Sample Formats Copy Autosaved

SAMPLE FORMAT OF A MEMORANDUM
Republic of the Philippines

PHILIPPINE NATIONAL POLICE
PALAWAN PROVINCIAL POLICE OFFICE
Aborlan Municipal Police Office
Aborlan, Palawan
AMPS-IN
MEMORANDUM
FOR : Provincial Director

Palawan Police Provincial Office
FROM : Chief of Police, AMPS
SUBJECT : Spot Report, Re: Shooting Incident
DATE : 28 AUGUST 2009
======================================================================
1. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
A. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
B. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxx
JUAN C. DELA CRUZ

Police Senior Inspector
1|Page
SAMPLE OF POLICE BLOTTER
Entry DATE TIME EVENTS/INCIDENTS DISPOSITION

No.
00001 Sept 28, 2010 0800H PS/INSP Espino and the members of this police station proceeded
to Roxas Municipal Hall to attend flag raising ceremony
00002 Sept 28, 2010 0900H PO3 Mark Anthony Revilla Fernandez left this station on board a
motorcycle and proceeded to Bgy San Jose to conduct patrol and
police visibility
00003 Sept 28, 2010 1030H Mrs. Marian Rivera y Locsin, 39 years old, married, a resident of PO3 Alan K. De Leon
Bgy. Abaroan this Municipality reported in this office that this and PO1 Gary Camo
morning, September 28, 2010, at 8:00 AM, she discovered that her Granada were
14 sacks of rice were stolen including three thousand pesos (P dispatched to
3000.00) cash from her store. investigate the incident
00004 Sept 28 2010 1210H One Jenny Madrigal y Castro, 30 years old, married, a resident of This station informed
Bgy Magara this municipality came and reported to this office that Mrs Madrigal that she
on or about 1000H September 07, 2010, she was travelling from the will be notified in case
above-mentioned place to Puerto Princesa City to renew her her folder is found.
passport, and upon reaching the city, she discovered that her folder
containing her passport was no longer there. She thought that it
fell from the vehicle and was lost.
00005 Sept 28, 2010 1400H Reference: Police Blotter Entry # 00003. Members of Roxas The case is still under
Municipal Police Station conducted an investigation regarding the investigation
incident reported by Mrs. Marian Rivera y Locsin. That according
to her, at more or less 8:10 in the morning, when she arrived at her
store at Bgy. Abaroan, she discovered that 14 sacks of rice and
three thousand pesos (P3,000.00) cash were missing from her store.
According to one (1) Eddie Damaso y Ermita, 35 years old,
married and the guard on duty during the time of incident, that
2|Page
during the previous night, September 27, 2010 at more or less 7:45
in the evening, while he was conducting patrol and inspection
around the market, he noticed that the store of Mrs. Marian
Rivera y Locsin have no lock/was not locked. He was worried and
so he locked the store. He further stated that he was the duty guard
that night together with one Julian Felipe y Felipo but they saw no
one who was roaming suspiciously that night.
00006 Sept 28,2010 1700H One Carlito Favila y Magaling, 41 years old, married, fisherman, a SPO3 Nixon P. Maximo
resident of Bgy. Malcampo came and reported to this station that and PO3 Mar X.
he was hacked by one (1) Emmanuel Capa y Siga on Sepember 25, Linogao were
2010 at more or less 12:00 noon in the aforementioned place while dispatched to
he was attending the wedding reception of one of his relatives. investigate the case.
00007 Sept 28, 2010 1820H SPO4 Cyril Candelaria and three other PNCO left this station on
board the PNP vehicle and proceeded to Bgy 2 to conduct patrol
and police visibility thereat.
00008 Sept 29, 2010 1130H Accused Joel Bernal y Sementeryo was released from the custody
of this PNP Station after posting his bail bond for provisional
liberty. In conformity, he affixed his signature below
joel s bernal
JOEL S. BERNAL
(ACCUSED)
00009 Sept 29, 2010 1240H One (1) Estanislao Lasengo, 46 years old, married a resident of PO1 _________ and
Bgy. Tumarbong, this Municipality, brought to this station one (1) PO2 ________ were
Benjo Santa Cruz y Torres, 70 years old, married, farmer and a dispatched to
resident of the same place. Mr. Santa Cruz allegedly hacked one investigate the case. The
Cris Cruz y Santos at the aforementioned place. Mr. Cruz was suspect is now under
already brought to Roxas Medicare Hospital for check-up and the custody of this
medication. station.
3|Page
4|Page
EXAMPLE OF A CERTIFICATION EXTRACTED FROM THE POLICE BLOTTER
WHICH IS BEING MAINTAINED BY THE POLICE STATION, AND ACCORDING TO
THE REQUEST OF THE VICTIM.

National Police Commission
SANTA ROSA POLICE STATION
Santa Rosa, Nueva Ecija
SRPS-IN February 14, 2004
TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that based on the Police Blotter of this station, as shown on page
No.6, under Entry No. C- 2004-040, dated February 14, 2004, the following entries of events exist,
to wit:
Feb. 14, 2004/1600H/C-2004-040
SERIOUS PHYSICAL INJURY
Stated in this portion is the statement of facts that answer the 5Ws and 1 H pertaining to the
incident.
The reportee has affixed his signature this 14th day of February 2004.
SGD. JOHN S. SAN PEDRO

(Reportee)
This certification is issued upon request of Mr. San Pedro for whatever legal purpose and
intents it may serve.
Prepared by:
JUNE T. ADALEM
PO3 PNP
Officer-on-Case
NOTED BY:
PETER DULNUAN GUIBONG

Police Superintendent
Chief of Police
5|Page
EXAMPLE OF A SPOT REPORT IN MEMORANDUM FORMAT

ABORLAN MUNICIPAL POLICE STATION
Magsaysay, Aborlan, Palawan
AMPS-IN
MEMORANDUM
FOR : Provincial Director, PPPO
FROM : Chief of Police, AMPS
SUBJECT : SPOT REPORT RE: (STATE THE NATURE OF CASE OR

INCIDENT BEING REPORTED)
DATE : February 16, 2004

=======================================================================
1. Reference: (Cite any references if there are any)

Example: Puerto Princesa Police Office Blotter Entry No.2211
2. Request be informed that on or about ______________(state the time and date of the
commission of the crime) at _____________ (state the place where the crime took place), a
____________ (state the nature of the incident, i.e. stabbing, shooting, etc.) transpired /took
place wherein the victim identified as one (1) _______________ (state the name and other
personal circumstances of the victim, i.e. age, civil status, occupation, complete address, etc.)
was __________ (state the act perpetrated by the suspect) by the suspect identified as one (1)
_______________ (state the name and other personal circumstances of the suspect, i.e. age,
civil status, occupation, complete address, etc.)
3. Initial investigation revealed that ___________________________ (state the

circumstances on how the crime was committed)
4. Further investigation disclosed that _____________ (write only this part if you have
gathered additional information relative to the crime committed)
5. The victim was _________________ (state the status of the victim i.e. rushed to the
hospital, was proclaimed DOA, etc.) while the suspect ______________ (state the status of the
suspect, i.e. immediately surrendered, escaped, disappeared, etc).
6. (In this part, state the action taken by the police officers, i.e. brought the cadaver to
PNPCL for autopsy, disposed the evidences properly, filed/prepared appropriate charges
against the suspect, etc)
7. For information/For reference and Progress report follows.
JUAN CRUZ DELA CRUZ

