of Section 11 Art. II of RA 9165

Name of Suspect/s:

DANIEL MONFORTE y AMBAS

Date/Time/Place of Occurence : at about 2:20 AM of January 18, 2024 at the house No. 27
Maynganay Sur Santa Maria Ilocos Sur.

Arresting Officer/s Unit: PO1 Charlie Carabot et al, SDET Operatives, Marikina City Police
Station, PCP-4

Description of Evidence: Two (2) pieces of small heat sealed transparent plastic sachet
containing white cystalline substance subjected to be “shabu” marked as CLC and CLC-1 all
with date and signature of seizing officer

Turned Over by: PO1 Charlie Carabot

Agency/Address: SDET operatives, Santa Maria Police Station, PCP-4
Time and Date: January 18, 2024, 3:25 AM

Received by: PO1 John David Samorio

Agency/Address: SDET Investigator, Santa Maria Police Station, PCP-4
Time and Date: January 18, 2024, 3:25 AM

Turned Over by: PO1 Charlie Carabot

Agency/Address: SDET operatives, Santa Maria Police Station, PCP-4
Time and Date: January 18, 2024, 3:55 AM

Received by: PO1 John David Samorio

Agency/Address: SDET Investigator, Santa Maria Police Station, PCP-4
Time and Date: January 18, 2024, 3:55AM

Turned Over by: PO1 Charlie Carabot

Agency/Address: SDET operatives, Santa Maria Police Station, PCP-4
Time and Date: January 18, 2024, 8:15 AM
Received by: NUP Armina G. Calupas
Agency/Address: Duty Desk Officer, CCCLO
Time and Date: January 18, 2024, 8: 15 AM

Turned Over by: NUP Armina G. Calupas

Agency/Address: Duty Desk Officer, CCCLO
Time and Date: January 18, 2024, 11:50 AM

(With markings)
Received by: PCI Ciarra F. Cabalida
Agency/Address: Forensic Chemist, CCCLO
Time and Date: January 18, 2024, 11:50 AM
 Republic of the Philippines
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria Ilocos Sur
Tel No. 628-0013

PRE-OPERATION REPORT

Date: January 18, 2024

I. Unit/Office : Station Drug Enforcement Team (SDET) Marikina City Police Station (PCP-4)

II. Name of Target/s : @TOTOY

III. Citizenship : ___Filipino ___Foreigner

IV. Specific Area of Operation: Marikina City Police Station (PCP-4)

V. Summary of Information:

Target personalities were allegedly engaged in the sale and distribution of Dangerous
drugs in the above-mentioned area.

JAKE S. IBALLA
Police Superintendent
Station Commander
Republic of the Philippines
Municipality of Santa Maria

JOINT AFFIDAVIT OF ARREST

We, the UNDERSIGNED Police Officers, All of Legal age, both members of the
Philippine National Police, and presently assigned at the Santa Maria Police Station PCP-4
and detailed as Operatives of Station Drug Enforcement Team (SDET), with office
address at Barangay Hall Maynganay Sur, Santa Maria Ilocos Sur. After having sworn to in
accordance with law, do hereby depose and state THAT:
At about 2:20 AM of January 18, 2024, at house No. 27 Brgy. Maynganay Sur, Santa
Maria, we effected the arrest of the suspect identified as, to wit;

DANIEL MONFORTE y AMBAS, male, 31 years old, single, tricycle driver and presently
residing at No. 27 Maynganay Sur Santa Maria for Violation of section 11 (Illegal
possession of dangerous drugs) of R.A 9165 Art II.

That prior to the arrest of the above named suspect, at about 10:00 PM of January 18,
2024, our regular confidential informant (DVG for brevity) appeared to our office and relayed
information to PCI ANTONIO V. LUALHATI, Chief of SDET regarding to rampart selling
activity and proliferation of illegal dangerous drugs particularly shabu of a certain @TOTOY at
Brgy, Manganay Sur Santa Maria and further informed him that he had an ongoing drug
transaction with the said suspect. After the receipt of the information, PCI LUALHATI relayed
the said information to PSUPT JAKE S. IBALLA, MCPS, PCP-4 Station Commander who
instructed PCI LUALHATI to conduct a buy-bust operation against the said suspect.

