Sample Format of Crime Report

Republic of the Philippines

Department of the Interior and Local Government
PHILIPPINE 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 Philippines

Department of the Interior and Local Government
PHILIPPINE 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 Philippines

Department of the Interior and Local Government
PHILIPPINE 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/ fiscal
taking cognizance of the case.
( ) Others

| | Signature
| |
| PHOTO |
| | Print Name
| |
| | Driver‟s License Number
Sample Format of CSI Form 1: First Responder’s Form

Republic of the Philippines

Department of the Interior and Local
Government
PHILIPPINE NATIONAL POLICE

FIRST RESPONDER’S 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)

Date
THIS 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 of
Investigator (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 COMMISSION
PHILIPPINE 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-Case
before 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 Philippines

Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE

Technical Inspection and Inventory Report for Recovered Motor Vehicle

Accomplished:

MOTOR VEHICLE DESCRIPTION Inside Features Engine

Compartment
Make/Type Plate No. Steering Wheel Air-con Compressor

Engine No. Fuel Shifting Rod with Knob Radiator

Chassis No. Color Hand Brake Radiator Cover

Registered Owner: Ammeter Radiator Inlet Hose

Owner’s Address Oil Pressure Gauge Radiator Outlet Hose

OUTSIDE FEATURES FRONT Temperature Gauge Water Bypass Hose

Bumper Front Fog Lights RPM Gauge Ignition Coil
Brand Emblem Headlights Headlight Knob High Tension Wire
Marking LR
Radiator Grill Windshield Parking/Hazard Knob Distributor Cap
wiper
Signal Lights L/R Windshield Wiper Knob Distributor Assembly
Glass
Hazard Lights L/R Windshield Dimmer Switch Contact Point
Wiper Blade
Headlights Guard Windshield Directorial Level Condenser
Wiper Motor
Left Side Portion: Speedometer Air-con Condenser
Right side Portion:
Side Mirror Side Mirror Fuel Gauge Rotor
Wind Tunnel Glass Wind Tunnel Cars Seats Front Advancer
Glass
Window Glass Window Car Seat Back Oil Dipstick
Front Seat Glass Front
Seat
Weather/Wi Car Seat Cover Air-con Driver Belt
ndow Strip
Rear Back Portion: Floor Carpet Carburettor Assembly
Luggage Compartment:
Rear Bumper Spare Tire Floor Matting Alternator
Brand Emblem Spare Tire Steering Wheel Alternator Voltage
Marking Mounting- Computer Box Regulator
Note: no
spare tire
cover.
Plate Light Floor Seat Adjustment Knob Air Cleaner
Luggage
Mat
Tail Light Assembly Mechanical ACCESSORIES: Fuel Pump
Tools
TIRES: Air-condition Unit Oil Filter
Brand/Make: Car Stereo Steering Gear Box
Size: 235/75 R15 Interceptor Cable Water Pump
Assembly
Condition: Used Stereo Speakers Engine Fan
Type Twitters Auxiliary Fan
No. of Studs: Car Radio Fan Belt
General Condition of the MV: Equalizer Spark Plugs
Running CD Changer Battery
Deadline Lighter Battery Cable
REMARKS Barometer Battery Terminal
Fire Extinguisher Horn Assembly
Antennae Horn Relay
GENERAL APPEARANCE: Accelerator Cable
Newly painted Intake Manifold
Paint Discoloring Exhaust Manifold
Good body shape Engine Mounting
Body in Bad Shape Ignition wiring
Body ongoing repair Transmission
For Repainting Suspension Assembly
Beyond Economical Repair Tie Rod End
and corrosion have set in
which requires a major
body repair.
Idler Arm
Front Coil Spring
Pitman Arm
Recovering Personnel: WITNESS/OWNER/Barangay NOTED BY (HEAD OF
Official: OFFICE):

Rank/Name
Date: Date: Date:

8 - 31
-
Sample Format of Inventory/Receipt of Property

Republic of the Philippines

Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
_ _
_

Date:_ _

INVENTORY SHEET/RECEIPT FOR PROPERTY / GOODS RECOVERED

Inventory Sheet of article/items seized from the premise/establishment of

__ located at _ _ by virtue of
_ _ _

ITEMS/ARTICLES QUANTITY/UNITS

_ _ _ _
_ _ _ _
_ ___ _ _
_ _ _ _
_ _ _ _
_ _ _ _
_ _ _ _

_
(Seizing Officer)

Witness by:

_ _

8 - 32
-
Sample Format of Impounding Receipt

Republic of the Philippines

Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE

Date:_

IMPOUNDING RECEIPT
Description 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 to
HQS 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 Philippines

Department of the Interior and Local Government
PHILIPPINE 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 Philippines

Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
_ _

CERTIFICATION OF LEGALLY, PEACEFULLY AND ORDERLY

EXEC UTION OF SE ARC H W ARR ANT :

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 Search
W 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 Philippines

REGIONAL T RIAL COURT

Branch _

PEOPLE OF THE PHILIPPINES

Plaintiff
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:

That at abo ut of , elements of the

led by the undersigned implemented the search warrant
_ at the premises of no. 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
_ to conduct Forensic Examinatio n on the seized computers and other electronic devices for evidentiary
purposes.