6|Page
7|Page
EXAMPLE OF A SPOT REPORT ON ARRESTED PERSON WITH WARRANT OF ARREST

PUERTO PRINCESA CITY POLICE OFFICE
San Pedro, Puerto Princesa City
MEMORANDUM
FOR : Regional Director
RPO4-B
Camp Efiginio C. Navarro
Calapan City, Oriental Mindoro
FROM : Officer-in-Charge
Puerto Princesa City Police Office
SUBJECT : Spot Report on Arrested Person with Warrant of Arrest
DATE : 17 July 2009

=====================================================================
1. Reference: Warrant of Arrest
2. Request be informed that on or about 171030H July 2009 at Ospital ng Palawan,

Bgy. San Miguel, this city, elements of Detective Unit of this office led by SPO2 William De Mesa,
arrested one Allan Franco y Marcos, aka Boy Kalbo, 37 years old, married, farmer, and a resident of
Sitio Tarabanan, Concepcion, Puerto Princesa City.
3. Subject person was arrested by virtue of Warrant of Arrest for the crime of Rape (2
counts), docketed under CC No. 22285-86 issued on May 10, 2007 by Hon. Judge Jocelyn Sundiang
Dilig of RTC Branch 50, No Bail recommended.
4. Subject person/accused is still confined at Ospital ng Palawan.
5. For information and reference.
MARK CRUZ DELA CRUZ

8|Page
EXAMPLE OF A SPOT REPORT WITH A RADIO CALL AS REFERENCE

MEMORANDUM
RPO4-B
SUBJECT : Spot Report found Cadaver
DATE : 17 July 2009

=====================================================================
1. Reference: Radio Call from 117 (or Radio call from a concerned citizen)
2. Request be informed that on or about 100845H August 2009 this office received a radio
call from 117 about the found cadaver at Purok Katiwasayan, Bgy. Luzviminda,Puerto Princesa
City.
3. Elements of this office and SOCO Operatives led by PSI Angel Locsin proceeded to the
area to conduct investigation.
4. Investigation conducted revealed that the found cadaver was identified as Romeo Cortez,
42 years old, single and a resident of the said barangay. According to the witness, Alfred de
Guzman, 17 years old, a companion of the victim, on or about 7:00 in the evening of August 9,
2009, he and the victim were in a house where they are residing. They were talking as they are
about to sleep. Suddenly, DOMINGO TACLESO Y GASCON aka DOMING, armed with bolo,
without any reason, attacked Romeo Cortez. The victim managed to evade the attack and ran for
his life in fear. Domingo chased him until reaching a small river; the victim jumped at the river to
evade the attack but REYMART TACLESO, the son of DOMINGO TACLESO struck him with a
piece of wood thereat, the father and son repeatedly struck and stabbed the victim. After the
incident, the duo left the area.
5. The motive of the attack is still unknown.
6. Elements of this office are continuously conducting follow-up operation for the possible
arrest of the suspects as the case is being readied against them.
MARK CRUZ DELA CRUZ

9|Page
EXAMPLE OF A PROGRESS REPORT IN MEMORANDUM FORM

SRPS-IN
MEMORANDUM
FOR : Provincial Director, NEPPO
FROM : Chief of Police, SRPS
SUBJECT : PROGRESS REPORT (STATE THE NATURE OF CASE OR

INCIDENT BEING REPORTED)

=====================================================================
1. Reference: Spot Report this station, Cite Number SRPS-02-14-40 dated

February 14, 2004, subject as above.
2. Submitted is the Progress Report re (state the nature of incident being

reported, time and date and place of occurrence).
3. Please be informed that (state the additional information answering the

5Ws and 1 H in relation to the case).
4. (In this portion state the action taken by the police unit handling the
case, and the status of the case and the suspect/s).
5. For information.

10 | P a g e
SAMPLE OF A PROGRESS REPORT IN A MEMORANDUM FORMAT

PHILIPPPINE NATIONAL POLICE
CAVITE PROVINCIAL POLICE OFFICE
Silang Municipal Police Office
Silang, Cavite
MEMORANDUM
FOR : Provincial Director

Cavite Provincial Police Office
Imus, Cavite
Attn: DPD for Operations
FROM : Chief of Police, SMPO
SUBJECT : Progress Report Re: Shooting to Death of Rogelio Bathan
DATE : 30 August 2007

=====================================================================
1. Reference: Spot Report, dated 30 August 2007, Re: Shooting to Death of one
Rogelio Bathan of Brgy. Tartaria, Silang, Cavite.
2. Further investigation reveals that (a) the victim has been receiving death threats
(anonymous letters), consistently warning him that if he continues his illicit relationship with Mrs.
Vanessa Villegas, the suspect’s wife, he will surely die, but former did not consider these death
threats seriously; (b) the suspect has long been jealous to the victim; (c) suspect issued caliber .45
pistol as NBI civilian agent is covered by Mission Order dated 12 June 2007, duly issued by NBI
Director PERALTA; (d) said shooting incident was actually seen by two witnesses, both residing at
the said place; (e) the five (5) empty shells of caliber .45 pistol taken from the crime scene were
fired by the suspect’s issued firearm; and (f) suspect’s right hand was found positive of nitrates.
3. Criminal complaint for MURDER against Ramon Villegas Jr. was filed today by
SPO1 Manalo with the Cavite Provincial Prosecutor’s Office, Imus, Cavite, under I.S. No. 1468,
pending preliminary investigation. Suspect is still under the protective custody of this office.
Investigation has been terminated.
4. Please acknowledge receipt.
AURELLO BALAT SIBUYAS

Police Superintendent (DSC) **
** DSC-Directorial Staff Course
11 | P a g e
CHRONOLOGICALLY ARRANGED PARTS OF THE BODY OF A
MODIFIED RADIOGRAPHIC SPOT REPORT
1. Cite Number (CONFID SMPO-B 07-06-002);

2. Nature of Communication (Spot Report, etc.);
3. Time and Place where the crime was committed (OOA 171600H JUN 07)
4. Name of victim and his/her personal circumstances (Name, age, aliases,
address, if known);
5. How did the suspect commit the crime (if he stabbed, hacked, shoot the victim,
state so);
6. Name of suspect and his/her personal circumstances (Name, age, aliases,
address, if known);
7. What did the suspect do after committing the crime? ( if he surrendered to the
police, state so);
8. Was he placed under custodial investigation? (If affirmative, state so);
9. The description of the weapon used by the suspect (caliber .45 pistol, knife,
etc)
10.What did the suspect do with the weapon he used? (if he surrendered it to the
police, state so)
11. If weapon used was recovered, was it brought to the PNP Crime Laboratory
for exam?
12.What are the locations of wounds sustained by the victim that caused his/her
death?
13.If the suspect waived his right to remain silent and to counsel, state so.
14.Name and rank of the officer-on-case.
15.Purpose of the report and nature of the report to be submitted next.
EXAMPLE OF MODIFIED RADIOGRAPHIC SPOT REPORT