That, after which PCI LUALHATI gathered the operatives to have a briefing and during
the said briefing, a coordination from the PDEA is being prepared and was later granted
issuing a control number 10001-10201954-0221 dated January 18, 2024, Likewise PO1
Charlie Carabot was tasked as the POLICE POSEUR BUYER and was given Two (2) pieces
of one hundred peso bill with pre-marked astheris symbol at the left eye of Manuel A. Roxas
to be used as marked money, Furthermore, the team agreed upon the pre-arranged signal
that if the buy-bust was consummated PO1 Carabot will dropped/miscall to PO1 Mariano.

That, at about 2:00 AM, January 18, 2024 we are dispatched to conduct buy-bust
operation, the DVG together with PO1 Carabot walked casually along Brgy Maynganay Sur,
Santa Maria while the other operatives pre-positioned themselves wherein they can see the
movement of transaction. Then I, PO1 Carabot instructed the DVG to send a text message to
@TOTOY “DITO NA KAME MAYNGANAY KOSA” then @TOTOY replied “PUNTA KAYO
DITO SA TAPAT NG BAHAY NG TROPA KUKUHA KASI” referring to the house NO. 27
BRGY. MAYNGANAY SUR, SANTA. MARIA. Upon the receipt of information, I PO1 Carabot
together with DVG proceeded to the area and upon arrival at the area, I saw Two (2)
unidentified male malefactor who have brief conversation then the DVG approached and
greeted @TOTOY and have a short conversation.
 After their conversation, DVG introduced me as his friend who wants to buy shabu the
@TOTOY told his friend in vernacular “KOSA PWEDE BA TAYO SA LOOB NG BAHAY
NYO? DUN KO NA AABOT SAYO YUNG BINILI MO.” Then the one (1) unidentified male
malefactor later identified as DANIEL MONFORTE y AMBAS replied “TARA” thereafter, we
entered the house and entered to the room of DANIEL AMBAS, then @TOTOY without any
hesitation asked me in vernacular “MAGKANO BA KUKUNIN MO?” then I PO1 Carabot
replied “MGA 200 LANG KOSA” then @TOTOY wants to have the money first before he
gave the shabu then, I PO1 Carabot took from my left front pocket two (2) pieces of one
hundred peso bill as marked money gave it ot @TOTOY then inserted the marked money to
his left front pocket, afterwhich @TOTOY took from his right front pocket a two (2) pieces of
heat sealed transparent plastic sachet containing white crystalline substance suspected to be
shabu then @TOTOY asked me in vernacular “PILI KA” then I PO1 Carabot took from his
right hand one (1) small heat sealed transparent plastic sachet containing white crystalline
substance suspected to be shabu later marked as “CLC” with date and signature of seizing
officer and inserted it to my right clear front pocket. Then I PO1 Carabot discreetly
dropped/miscall to PO1 Mariano signed as the buy-bust was consummated.

That, while I PO1 Carabot examining the contents of the said plastic sachet I actually
saw and observed @TOTOY asked his friend DANIEL AMBAS in vernacular “KOSA YAN
NA BINILI MO AH WALA NA AKONG UTANG SAYO”, then I PO1 Carabot actually saw
@TOTOY give to DANIEL AMBAS one (1) small heat sealed transparent plastic sachet
containing white crystalline substance suspected as shabu and inserted it to his right front
pocket.

That, right after, I , PO1 Carabot grab and hold @TOTOY and introduced myself as a
police officer upon seeing PO1 MARIANO and other operatives entering the house, But
@TOTOY wrestling and pushed PO1 Carabot to elude arrest then and there @TOTOY run
towards and jumped out. I, PO1 Mariano and other operatives tried to chased @TOTOY but
@TOTOY managed to escape from apprehension. Thereafter suspect DANIEL AMBAS was
stunned and apprehended by PO1 Carabot as standard operating procedure. I, PO1 Carabot
ordered him to empty the content of his pockets wherein, I, PO1 Carabot
recovered/confiscated form his right pocket one (1) small heat sealed transparent plastic
sachet containing white crystalline substance suspected to be shabu later marked as CLC-1
with date and signature.

That, when we are preparing to make marking and inventory in the area of arrest, but
suspect upon seeing his family and relatives became unruly and make uncooperative
resulting to undersigned police operatives to brought him out of his resident. Then we decided
to brought the arrested suspect and pieces of recovered evidence in our office at Santa Maria
Police Station to secured them and to avoid commotion in the area.

Suspect was informed about the nature of his arrest and apprised his constitutional rights
in the language he can easily understood (tagalog) but opted to remain silent. Suspect was
brought at Sto. Niño Hospital for medical examination.

That, the markings, physical inventory and taking of photographed were conducted as
SDET office in the presence of the suspect and witnessed by Kagawad Glenn M. Evangelista
of Barangay población, santa maria.