Other relief‟s 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 Philippines

Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
_
_

BOOKING AND ARREST REPORT

Picture _ DATE:
2x2 (Last Name) (First Name) (Middle Name)

ADDRESS : Tel No. __ _ _

PLACE & DATE OF BIRTH :
OCCUPATION : MARITAL STATUS : _ HEIGHT:
NATIONALITY : SEX : _
_ WEIGHT : _

AGE : _ EDUCATIONAL ATTAINMENT : _

NAME OF SCHOOL: _ _LOCATION OF SCHOOL:
SCARS AND MARKS : _ _ OTHER IDENTIFYING MARKS:
NAME & ADDRESS OF FATHER: _
NAME & ADDRESS OF MOTHER: _
NAME & ADDRESS OF RELATIVES: _ _

OFFENSE CHARGE:

_
(NATURE OF OFFENSE) (CRIM/IS NO.)

ARRESTED BY: _ UNIT: _ _

WHERE ARRESTED: _ DATE/TIME ARRESTED: _
BOOKED BY : _ BRANCH/SECTION:

SIGNATURE OF PERSON ARRESTED: _

NAME OF 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 Government

NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE INTELLIGENCE GROUP
PHILIPPINE BOMB DATA CENTER

nd
2 Floor Maritime Building
Camp Crame, Quezon City
Tel. Nos. (02) 4120065 / 7230401 loc 4496 Email: do_pbdc @y ahoo.com

EXPLOSIVE-RELATED INCIDENT REPORT FORM

BDC Incident Number Date Received

Police Blotter Case Number

Reporting PNP Unit

Chief of Office
Investigator-on-Case
Address
Unit Contact Details Phone
E-mail
Bomb Squad Unit
Team Leader
Address
Unit Contact Details Phone
E-mail
SOCO Unit
Address
Unit Contact Details Phone
E-mail
Date/Time of Incident
Location

Bombing Theft
Incident Category Attempted Bombing Recovery Other

Casualties Yes No Number:

Deaths Yes No Number:

Pre-Incident Threat Yes No Method of Threat:

Post-Incident Threat Yes No Method of Threat:
 Delivered Buried
Dropped Other
Delivery Method Thrown
Placed
Suicide
Details
Time
Victim
Initiation Method Environmental
Command
Other
Details

Power Source Battery

Mains
Details

Commercial
Military / Ordnance
Explosive Type
Improvised
Other
Details

Commercial
Military
Detonator Type
Improvised
Other
Details

Plastic Wood
Metal Other
Container Type Carton
Bag
Cloth
Details

Vandalism Domestic Dispute

Terrorist Experimentation
Motive
Criminal Extortion
Religious Other
Details

Government
Commercial
Target
Private
Other
Details

Suspected Group: Details:

Device/Component Description
This box needs to include a device description and a components list. This requires as
much information as possible.
Incident Details
Include information on injuries, property damage, motive and incident description, device
location and any other relevant information.

Render Safe Procedure

List 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:

Time Pertinent 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

Description Camera
Photo of Settings Distance Use of
Sketch (of Applicable)
# Photograph and Lens Scale
ic Subject Type

CRIME SCENE DIAGRAM / SKETCH

Location: Reference
Date: Scale of Disclaimer
Case Identifier/Number: Compass Orientation
Preparer/ Assistants Evidence
Fixed Objects
Measurements
Key / Legend
 EVIDENCE RECOVERY LOG

Location: Personnel Involved:

Date:
Case Identifier/Number:
Preparer/ Assistants:

Marking
Description of Photo Packaging Comm
Item # Location Recovered by: Direct = D
Item Log # Method ents
Indirect = I
CUSTODY LOG

Item # Case Number:

Delivered By: Date Time

To:

Returned To: Date Time

By

Delivered By: Date Time

To:

Returned To: Date Time

By

Delivered By: Date Time

To:

Returned To: Date Time

By

Delivered By: Date Time

To:

Returned To: Date Time

By

Delivered By: Date Time

To:

Returned To: Date Time

By
 BOMB SUMMARY CHART

Bomb Type
Incident Location Pipe Method Initiation
Incident # Container Explosive

BOMB SUMMARY CHART

Battery Wire Tape Glue Switch Clock Contact Screw Solder

R/C Devices # Construction Similarities Fingerprints Remarks

x. Sample Format of Detainees Report

Republic of the Philippines

Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
CRIMINAL INVESTIGATION DETECTION GROUP
CIDG DETENTION CENTER
Camp Crame, Quezon City

CERTIFICATION

THIS IS TO CERTIFY that the undersigned Incoming Duty Jail Guards assumes the
duties and responsibilities from the Outgoing Duty Jail Guards from to
and received the following to wit:

DETAINEES REP ORT

Name Offenses Arrest Unit Date Court Remarks

Male
1.
2.

Female
1.
2.

Current Detainees... = 41 Female = 08 Total = 49

Actual Detainees... = 41 Female = 08 Total = 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 Philippines

Department of the Interior and Local Government
NATIONAL 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 for
reinvestigation 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 Philippines

Department of the Interior and Local Government
NATIONAL 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 of
deceased _ _ 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)