12 | P a g e
FM COP SILANG MPO C L R
“P”
TO PD CAVITE PPO 172000H JUN 07
CONFID SMPO-B 07-06-002 PD SPOT RPT RE SHOOTING

INCIDENT PD OOA 171600 JUN O7 AT BRGY TARTARIA CMM
SILANG THIS PROV CMM ONE ROBERTO LASTIMOSO YANKEE
PEDROSO CMM TWO EIGHT YRS OLD CMM SINGLE CMM
JOBLESS AND RES OF SAME PLACE CMM WHILE GOING TO
RUDY’S BARBERSHOP CMM WAS SUDDENLY SHOT THREE
TIMES BY ONE MARIO TINDERO YANKEE OMBRE CMM THREE
ONE YRS OLD CMM MARRIED CMM MIG4 AGENT AND RES OF
BRGY LUMIL THIS MPLTY PD SUSPECT IMDTLY SURRENDERED
TO THIS OFC WITH HIS ISSUED CAL 45 PSTL COLT SN 2349 WITH
ONE MAG ASSY AND FIVE LIVE AMMO PD INITIAL INVES
CONVEYS THAT VICTIM WAS PRIME SUSPECT IN KILLING
GREGORIO TINDERO CMM MARIO’S FATHER CMM FIVE MOS
AGO PD MOTIVE DASH REVENGE PD SUSPECT’S FA AND THREE
EMPTY SHELLS TAKEN FM SCENE WERE SUBMTD TO PNPCL
RO4 CMM CALAMBA CITY CMM FOR BLSTCS EXAM PD
VICTIM’S CADAVER AND SUSPECT WERE ALSO BROUGHT TO
SAME CRIME LAB FOR AUTOPSY AND PARAFFIN TEST PD
VICTIM SUSTAINED THREE GSWS ON HIS CHEST CAUSING HIS
INSTANT DEATH PD SUSPECT EXECTD WAIVER OF DETN AND
NOW UNDER CUSTODIAL INVES PD OFFICER ON CASE DASH
SPO2 REMIGIO RAMOS PD FOR INFO AND PROG RPT FOLWS PD
BT
DRAFTER: RELEASER:
SPO2 RAMOS PSUPT BERREDO

INVESTR COP
13 | P a g e
EXAMPLE OF A SPOT REPORT FOR VIOLATION OF LAW IN A RADIOGRPHIC
MESSAGE FORM
RADIO MESSAGE FOR TRANSMISSION
FM: COP SRPS C L R
TO: PD NEPPO ATTN PIIB -P-
CN: SRPS-IN-02-14-40 141600 FEB 2004
T E X T
_________PD SPOT RPT ON (STATE THE VIOLATION OF LAW

COMMITTED) PD OOA (STATE THE TIME AND DATE WHEN THE
INCIDENT TOOK PLACE) ALPHA (STATE THE NATURE OF THE OFFENSE)
TRANSPIRED AT (STATE THE PLACE, BRGY/MPLTY/CITY/AND PROV
WHERE THE INCIDENT TOOK PLACE) CMA WHERIN THE VICTIM CMA
IDENTIFIED AS ONE (STATE THE NAME AND OTHER PERSONAL
CIRCUMSTANCES OF THE VICTIM) WAS (STATE THE ACT PERPETRATED
BY THE SUSPECT) BY THE SUSPECT CMA IDENTIFIED AS ONE (STATE
THE NAME AND OTHER PERSONAL CIRCUMSTANCES OF THE SUSPECT)
PD INVESTIGATION DISCLOSED THAT (STATE IN THIS PORTION THE
FACTS AND CIRCUMSTANCES RELATIVE TO THE INCIDENT TO
INCLUDE THE MOTIVE OF THE SUSPECT AND THE HOW AND WHY OF
THE CASE) PD THE VICTIM WAS (STATE THE STATUS OF THE VICTIM)
WHILE THE SUSPECT (STATE THE STATUS OF THE SUSPECT) PD (STATE
THE ACTION TAKEN BY THE POLICE AUTHORITIES) AND PROGRESS
RPT TO FOLLOW PD OFFICER ON CASE DASH (STATE THE NAME OF THE
INVESTIGATOR) PD FOR INFO PD BT …….
DRAFTER: RELEASER:
ADALEM JT GUIBONG PD
Officer-on-Case Chief of Police
14 | P a g e
EXAMPLE OF SPOT REPORT ON ARRESTED WANTED PERSON
FM: COP SRPS C L R
CN: SRPS-IN-02-15-41 150900 FEB 2004
T E X T
_______ PD SPOT RPT ON ARRESTED WANTED PERSON PD OOA

(STATE THE TIME AND DATE WHEN THE PERSON WAS
ARRESTED) AT (STATE THE PLACE, BRGY/MPLTY/CITY AND
PROV WHERE THE ARREST WAS CONDUCTED) CMA WARRANT
OFFICERS THIS STN UNDER (STATE THE NAME AND
DESIGNATION OF THE TEAM LEADER) ARRESTED ONE (STATE
THE NAME AND OTHER PERSONAL CIRCUMSTANCES OF THE
PERSON ARRESTED) BY VIRTUE OF WARRANT OF ARREST
UNDER (STATE THE CRIM CASE NR) ISSUED BY (STATE THE
NAME OF THE ISSUING JUDGE AND COURT) FOR (STATE THE
NATURE OF THE OFFENSE) PD SUBJECT PERSON (STATE THE
STATUS OF THE PERSON ARRESTED) PD PROG RPT TO FOL PD
FOR INFO PD BT . . . . .
DRAFTER: RELEASER:
15 | P a g e
EXAMPLE OF A PROGRESS REPORT IN A RADIOGRPHIC MESSAGE FORM
FM: COP SRPS C L R
CN: SRPS-IN-02-15-41 150900 FEB 2004
T E X T
_________ PD PROG RPT REOURAD MSG CN SRPS-IN-02-14-40 PD
PLS BE INFORMED THAT OOA (STATE THE TIME AND DATE)
ALPHA CASE OF (STATE THE VIOLATION OF LAW) HAS
ALREADY BEEN FILED BY THIS STATION AGAINST THE
SUSPECT CMA IDENTIFIED AS ONE (STATE THE NAME AND
PERSONAL CIRCUMSTANCES OF THE SUSPECT) AT THE
(STATE WHETHER FILED AT THE CITY PROSECUTOR’S OFFICE
AND/OR COURT) AND DOCKETED UNDER (STATE THE CRIME
CASE OR IS NUMBER) PD FOR INFO PD BT . . . .
DRAFTER: RELEASER:
16 | P a g e
EXAMPLE OF A SPECIAL REPORT IN MEMORANDUM FORM

SRPS-IN
MEMORANDUM
FOR : Provincial Director, NEPPO
FROM : Chief of Police, SRPS
SUBJECT : SPECIAL REPORT ON (STATE THE NATURE OF CASE

OR INCIDENT BEING REPORTED)

=====================================================================
1. Reference: Spot Report this station with Cite Number SRPS-02-14-40
dated February 14, 2004, subject as above.
2. This pertains to the (WHAT - significant incident) that transpired at

(WHERE - place of occurrence) perpetrated by (WHO-name and other personal
circumstances of the suspect) on (WHEN – month, date and year) at (specific time) in
the (morning, afternoon, evening).
3. Report revealed that (HOW the incident occurred and WHY the incident
happened) that resulted in (result or consequence of the incident).
4. Further investigation disclosed that (other information relevant to the

incident which may answer another set of 5Ws & 1H, if necessary).
5. Elements of (unit taking action) are/have (police action conducted-

search/follow-up/pursuit operations/filing of charges/further investigation, etc.) that
resulted in the (result of police action –
seizure/arrest/surrender/confiscation/recovery/issuance of arrest warrant, etc).
6. Other developments regarding the incident shall be submitted as soon as

obtained.