That, the pieces of seized and confiscated evidence recovered by the arresting officer,
was presented to the duty investigator for investigation and documentation at about 3:25 AM,
January 18 2024. Later the confiscated seized evidences were submitted to Camp Crame
Crime Laboratory Office CCCLO for laboratory exam.
 That anything not mentioned in this affidavit will be narrated in an open court during
proper trial.

That, we, executed this affidavit to attest the truthfulness of the foregoing facts and to
support our charge against the about named suspect.

AFFIANTS FURTHER SAYETH NAUGHT.

PO1 Chalie Carabot PO1 Alvin Mariano

(AFFIANTS) (AFFIANTS)

SWORN and SUBSCRIBED to ~~~~~~~~nbefore me, this 18th day of January 2024, in
the Municipality of Santa Maria, Republic of the Philippines. This is also to certify, that I have
personally examined the herein affiants and I am fully convinced that this affidavit is their free
and voluntary act and that they fully undestood the contents hereto.

ANTONIO V. LUALHATI
ADMINISTERING OFFICER
Police Chief Inspector
Santa Maria Police District
Republic of the Philippines
Municipality of Santa Maria

AFFIDAVIT OF INVESTIGATOR

I, PO1 John David Samorio, of legal age and bonafide member of Philippine National
Police presently assigned at SANTA MARIA POLICE STATION PCP-4 and detailed as
investigator of Station Drug Enforcement Team (SDET) with office address at Marikina City
Police Station, Barangay Hall Maynganay Sur, Santa Maria Ilocos Sur, after having sworn to
in accordance with law hereby despose and state the following.

That, based on the narration of the arresting Police Officer, at about 2:20 AM of January
18, 2024, at house No. 27 Brgy Maynganay Sur Santa Maria. Our unit, conducted Buy-bust
operation against @TOTOY led by PCI ANTONIO V. LUALHATI, and Operatives of SDET,
MCPS, PCP-4 which resulted to the confiscation of the following items, as listed below;

Two (2) pieces of small heat transparent plastic sachet containing white crystalline
substance suspected to be “shabu” marked as CLC and CLC-1 all with date and signature of
seizing officer.

Above listed illegal drugs items were submitted to Camp Crame Crime Laboratory Office
CCCLO for examination and arrested suspect identified as;

DANIEL MONFORTE y AMBAS, male, 31 years old, single, tricycle driver and presently
residing at No. 27 Brgy Maynganay Sur Santa Maria for Violation of section 11 (Illegal
possession of dangerous drugs) of R.A 9165 Art II.

That the undersigned was designated as investigator-on-case of the said cases and
caused the preparation and provide the following documents;

1. Joint Affidavit of Apprehension

2. Booking sheet and arrested report of the suspect
3. Spot report
4. Request for laboratory examination
5. Receipt of inventory of seized evidence
6. Chain of custody
7. Took the photograph/mugshot of the suspect and evidence
8. Took photographed while conducting marking and inventory of evidence

That, the pieces of seized and confiscated evidences recovered by the arresting officer,
was presented to me for investigation and documentation at about 3:25 AM, October 09.
2019.

That at about 8:15 AM on October 9, 2019, PO1 Charlie Carabot turned over the seized
evidences to the Camp Crame Crime Laboratory Office, for laboratory examination and
custody and was received by NUP ARMINA G. CALUPAS duty desk CCCLO. That at about
11:50 AM on October 9, 2019 NUP ARMINA G. CALUPAS turned over the seized evidences
to duty chemist PCI CIARRA F. CABALIDA. After which CCCLO Crime laboratory office
issued a Chemistry report D-1017-19 dated January 18, 2024 which gave “POSITIVE
RESULT” for the test Methamphetamine hydrochloride, a dangerous drugs.
 That anything not mentioned in this affidavit will be narrated in an open court during
proper trial.

That, after the investigation the arrested suspect will be charged before City Prosecutor’s
office of Marikina for Violation of section 11 of Art. II R.A 9165.

That, I am executing this affidavit to attest to the truthfulness of the foregoing statements
and to support the filing of appropriate charges against the suspect.

FURTHER AFFIANT SAYETH NAUGHT

PO1 JOHN DAVID SAMORIO

(AFFIANTS)

SWORN and SUBSCRIBED to before me, this 19th day of January 2024, in the City of
Marikina, Republic of the Philippines. This is also to certify, that I have personally examined
the herein affiants and I am fully convinced that this affidavit is their free and voluntary act and
that they fully understood the contents hereto.

