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Sworn Statement of Apprehending Officer: Republic of The Philippines

This sworn statement from an apprehending officer details the apprehension of an individual for mining, extracting, transporting, or possessing mineral commodities without proper permits or licenses. Specifically: 1. The officer apprehended an individual on [DATE] in [LOCATION] for these unauthorized activities involving [MINERAL] totaling [QUANTITY] estimated at [VALUE]. 2. The mineral commodities were mined, extracted, transported, or possessed without permits by order of [COMPANY] and its officials [NAMES]. 3. The officer signed the affidavit on [DATE] attesting to these events.

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Calderón Gutiérrez Marlón Pówan
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62 views

Sworn Statement of Apprehending Officer: Republic of The Philippines

This sworn statement from an apprehending officer details the apprehension of an individual for mining, extracting, transporting, or possessing mineral commodities without proper permits or licenses. Specifically: 1. The officer apprehended an individual on [DATE] in [LOCATION] for these unauthorized activities involving [MINERAL] totaling [QUANTITY] estimated at [VALUE]. 2. The mineral commodities were mined, extracted, transported, or possessed without permits by order of [COMPANY] and its officials [NAMES]. 3. The officer signed the affidavit on [DATE] attesting to these events.

Uploaded by

Calderón Gutiérrez Marlón Pówan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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MGB Form No.

12-2

SWORN STATEMENT OF APPREHENDING OFFICER

REPUBLIC OF THE PHILIPPINES


Municipality of ______________
Province of __________________

AFFI DAVI T

I, ____________________________________, of legal age and a resident of


___________________________________________________, after being duly sworn,
depose and state:

1. That I am a/an ____________________________ of the Department of Environment


(Position)
and Natural Resources, Region __________________ with place of assignment at
____________________________________________________________________;

2. That on or about _______________________ at ________________________, I was

_____________________________________________________________________
____________________________________________________________________;
(state activity such as conducting surveillance, patrolling, etc.)

3. That in the course of performance of my work on or about ________ in


______________________________________________ I apprehended a certain
____________________________________________________________________
for having mined, extracted, quarried, excavated, removed, transported and /or
possession of mineral commodities termed/called/described as __________________
______________________________________ with a total volume/tonnage/quality
________________________________________ cu. m/tons/kilos/grams/bags/sacks
and with an estimated value of P___________________ without a permit or
license or legal supporting documents;

4. That said mineral commodities/products were mined, extracted, quarried, excavated,


transported and/or possessed without permit, license or legal supporting documents
upon order of ________________________________ company more particularly,
____________________________ who are officials of said company or
corporation.

IN WITNESS WHEREOF, I have hereto signed the affidavit this ____________


day of ____________________ , 19 _____ at ______________________________ .

_______________________
Affiant
TIN _________________
MGB Form No. 12-2

ACKNOWLEDGEMENT

Republic of the Philippines _____ )


Province of ________________ ) S. S.
City/Municipality of _________ )

SUBSCRIBED AND SWORN to before me at the place aforesaid, on this


__________ day of ____________________, 19_____. The affiant exhibited to me
his/her Community Tax Certificate No. ____________ issued at ___________ on the
___________ day of _______________, 19____.

___________________________
NOTARY PUBLIC
Until Dec. 31, 19 ______
PTR No. ____________
Doc. No. _______
Page No. _______
Book No. _______
Series of _______

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