17 | P a g e
EXAMPLE OF A LETTER OF REQUEST FOR LABORATORY
EXAMINATION

NATIONAL POLICE COMMISSION
WESTERN POLICE DISTRICT OFFICE
MANILA
22 November 2000
SUBJECT : Request for Laboratory Examination
TO : Chief, PNP Crime Laboratory SPDO
Fort Andres Bonifacio, Taguig, Metro Manila
Attn: Service Technician
Request Laboratory Examination on the accompanying specimen/subject (s)

specifically for the purpose of determining the relevance of the specimen below.
FACTS OF THE CASE:

1. Nature of the Case: Shooting Incident
2. Suspect(s): A. Juan Pedro y Cuesta Age: 34 years old
B. ______________ Age: __________
C. ______________ Age: __________
3. Complainant(s): A. Olivia Dela Cruz y Montes
B. _____________________
4. Apprehending Officer: __________________
5. Place of Incident/ Where the Evidence was Obtained/Confiscated: Sta.
Cruz, Manila
6. Time and Date the Incident Occurred/Evidence was Obtained: 9:00 p.m. 22
Nov 2000
Evidence/Documents Submitted: (for documents, SPECIFY Question and
Standard Documents)
1. Caliber .45 automatic with marking “AVV1” 22 November 2000.
2. Three (3) empty shells of caliber .45 marked as “AVV2” 22 November 2000.
3. Two (2) spent bullets of caliber .45 marked as “AVV3” 22 November 2000.
4. Body of Juan Dela Cruz for autopsy.
Anticipating for your usual cooperation.
SPO1 BENJAMIN PAYUMO

Officer-on-Case
18 | P a g e
EXAMPLE OF A SWORN STATEMENT IN QUESTION-AND-ANSWER FORMAT
Any person under custodial investigation for the commission of an offense shall have
the right to be informed of his rights to remain silent and to have a competent and
independent counsel of his or her choice. If the person cannot afford the services of counsel,
he or she must be provided with one. These rights cannot be waived except in writing and in
the presence of a counsel.
No torture, force or violence, threat, intimidation or any means which influences the
free will shall be used against him or her. Secret detention places, solitary or other similar
forms of detention are prohibited.
Any confession or admission obtained in violation of Section 12, Article III of the
New Philippine Constitution of 1987, shall be considered inadmissible evidence.
The law provides for penal and civil sanctions for violation of this section as well as
compensation to and rehabilitation of victims of torture or similar practices, and their
families. Below is a typical example of a sworn statement in question-and-answer format in
compliance with Section 12, Article III, NPC.
Example:
SWORN STATEMENT OF MR. PEDRO SANTOS Y DELA CRUZ TAKEN BY PO3

JUNE T. ADALEM PNP AT THE OFFICE OF THE INVESTIGATION SECTION,
SANTA ROSA POLICE STATION, SANTA ROSA, NUEVA ECIJA IN THE PRESENCE
OF SPO4 ROBERTO B. NERI PNP, THIS 20 TH DAY OF FEBRUARY 2004, AT ABOUT
9:00 O’ CLOCK IN THE MORNING . . . . . . . . . . . . . . . . . . . . . . . . x
PRELIMINARY: Mr. Pedro DC Santos, you are being informed that you are under
investigation for your involvement in the commission of an offense.
You are reminded that under our New Constitution, you have the right
to remain silent and to be assisted by a counsel of your choice. If you
cannot afford to hire one, and you want to be assisted by counsel, this
office will provide you with a lawyer free of charge. Any statement
that you will make can be used for or against you in any court of law
in the Philippines. Is this clearly understood by you?
ANSWER : Yes, Sir.
QUESTION : Having been informed of your rights under the constitution to remain
silent, do you wish to proceed with the investigation?
ANSWER : Yes, Sir.
QUESTION : Do you also wish to be assisted by a counsel of your choice?
ANSWER : I do not need the assistance of the counsel.
QUESTION : You are also reminded that whatever statement you will give might be
used against you. Is this clearly understood by you?
19 | P a g e
ANSWER : Yes, sir.
QUESTION : In short, you are waiving your right to counsel in this investigation?
ANSWER : Yes, sir.
QUESTION : Are you willing to sign a waiver to that effect with the assistance of
Atty. Pedro S. Madlangbayan, who is here present?
ANSWER : Yes, sir.
WAIVER OF CONSTITUTIONAL RIGHTS
I, PEDRO SANTOS Y DELA CRUZ, do hereby certify that before taking down
my statements, the investigator fully explained my constitutional rights under Section 12,
Article III of the New Constitution, which are fully understood, and I hereby waive my
rights to remain silent and to be assisted by counsel in the presence of, and with the
assistance of, Atty. Pedro S. Madlangbayan.
PEDRO DC. SANTOS

(Affiant)
QUESTION : Are you ready to give a free and voluntary statement?
ANSWER : Yes, sir.
Q1 : Please state your name and other personal circumstances.
A1 : JUAN DELA CRUZ Y SANTOS, 34 years old, married, and presently

residing at # 46 Magilas St., Purok 4, Manubay Subd., Brgy
Valenzuela, Santa Rosa, Nueva Ecija .
Q2 : Please state the name of the school you have attended.
A2 : ______________________________.
Q3 : Do you know why you are here? Or do you know the reason why you
have been invited for questioning?
A3 : ____________________________________.
NOTE : Questions No. 4 to 11 deal with the six cardinal points of investigation,
the 5Ws and 1H. These questions are very important in order to unravel
the facts and circumstances of the case.
20 | P a g e
Q12 : The investigator has nothing to ask you for the moment. Do you have
anything to add in this statement?
A12 : No more, Sir.
Q13 : Are you willing to sign this statement of yours, consisting of __ pages,
including this last page, and affirm under oath to its truthfulness?
A13 : The answer to this question should not be typed but should be written
in the suspect’s or witness’ own hand. The typist should leave a space
for the handwritten answer of the affiant and the latter should be made
to write out in his own handwriting the following statement: “Yes, sir,
I have read this statement of mine consisting of ____ pages and it is
the truth. I made it of my own free will, without any threats or
promises having been made to me by anyone.”
PEDRO DC SANTOS
(Affiant)
SUBSCRIBED AND SWORN to before me this 20 th day of February 2004, at Santa

Rosa, Nueva Ecija. I herby certify that I have personally examined the affiant, and I am
satisfied that he voluntarily executed and understood his statement.