ANTONIO V. LUALHATI
ADMINISTERING OFFICER
Police Chief Inspector
Marikina Police District
 Republic of the Philippines
National Police Commission
PHILIPPINE NATIONAL POLICE
CAMP CRAME CRIME LABORATORY OFFICE
National Headquarters, EDSA, Camp Crame,
Quezon City, 1111 Metro Manila

Chemistry REPORT NO: D-1017-19

CASE: Alleged Violation of RA 9165 SUSPECT: DANIEL MONFORTE y AMBAS

VICTIM/S:

TIME AND DATE RECEIVED: 11:50 AM, January 18, 2024

REQUESTING PARTY/UNIT: PCI ANTONIO V. LUALHATI

Chief, SDEU, PCP-4, Santa Maria Police

SPECIMEN SUBMITTED:
Two (2) heat sealed transparent plastic sachets each containing white crystalline
substance with the following markings and recorded net weights:
A- CJC 10-09-19 and signature = 0.045 gram
B- CJC-1 10-09-19 and signature = 0.060 gram.xxx

PURPOSE OF LABORATORY EXAMINATION:

To determine the presence of dangerous drugs.xxx

FINDINGS:
Qualitative examination conducted on the above-stated speciments gave POSITIVE result
to the tests for Methamphetamine hydrochloride, a dangerous drug.xxx

CONCLUSION:
Specimen A and B contain Methamphetamine hydrochloride, a dangerous drug.xxx

REMARKS:

TIME AND DATE COMPLETED: 5:00 AM January 18, 2024

EXAMINED BY: CIARRA F. CABALIDA

Police chief inspector
Forensic Chemist
PRC Reg. No. 0001116
APPROVED:

SWORN and SUBSCRIBED to before me, this 19th day of January 2024, at Camp Crame
Crime Laboratory.

NOTED: EDNA SANCHEZ MENDOZA

Police chief Inspector
OIC, CCCLO

PCI RONA B. ESTO

Administering Officer
 MEDICAL CERTIFICATE

CASE NUMBER: 19- 00390

DATE: January 18, 2024
TIME: 6:20 AM

TO WHOM IT MAY CONCERN:

This is to certify that _______________________________ age/ sex:_____________

With address ______________________________________ was examined/treated in
this hospital.

Findings:

No external signs of Physical injury at the time of examination.

Danica M. Delatore, , MD
(Name and signature of Attending Physician)
 Republic of the Philippines
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria, Ilocos Sur
Tel No. 628-0013

BOOKING SHEET AND ARREST REPORT

NAME: ALIAS/ES: DATE:

DANIEL MONFORTE y AMBAS January 18, 2024
ADDRESS:
No. 27, Barangay Maynganay Sur, Santa Maria Ilocos Sur
DOB: POB: AGE: SEX: CIVIL OCCUPATION:
STATUS:
January 2, 1993 No. 27 Brgy. 31 y/o Male Tricycle
Maynganay Sur Single driver
GANGS/AFFLIATION: HEIGHT WEIGHT: BUILT: RELIGION:
:
None 55 Slim Cathol
5 kgs ic
”7’
IDENTIFYING CHARACTERISTICS/ MARKS: HAIR: EYES: COMPLEXION:
Right Handed, Has birth mark on lower left Black Black Fair
back
NAME/S OF NEAREST EDUCATIONAL NATIONALITY:
RELATIVES/KIN/ADDRESS: ATTAINMENT:
Filipino
Jane M. Ambas, Mother, Same address High school graduate

OFFENSE/S: D T P O:
Section 11 (illegal possession of dangerous At about 2:20 AM of January 18, 2024, At
drugs) No. 27 Brgy. Maynganay Sur, Santa Maria
of R.A 9165 Art II
ARRESTING OFFICER/S: UNIT:
PO1 Charlie Carabot Operatives pf SDET, Marikina City Police, PCP-4

FACTS OF THE CASE

 (See attached Joint Affidavit of Apprehension)

Accused was apprised of his CONSTITUTIONAL RIGHTS to remain silent, to counsel

and all that he will say can and will be used in favor or against him in any court of law.

Case will be referred for Inquest.