Chief of Police
(Administering Officer)
21 | P a g e
REMINDERS CONCERNING THE QUESTION-AND-ANSWER FORMAT
1. In question number 2
At the trial, the offender may question the validity of a confession by alleging
that he only stated what he was told to say, that the investigator “put the words into
his mouth.” An excellent measure to effectively meet such an accusation is to
incorporate in the confession a number of questions calling for answers that only the
offender would know. For instance, he may be asked the name of the grade school he
attended, or other similar information.
When accurate personal information is included in a confession, the prosecutor

may point to it as evidence that the accused actually gave the information and was not
merely accommodating the investigator by repeating what he was told to say.
2. In question number 3
A guilty party who is asked such question is immediately placed in a
vulnerable defensive position. If the subject is innocent or ignorant of the particular
offense under investigation, but guilty of another offense or is in possession of
pertinent information concerning such offense, a “do you know why you are here?”
question may result in leading to the solution of the latter offense. For instance, a
reply of “yes, you think I had something to do with the Mary dela Fuente
falsification?” referring to an unsuspected offense, would obviously prompt the
investigator to make further inquiries about it. Information gained in this unexpected
manner has led to the solution of cases which otherwise might have escaped the
investigator’s attention.
3. Intentional Errors
The sworn statements of suspects and witnesses should contain errors or
mistakes in every page, intentionally committed by the investigator or typist. While
reviewing his statement, the affiant’s attention should be invited to these errors or
mistakes. He should be made to correct them in his own handwriting and affix his
initials and number them. These intentional errors are committed for a very essential
purpose in evidence. In many instances, the affiant, upon advice of counsel, would
wish to deny the statements or otherwise pretend inadvertence or claim that he signed
the sworn statement without reading it. The existence of these intentional mistakes or
errors is vital at this point, as the affiant’s personal corrections would disprove all the
foregoing denials.
22 | P a g e
EXAMPLE OF A SWORN STATEMENT IN NARRATIVE FORM
Commonly practiced by the police organization during an application for a

search warrant and affidavit of arrest is the execution of sworn statement in narrative
form. This is being done for a purpose of simplicity and expeditious filing of
complaints against violators of the law. Below is a typical example of an affidavit.
=======================================================
Example:
Republic of the Philippines)

Province of Nueva Ecija )
Municipality of Santa Rosa) S.S.
JOINT AFFIDAVIT
WE, PO3 Amorsolo A. Esmundo PNP and PO3 Jonathan M. Reyes PNP,
both of legal age, members of the Santa Rosa Police Station, Santa Rosa, Nueva
Ecija, and presently assigned to the Investigation Section, after having been duly
sworn in oath in accordance with law, do hereby voluntary depose and state the
following:
That, we were the investigators tasked to conduct the necessary

surveillance on the proliferation of pornographic materials and sleazy
tabloids in the municipality of Santa Rosa, Nueva Ecija, exhibiting obscene
language and vulgar photographs of males and females which we believe are
detestable and offensive to common decency, morals and good customs and
are therefore violative of our penal laws;
That, on the 21st day of February 2004, at around 4:00 o’clock in the
afternoon, in order to ascertain the veracity of the report in the circulation of
smut publications, we proceeded to a printing office located at Brgy. Rizal,
Santa Rosa, Nueva Ecija, where we were able to gain entry to the printing
office by posing as owners of delivery vehicles interested in hauling
newspapers and magazines. While inside, we were able to see for ourselves
that this office was indeed printing pornographic materials;
That, having confirmed the presence of pornographic publications, we

are executing this affidavit to support our application for the issuance of a
search warrant for the projected search and seizure of the pornographic
materials at the premises of the printing office and arrest the suspects for
violation of Article 201 of the Revised Penal Code.
FURTHER AFFIANT SAYETH NAUGHT:
23 | P a g e
IN WITNESS HEREOF, we affixed our signatures over our printed names
st
this 21 day of February 2994, at Santa Rosa, Nueva Ecija.
PO3 AMORSOLO A ESMUNDO PNP PO3 JONATHAN M. REYES

(Affiant) (Affiant)
SUBSCRIBED AND SWORN to before me this 20th day of February 2004,

at Santa Rosa, Nueva Ecija. I hereby certify that I have personally examined the
affiants, and I am satisfied that they voluntarily executed and understood their
statement.

Chief of Police
(Administering Officer)
24 | P a g e
EXAMPLE OF A REFERRAL LETTER
For purposes of referring a criminal case to the Prosecutor’s Office,

hereunder is a typical example of a referral letter.
Example:

SRPS-IN February 21,

2004
The Honorable Provincial Prosecutor

Maharlika Road, Cabanatuan City
Attn: Inquest Prosecutor
Sir:
Respectfully sending to your office a case of HOMICIDE for inquest only,

wherein the victim was identified as one CELESTINO CORPUZ Y SIERRA,
27 years old, single, jobless, with address at #14 San Pedro Extn., Brgy.
Zamora, Santa Rosa, Nueva Ecija.
The suspect was identified as one ROMEO DELA CRUZ Y PEREZ, 25 years
old, single, vendor, native of Camarines Norte, and presently residing at #69 De
Leon St., Kapt. Pepe Subd., Brgy. Zulueta, Cabanatuan City, and is presently
under the custody of this station for proper disposition.
Enclosures:
1. Crime Report dated 21 February 2004;
2. Booking Sheet and Arrest Report of Accused;
3. Sworn Statement of Onofre D. Corpuz, Father of the Deceased;
4. Sworn Statement of Witness, Darius C. Santos;
5. Sworn Statement of Witness, Pedro S. Dela Cruz;
6. Death Certificate of the Deceased; and
7. Necropsy Report from the Medico-Legal Officer.
25 | P a g e
Witnesses:
1. Onofre D. Corpuz, Brgy. Zamora, Santa Rosa, Nueva Ecija
2. Darius C. Santos, Brgy. Zamora, Santa Rosa, Nueva Ecija
3. Pedro S. Dela Cruz, Purok 4, Brgy. San Juan, Accfa, Cabanatuan City
4. Dr. Marcial V. Tan, City Health Office, Cabanatuan City
5. Dr. Cesar V. Uy, Cabanatuan City Gen. Hospital, Cabanatuan City
6. PO3 June T. Adalem PNP, Santa Rosa Police Station, Santa Rosa,
Nueva Ecija.
Facts of the Case:

Investigation disclosed that victim and suspect were long-time friends. On
February 21, 2004, at around 7:30 p.m., the two men, together with several
others had a drinking spree inside the house of the victim, located at Brgy.
Zamora, Santa Rosa, Nueva Ecija. After consuming several bottles of beer, a
heated altercation ensued between one of the victim’s guests and the suspect
which eventually led to a fistfight. The victim, while trying to pacify the
commotion, was stabbed by the suspect. The victim was taken to the Nueva
Ecija Doctor’s Hospital, Cabanatuan City, but was pronounced dead on arrival
by the attending physician. The suspect who was apprehended by the
responding police officers was turned over to this station for proper
investigation.
The suspect, after having been informed of his constitutional rights, refused to
give any written statements. However, the suspect was positively identified as
the assailant by witnesses when confronted.
The suspect was arrested and charged with HOMICIDE. This will be brought to
the attention of an inquest fiscal for proper disposition and recommendation.
This case will be brought to you by PO3 June T. Adalem PNP, Officer-on-case.
Respectfully yours,

Chief of Police
26 | P a g e
EXAMPLE OF A REFERRAL LETTER

MANILA
23 November 2000
TO: Chief City Prosecutor

Manila Prosecutor’s Office
Attn: Duty Inquest Prosecutor
Sir/Madam:
I have the honor to indorse herewith the case of MURDER against the person
of JUAN PEDRO y CUESTA, 34 YERS OLD, BUSINESSMAN, OF NO. 17
BLUMENTRITT ST., STA. CRUZ, MANILA. PROVINCIAL Address: Barangay
13, Del Rosario St., Tugegarao, Cagayan (at-large).
COMPLAINANT/S:
Olivia Dela Cruz y Montes, 28 years old, of nO. 15 Blumentritt St., Sta.
Cruz,Manila, widiw of the deceased victim, Juan Dela Cruz of same address.
WITNESSES:
1. PEDRO FLORES y IBA
2. DELIA REYES y OMAR
3. Forensic Chemist of PNP Crime Laboratory Service
EVIDENCES:
1. Death Certificate (post-mortem examination)
2. One (1) caliber .45 pistol marked as “AVV1”dated 22 November 2000.
3. Two (2) spent bullets duly marked as “AVV2” dated 22 November 2000.
4. Three (3) spent shells of .45 caliber ammunitions duly marked as “AVV3”
dated 22 November 2000, recovered from the crime scene by the elements
of the SID
DTPO
The incident transpired at about 8:00 p.m., November 22, 2000 at the vacant
parking area located at corner of Blumentritt and Maria Clara Streets.
27 | P a g e
FACTS OF THE CASE:
A shooting incident transpired at about 8:00 p.m. on November 22, 2000 at the
parking area located at corner of Blumentritt and Maria Clara Streets, Sta. Cruz,
Manila. The victim sustained multiple gunshot wounds in the different part s of his
body that resulted to his instantaneous death. The incident was witnessed by two (2)
minors namely, Pedro Flores y Iba and Delia Reyes y Omar who were playing within
the vicinity of the crime scene. The suspect was identified as Juan Pedro Cuesta, 34
years old, married, businessman, a native of Cagayan Province and billeted at No. 15,
Blumentritt St., Sta. Cruz, Manila.
Officer on Case:
PO2 ALLAN VERGARA VALDEZ
Enclosures:
1. Sworn statement of complainant

2. Sworn Statements of Witnesses
3. Request/Initial Result of laboratory examination conducted by PNP Crime
Laboratory Service, Camp Crame.
Early advice on the action taken heron will be highly appreciated.
Respectfully yours,
DOMERLIN Z. SAYSON
Chief, SID
28 | P a g e
EXAMPLE OF A CRIMINAL COMPLAINT
For purposes of filing a complaint against a suspect for the commission of a crime or
violation of the law, regarding the conduct of a preliminary investigation to determine (by the
justices-of-the-peace) whether there is a prima facie case that necessitates the issuance of warrant of
arrest. The following is a typical example of a criminal complaint:
Example:

In the Municipal Trial Court of Santa Rosa
People of the Philippines,

Plaintiff
-versus- Criminal Case No. 1081
Juan Dela Cruz y Santos,

Accused FOR: HOMICIDE
COMPLAINT
The undersigned Chief of Police of Santa Rosa Police Station, Santa Rosa, Nueva Ecija,
after having been duly sworn in oath in accordance with law, hereby accuses Juan dela Cruz y
Santos of the crime of Homicide, defined and penalized under Article 248 of the Revised Penal
Code, committed as follows:
That on the 21st day of February 2004, at more or less 2:00 o’ clock in the afternoon at
Brgy. Cojuangco, in the Municipality of Santa Rosa, Province of Nueva Ecija, Republic of the
Philippines, and within the jurisdiction of this Honorable Court, the above-named accused did
then and there willfully, unlawfully and feloniously attack one (1) Pedro Delos Reyes y Santos
with a fan knife, wounding the latter in the chest and abdomen, which resulted in the
immediate death of the above-named victim, as per attached Autopsy Report and Death
Certificate.
Contrary to Law:
Santa Rosa, Nueva Ecija, 20 February 2004.

Chief of Police
WITNESSES:
1. Mrs. Juana S. Dela Cruz, Brgy. Cojuangco, Santa Rosa, Nueva Ecija
2. Dr. Luis T. Moran, RHO, MHO, Santa Rosa, Nueva Ecija
3. SPO1 Pedro S. Reyes PNP, Santa Rosa Police Station, Santa Rosa, Nueva Ecija
4. And others x. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .x
SUBSCRIBED AND SWORN to me this 21st day of August 2004, at Santa Rosa, Nueva Ecija.
HECTOR F. DYSANGCO
Municipal Trial Judge
29 | P a g e
SAMPLE OF INFORMATION REPORT (USED ONLY WHEN THE JURISDICTION IS
NOT COVERED BY A PARTICULAR POLICE STATION

Silang, Cavite
MEMORANDUM
FOR : Chief of Police

Santa Rosa Police Station
Santa Rosa, Laguna
FROM : Chief of Police, SMPO
SUBJECT : Information Report
DATE : 02 September 2007

=====================================================================
1. Request be informed that on or about 021100H September 2007, at Brgy Lumil,
Silang, Cavite, one REDENTOR ALMEDA Y PILASPILAS, 38 years old, married, businessman,
and resident of Brgy. Balibago, Santa Rosa, Laguna, was arrested by mobile patrols this Office
under P/INSP ROMULADO REYES, after he was sighted throwing suspicious materials contained
in black plastic bags along the creek at the same place, which turned out to be several newly cut,
sliced or chopped parts of a male human body.
2. During the investigation, suspect revealed that he hacked to death his wife’s illicit
lover, “Boy Negro”, inside their house at Brgy. Polong Santa Cruz, Santa Rosa, Laguna, upon
seeing him on top of his wife, Erlinda Almeda- totally naked during love-making, inside their
master’s bedroom on or about 210900H June 2005, but he spared the life of his wife, who knelt and
prayed for forgiveness, still totally nude. The killing was probably committed under exceptional
circumstances (Art. 247, RPC).
3. Considering that this office lacks jurisdiction over this case, we are requesting your
good Office to please take into your custody the above-named suspect from this Office and get the
dismembered remains of his wife’s lover for proper disposition.
4. Further request acknowledgment.

Police Superintendent (DSC)
30 | P a g e
EXAMPLE OF A CRIME REPORT (CRIMES AGAINST CHASTITY, ESTAFA, WHITE SLAVERY, ETC.)