PO1 JOHN DAVID SAMORIO

Investigator-On-Case
 SMALL HEAT SEALED TRANPARENT
PLASTIC SACHET CONTAINING WHITE
CRYTALLINE SUBSTANCE SUSPECTED TO
Republic of the Philippines BE SHABU.
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria, Ilocos Sur
Tel No. 628-0013

RECEIPT/INVENTORY OF PROPERTY SEIZED

DATE: January 19, 2024

THIS IS TO CERTIFY that the undersigned has seized and taken the possession of the
property of the herein below described from

SUSPECT: DANIEL MONFORTE y AMBAS, male, 26 years old, single, tricycle driver and
presently residing at No. 27 Brgy. Maynganay Sur, Santa Maria.

T D P O: At about 2:20 AM of January 19, 2024, At No. 27 Brgy. Maynganay sur, Santa
Maria

TYPE OF OPERATION: Buy-Bust

ITEM NO. QUANTITY DESCRIPTION

1 TWO (2) PIECES

A

copy hereof was furnished to Mr/Ms KAGAWAD GLENN M. EVANGELISTA who was
present during the inventory of the described property/items.

ARRESTING OFFICER/S:
1. PO1 CHARLIE CARABOT

WITNESS TO INVENTORY
1. KAG. Glenn M. Evangelista
Baranggay Poblacion, Santa Maria

SUBSCRIBED AND SWORN to before me this 19th day of January 18, 2024 at the
Municipality of Santa Maria

ANTONIO V. LUALHATI
Police Chief Inspector
 Republic of the Philippines
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria, Ilocos Sur
Tel No. 628-0013

COORDINATION FORM

(PDEA) Control Number: 10001-10201954-0221 Date: January 18, 2024

I. Coordinating Unit: Marikina Police Station, PCP-4 Drug Enforcement Team

II. Type of Operation:

Surveillance Buy- Bust x

Casing Search Warrant

III. Duration of Operation: January 18, 2024 1:00 AM to January 18, 2024 1:00 PM

DATE TIME DATE TIME

IV. Area of Operation: (Santa Maria Police station, Police community Precinct-4)

V. Team Leader: PCI ANTONIO V. LUALHATI

VI. Members:

PO3 VERDAN, DYLAN PO1 IBUS, RHEY PO1 GAAN, KENNETH

PO3 TABOADA, MARIO PO1 PAGLINAWAN, EMIL PO1 IGNACIO, JEROME

PO2 RODRIGUEZ, RHAFAEL PO1 DELA CRUZ, RIC

PO2 BACORUM, RANNY JAY PO1 CHARLIE CARABOT One (1) confidential Informant

PO2 GALUTERA, JAYCEE JOHN PO1 LEGASPI, MARK

PO2 MARIANO, CHUCK JETHRO PO1 SANTIAGO, GARRY

PO1 MACAPAZ, ARVIN PO1 JOHN DAVID SAMORIO

VII. Description of Vehicles Involved:

TYPE MAKE COLOR PLATE NUMBER

NMAX YAMAHA RED FOR REGISTRATION

NMAX YAMAHA GRAY FOR REGISTRATION

NMAX YAMAHA BLACK FOR REGISTRATION

MIO 125 YAMAHA PINK FOR REGISTRATION

AEROX YAMAHA BLACK FOR REGISTRATION

 SEDAN MITSUBISHI SILVER ASA 876

SUV MITSUBISHI WHITE PQR 666

Approved by:

Antonio V. Lualhati Jake S. Iballa

Police Chief Inspector Police Superintendent
Chief, SDET Station Commandern

Noted by: CYRUS BUNDA

Police senior superintendent
DDDO
 Republic of the Philippines
PHILIPPINE NATIONAL POLICE
ILOCOS SUR POLICE DISTRICT
SANTA MARIA POLICE STATION
Santa Maria, Ilocos Sur
Tel No. 628-0013

MEMORANDUM

FOR : Director, PNP Crime Laboratory

FROM : Station Commander

SUBJECT : Request for Ultra-violet (Fluorescence Powder) Test

DATE : January 18, 2024

1. Request conduct examination on the person of DANIEL MONFORTE y AMBAS,

26 years old, Single, Tricycle Driver, and resident of no. 27, Brgy. Maynganay Sur, Santa
Maria who was arrested during buy-bust operation conducted at about 2:20 in the
Morning at No. 27 Maynganay Sur, Santa Maria.

a) NATURE OF CASE : R.A 9165 section 11 of Art II

b) SUSPECT : DANIEL MONFORTE y AMBAS,

d) T D P O : At about 2:20 AM of January 18, 2024, At

No. 27 Maynganay Sur, Santa Maria.

e) SPECIMEN SUBMITTED :
 2. Further request that this Office be furnished a copy of examination result for our
reference.

3. For consideration.

ANTONIO V. LUALHATI
Police chief inspector