Silang, Cavite
Case Report No. 07-08-001 19 August 2007
CRIME REPORT
NATURE OF THE CASE : RAPE
VICTIM : Nympha Mandigma y Reyes, 11 yrs old, Grade V pupil and a

resident of Brgy. Tartaria, Silang, Cavite
(NAMES, PERSONAL CIRCUMSTANCES OF COMPLAINANT)
Medico-Legal Report (Annex “A”) – that victim’s vulva sustained fresh
lacerations at 6 o’clock wit positive spearmatozoa.
(IN RAPE CASES, ENCLOSE THE MEDICAL FINDINGS)
DATE/TIME/PLACE : 190700H August 2007 at Brgy. Tartaria, Silang, Cavite
OF OCCURRENCE
SUSPECTS : Diosdaodo Mandigma y Tigasin, 44 years old, married, carpenter,
victim’s father and resident of Brgy. Tartaria, Silang, Cavite
(NAMES, ADDRESSES ETC., IF KNOWN, AND PHYSICAL
DESCRIPTION IF AT-LARGE)
EVIDENCE : Medico-legal Certificate of Victim; Affidavits of Victim and her
mother, Mrs. Loreta Mandigma y Reyes (Annexes “B” and “C”).
WITNESSES : Nymphia Mandigma; Mrs. Loreta Mandigma; SPO2 Lina Gising, Investigator-on-
case of Poblacion, Silang, Cavite; Dr. Rebecca Sta Ana of PNPCL-RO4, Camp
Vicente Lim, Calamba City, Laguna.
(NAMES AND ADDRESSES)
FACTS OF THE CASE:
Initial investigation reveals that, while Mrs. Loreta Mandigma y Reyes, victim’s mother, was at the Tagaytay
Public Market, Tagaytay City, Nympha Mandigma, her 11-year old daughter, was suddenly pulled by her father,
Diosdado Mandigma, brought her inside their bedroom, kissed her and gave her Php 100.00, then undressed her,
promised to buy her a very beautiful baby doll, then kissed her private parts and eventually had carnal knowledge of
her, with the latter’s consent. When her mother arrived at their house, she noticed blood stains at the back of Nympha’s
dress which prompted her to inquire her daughter what happened to her but her daughter refused to talk. His husband
left the house earlier after the incident and went to work. Mrs. Mandigma then brought her daughter to this office, on
her suspicion that he girl was molested by her father, for interview. During the interview, Nympha tearfully confided
that her father Diosdado had inserted his penis into her vagina and then repeatedly made a push-and-pull motion, after
giving her money and promising to buy her a baby doll. She was brought to the PNPCL RO-4 for medico-legal
examinations. Suspect is now under man-hunt by operatives this Office under P/INSP ARMANDO REYES. SPO2
Rosalia Ligarte – Officer-on-Case.
ROSALIA SIRA LIGARTE
Senior Police Officer II

Investigator-on-Case
NOTED AND FORWARDED:

31 | P a g e
Chief of Police
EXAMPLE OF ADVANCED INFORMATION (CRIMES AGAINST PERSON SUCH AS MURDER,
PARRICIDE, HOMICIDE ETC.)

Silang, Cavite
Case Report No. 07-08-001 18 August 2007
ADVANCED INFORMATION
NATURE OF THE CASE : MURDER

VICTIM : Rogelio Isagon Bathan, 21 years old, single, farmer and a resident of
Brgy. Tartaria, Silang, Cavite
(Give the name/s and personal circumstances of Victim)
Victim sustained 5 gunshot wounds on his chest and was pronounced
DOA at the Biñan Doctor’s Hospital, Biñan, Laguna
(If injured, diagnosis of the Attending Physician/Name of the
Hospital)
DATE/TIME/PLACE : 171600h August 2007 at Brgy. Tartaria, Silang, Cavite
OF OCCURRENCE
SUSPECTS : Ramon Julva Villegas, Jr., 24 years old, single, Brgy Captain and
resident of Brgy. Tartaria, Silang, Cavite-arrested.
(Names, residence and status-whether suspects are arrested or not)
EVIDENCE : Cal .45 pistol “colt” SN 142376 with 1 long magazine assembly and 5
live ammo; 5 empty shells for same caliber covered with PTCFOR; result
of ballistics examination; Necropsy report; affidavits of witnesses; and
result of paraffin test.
WITNESSES : SPO2 Emmanuel B. Manalo,investigator-on-case; Rosita LAngcay y
Lopez and Ruben Tira y Agnanayon, and Isabel I. Bathan, victim’s
mother – all of Brgy. Tartaria, Silang, Cavite; and Dr. Rufino Brillantes,
M.D. of PNPCL, RO-4, Camp Vicente Lim, Calamba City, Laguna.
-------------------------------------------------------------------------------------------------------------------------------
FACTS OF THE CASE:
1. On said time and date, at Brgy. Tartaria, Silang, Cavite, one ROGELIO BATHAN Y
ISAGON, while washing his car in front of their house, was suddenly shot repeatedly by BRGY. CAPT.
RAMON JULVA VILLEGAS, JR., thus, the victim sprawled dead on the ground. Suspect surrendered right
away to this Station with his licensed caliber .45 pistol “colt” bearing SN 142376 with one (1) long magazine
assembly and five live ammo, covered by PTCFOR. He voluntarily executed a waiver of detention and now
under custodial investigation of this Office. Victim’s cadaver was brought to the PNP Crime Laboratory,
Camp Vicente Lim, Calamba City, Laguna for necropsy examination while the suspect was also brought
there for paraffin test. This killing was motivated by jealousy. Further investigation is being conducted by
SPO2 Emmanuel B. Manalo this Office.
2. For information.
ROSENDO VALLE BELARMINO
Senior Police Officer III

Investigation Section, PNCO
SAMSON LOPEZ BARCENA

32 | P a g e
Chief of Police
EXAMPLE OF ALARM REPORT (FOR THEFT AND ROBBERY CASES)

Silang, Cavite
Case Report No. 07-08-001 14August 2007
ALARM REPORT
NATURE OF THE CASE : Robbery

COMPLAINANT : Ms. Lucila Makati y Galapon, 17 years old, single, 4 th year HS student
and resident of Brgy. Tartaria, Silang, Cavite.
(Names, personal circumstances and addresses of victims and
complainants)
LOSSES : One (1) Samsung Cellular Phone valued at Php 21,000.00 and FIVE
THOUSAND PESOS (Php 5, 000.00) CASH inside her wallet (unrcvrd)
(Itemized List of Losses of Victims/Value Recovered or Not
Recovered)
DATE/TIME/PLACE : 141800H August 2007, Brgy. Tartaria, Silang, Cavite
OF OCCURRENCE
SUSPECT : Unidentified men, armed with a dagger, abt 20 yrs old, 5 ft 4 inches in
height, wearing black t-shirt, maong pants and black rubber shoes
(Personal/Physical Description of each Suspect)
REPORTED BY : Ms. Marcela Makati y Galapon
DATE/TIME REPTD : 142000H August 2007
FACTS OF THE CASE :
1. On the said time, date and place, at Brgy. Tartaria, Silang, Cavite, while Ms. Lucila Makati y
Galapon, 17 years old, single, a 4th year high school student and a resident of same place, was studying her
lesson inside their house, an unidentified armed man suddenly entered their house thru the comfort room,
warned Lucila not to shout if she wants to live and leveled his dagger against her neck, then grabbed and
seized her cellular phone with camera (worth Php 21, 000.00) and her wallet containing not less than FIVE
THOUSAND PESOS (Php 5,000.00) CASH, intended to pay her entrance and her first monthly tuition fee.
Suspect casually left the house thru the main door, boarded and drove his car, a blue Toyota car, without
plate number, and sped towards Tagaytay City. Lucila told her mother right away the details of what
happened then her mother proceeded to this Office and reported the incident. A 7-man team of our
intelligence operatives under PINSP GENARO S SANCHEZ was immediately organized and dispatched to
track down said suspect at Tagaytay City.
2. Request direct Tagaytay CPO to augment our operatives under P/INSP SANCHEZ in tracking
down the above-described suspect within its AOR, on board a blue Toyota car without plate number.
ROBERTO RAZON SANTIAGO
Senior Police Officer III

Chief, Investigation Section
NELSON LOPEZ BARCENA

33 | P a g e
Chief of Police
EXAMPLE OF A SPOT REPORT ON ARRESTED PERSON WITH WARRANT OF ARREST

MEMORANDUM
RPO4-B
SUBJECT : Spot Report on Arrested Person with Warrant of Arrest
DATE : 17 July 2009

=====================================================================
6. Reference: Warrant of Arrest
7. Request be informed that on or about 171030H July 2009 at Ospital ng Palawan,

Bgy. San Miguel, this city, elements of Detective Unit of this office led by SPO2 William De Mesa,
arrested one Allan Franco y Marcos, aka Boy Kalbo, 37 years old, married, farmer, and a resident of
Sitio Tarabanan, Concepcion, Puerto Princesa City.
8. Subject person was arrested by virtue of Warrant of Arrest for the crime of Rape (2
counts), docketed under CC No. 22285-86 issued on May 10, 2007 by Hon. Judge Jocelyn Sundiang
Dilig of RTC Branch 50, No Bail recommended.
9. Subject person/accused is still confined at Ospital ng Palawan.
MARK CRUZ DELA CRUZ

34 | P a g e
EXAMPLE OF AN INVESTIGATION REPORT
CONFIDENTIAL

MANILA
CODE DATELINE ( 22 November 2000)
SUBJECT: SHOOTING INCIDENT
TO: The District Director

Western Police District Office
__________________________________________________________________
AUTHORITY: SOP
MATTERS INVESTIGATED:
Shooting victim identified as Juan Dela Cruz, 35 years old, married,
businessman, presently residing at house No. 20 Blumentritt St., Sta. Cruz, Manila,
who was allegedly shot by one (1) Juan Pedro Cuesta, 35 years old, married,
businessman, a Cagayano and billeted at house No. 17 Blumentritt St., Sta. Cruz,
Manila on or about 8:00 p.m., 22 November 2000, at the parking area of the corners
of Blumentritt and Maria Clara Sts., Sta. Cruz, Manila.
FACTS OF THE CASE

At about 8:15 p.m., 22 November 2000, concerned citizen who refused to give
her name informed this office through telephone that a shooting incident is in
progress at the parking area located at the corner of Maria Clara St. and Blumentritt
St., Santa Cruz, Manila. SID Chief, PSINSP DOMERLIN Z. SAYSON immediately
dispatched SPO2 Ybanes, SPO1 Hilotin, PO2 Baligat and PO2 Valdez to check and
verify the alleged report.
That at the crime scene, responding officers spotted a body inside a White
Toyota Corolla, model 1990, bearing Plate # PNA 529, full of blood scattered therein,
at that juncture. The victim was immediately rushed to the nearest hospital by the
aforesaid responding policemen.
35 | P a g e
While inside the emergency room of the Ospital ng Maynila, attending physician
Dr. Domingo De Jesus confirmed that the victim is dead on arrival (DOA) at about
8:30 p.m. the said date for multiple gunshot wounds sustained on the right side of his
body.
Initial investigation revealed that at the specified DTPO, two vital witnesses,
namely: PEDRO FLORES y IBA and DELIA REYES y OMAR, both minors and
residents of said community, who were playing at that time and place, narrated that
said victim/suspect were inside the said car and a few minutes later after hearing an
argument between the duo, the two minors witnessed through the opened window of
the car that Mr. Juan Pedro Cuesta pulled an unknown gun and fired three (3) times
towards the body of Mr. Dela Cruz. That, immediately thereafter, suspect escaped
hurriedly on foot. That, at the crime scene, investigating team recovered a caliber .45
automatic and three (3) empty shells of caliber .45 ammunition.
ACTION TAKEN
1. A team was formed by the undersigned chief SID, to track down the
whereabouts of the suspect for his immediate arrest.
2. Statements of witnesses were reduced into writings.
3. Spot investigation was conducted at the scene of the crime.
FINDINGS
The case is still in the process of determining all relevant and necessary facts for
presentation to the court.
CONCLUSION/RECOMMENDATION
This case is under investigation and follow-up.
DOMERLIN Z. SAYSON
Chief, SID
36 | P a g e
CONFIDENTIAL
37 | P a g e

Sample Formats Copy Autosaved

Uploaded by

Copyright:

Available Formats

Sample Formats Copy Autosaved

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Sample Formats Copy Autosaved

Uploaded by

Copyright:

Available Formats

SAMPLE FORMAT OF A MEMORANDUM

Republic of the Philippines

FOR : Provincial Director

FROM : Chief of Police, AMPS

SUBJECT : Spot Report, Re: Shooting Incident

DATE : 28 AUGUST 2009

JUAN C. DELA CRUZ

Entry DATE TIME EVENTS/INCIDENTS DISPOSITION

Republic of the Philippines

SRPS-IN February 14, 2004

TO WHOM IT MAY CONCERN:

Feb. 14, 2004/1600H/C-2004-040

SERIOUS PHYSICAL INJURY

SGD. JOHN S. SAN PEDRO

PETER DULNUAN GUIBONG

Republic of the Philippines

FOR : Provincial Director, PPPO

FROM : Chief of Police, AMPS

SUBJECT : SPOT REPORT RE: (STATE THE NATURE OF CASE OR

DATE : February 16, 2004

1. Reference: (Cite any references if there are any)

3. Initial investigation revealed that ___________________________ (state the

7. For information/For reference and Progress report follows.

JUAN CRUZ DELA CRUZ

Republic of the Philippines

SUBJECT : Spot Report on Arrested Person with Warrant of Arrest

DATE : 17 July 2009

1. Reference: Warrant of Arrest

2. Request be informed that on or about 171030H July 2009 at Ospital ng Palawan,

4. Subject person/accused is still confined at Ospital ng Palawan.

5. For information and reference.

MARK CRUZ DELA CRUZ

Republic of the Philippines

SUBJECT : Spot Report found Cadaver

DATE : 17 July 2009

5. The motive of the attack is still unknown.

7. For information and reference.

MARK CRUZ DELA CRUZ

Republic of the Philippines

FROM : Chief of Police, SRPS

SUBJECT : PROGRESS REPORT (STATE THE NATURE OF CASE OR

DATE : February 16, 2004

1. Reference: Spot Report this station, Cite Number SRPS-02-14-40 dated

2. Submitted is the Progress Report re (state the nature of incident being

3. Please be informed that (state the additional information answering the

PETER DULNUAN GUIBONG

Republic of the Philippines

FOR : Provincial Director

FROM : Chief of Police, SMPO

SUBJECT : Progress Report Re: Shooting to Death of Rogelio Bathan

DATE : 30 August 2007

4. Please acknowledge receipt.

AURELLO BALAT SIBUYAS

** DSC-Directorial Staff Course

1. Cite Number (CONFID SMPO-B 07-06-002);

EXAMPLE OF MODIFIED RADIOGRAPHIC SPOT REPORT

CONFID SMPO-B 07-06-002 PD SPOT RPT RE SHOOTING

SPO2 RAMOS PSUPT BERREDO

RADIO MESSAGE FOR TRANSMISSION