Annex B - CSI FORM “1”
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)
December 04, 2021
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:
VLTE Villa Leyson Subdivision
Secondary Place of Occurrence: Bacayan, Cebu City
Type/Nature of Incident: Murder
Rank and Names of First Responders: Patrolwoman Nielita P. Aragon
PSMS. Gimuel Atabelo
Time/Date Report of Incident was received by FRs: 01:10 PM/December 04, 2021
Time FRs Arrived at the Crime Scene: 01:20 PM
Weather Condition: Cloudy Bright
Time CS Cordoned Off and Secured/Signs Posted:
Time Flash Alarm/Request for Support Relayed by FR to TOC: _________________
__________________________________________________________________
A. Names of Victim/s and Status (Safe/Injured/Hospitalized/Deceased, etc.,):
Name: Alyas “Pildu”
Status: Deceased
B. Names of Persons Found at (inside) the Crime Scene by FR (Address/Contact Nrs):
__________________________ _________________________________
__________________________ ________________________________
__________________________ _________________________________
__________________________ _________________________________
__________________________ _________________________________
C. Names of Suspect/s and Status (Arrested/At-large, etc..) and Weapons, if any ;
Suspect Name:
Suspect Status:
D. Names of Person Found Near or at the Vicinity of CS (Address/Contact No):
1. Name: Gerna Mae Ubanan
Address: Dulhugan Buhisan, Cebu City
Contact Nr: 09219854215
2. Name: Sanito Romo
Address: Consolacion, Dalaguete, Cebu
Contact Nr: 09274474291
3. Aldin Lariosa
Address: Bugtong kawayan, Barili, Cebu
Contact Nr: 09513299301
E. Names of Persons Interviewed by the FR (Address/Contact Nr):
Name: Alfred Fiel
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):
1. Name: Princess Aying
Address: Lahug,Beverly Hills
Contact Nr: 09302608349
2.Name: Charlyn Calago
Address: Villa Leyson Bacayan, Cebu City
Contact Nr: 09223895316
3. Name: Rosemarie Mae Delgado
Address: High 77 Talamban, Cebu City
Contact Nr: 09312031746
4. Name: Mario Toquero
Address: Lawa-an Alcantara, Cebu
Contact Nr: 09605060587
5. Name: Rodmel Apa
Address: Cuaming, Inabanga, Bohol
Contact Nr: 09513638782
6. Name: Junry Calago
Address: Manlapay Dumanjug, Cebu
Contact Nr: 09679150012
7. Name: Jane Melody Calago
Address: Manlapay Dumanjug , Cebu
Contact Nr: 09326171684
(Note: Use the overleaf or back page for extra entries)
11
G. List of Evidence That Have Been Seized/Collected/Recovered by the FR (If Any):
Description Disposition
Gun (45 Caliber)
Bullets (Empty shell)
Cadaver (Male)
H. Area/s where Initial Search were conducted:
VLTE Villa Leyson, Parking Lot
On-Scene Command Post (OSCP) established at:
Near the Crime Scene
Time and Date of Arrival of Investigator at the CS:
01:35 PM/ December 04, 2021
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:
PMSg. Nielita Aragon
PSMS. Gimuel Atabelo
CS Received By Duty Investigator/ IOC:
. Allant Clent Morales
Time/Date: 01:40 PM/ December 04, 2021
Witnessed By:
Prepared and Submitted by:
__________________________________________________________________
Rank/Name/Designation of Officer/
Signature over Printed Name
Annex C- CSI FORM “2”
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
December 04, 2021
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)
Annex D- CSI FORM “3”
CSI Form 3: Turn-Over of Collected Evidence from Investigator to SOCO Team
Leader
Republic of the Philippines
Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
______________________________________
_______________________
TURN-OVER OF COLLECTED EVIDENCE AT THE CRIME SCENE
FROM INVESTIGATOR TO SOCO TEAM
(If Applicable)
__________
Date
This further certifies that the following items/physical evidence found, collected
And initially marked and inventoried by the investigator at the crime scene were
properly
Turned over to SOCO Team Evidence Custodian:
ITEMS/ARTICLES QUANTITY/UNITS
(Technical Description)
________________________________ __________________________
________________________________
__________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
________________________________ __________________________
__________________________
(SOCO Team Evidence Custodian)
Witnessed by:
______ __________________
Duty Investigator/IOC
Received By:___________________
Time/Date: ___________________
Turned over By: ________________
Time/Date: ________________
Annex E – CSI Form “4”
SOCO REPORT FORM “1”
Republic of the Philippines
Department of the Interior and Local Government
National Police Commission
PHILIPPINE NATIONAL POLICE
CRIME LABORATORY
Camp Crame, Quezon City
____________________________
DATE
RE SOCO REPORT NR: __________________________
PERSON PRESENT AT THE CRIME SCENE
(Note: Please include the middle name of the person.)
NAME DATE/TIME DATE/TIME REASON/S TO BE AT REMARKS
CRIME SCENE ADDRESS
Prepared by: Certified by: Noted by:
____________________ _________________ __________________________
Recorder SOCO Team Leader Chief of Office
SOCO REPORT FORM “2”
Republic of the Philippines
Department of the Interior and Local Government
National Police Commission
PHILIPPINE NATIONAL POLICE
CRIME LABORATORY
Camp Crame, Quezon City
___________________________
DATE
RE SOCO REPORT NR: __________________________
EVIDENCE LOG
DESCRIPTIO SIGNATURE
QTY N COLLECTED TIME SPECIFIC REMARKS OF
OF BY COLLECTED PLACES SEARCHER
SPECIMEN
COLLECTED
Prepared by: Certified by: Noted by:
________________ _________________ ____________________
Evidence Custodian SOCO Team Leader Chief of Office
SOCO REPORT FORM “3”
Republic of the Philippines
Department of the Interior and Local Government
National Police Commission
PHILIPPINE NATIONAL POLICE
CRIME LABORATORY
Camp Crame, Quezon City
_________________________
DATE
RE SOCO REPORT NR:__________________________
SCENE OF CRIME EXAMINATION WORKSHEET
SKETCH DETAILS AND MEASUREMENT
NOTE: NOT TO SCALE
LEGEND:
TITLE BLOCK
Nature of Case:
Requesting Party:
Victim/s:
Officer-on-Case:
Date & Time Sketched:
Place of Incident:
Weather Condition:
Sketched by:
Witnesses: 1.
2.
Remarks:
SOCO REPORT FORM “4”
Republic of the Philippines
Department of the Interior and Local Government
National Police Commission
PHILIPPINE NATIONAL POLICE
CRIME LABORATORY
Camp Crame, Quezon City
INVENTORY OF EVIDENCE COLLECTED
1. SOCO Case Number: ______________________________________________
2. Time and Date of Inventory: ________________________________________
3. Facts of the Case:
a. Nature of the Case: ___________________________________________
b. Victim/s or Complainant: _____________________________________
c. Place of Incident: ___________________________________________
1. Evidence Collected at the Crime Scene:
a. __________________________________________________________
b. ____________________________________________________________
c. ____________________________________________________________
d. ____________________________________________________________
e. ___________________________________________________________
f. __________________________________________________________
g. ___________________________________________________________
h. ___________________________________________________________
i. ___________________________________________________________
CONCURRED: PREPARED BY:
__________________________ _____________________
Investigator-on-Case Evidence Custodian
WITNESSES:
Signature over Printed Name Address
_______________________________ __________________________
_______________________________ __________________________
Annex F – CSI FORM “5”
CSI Form 5 - Release of Crime Scene Form
Republic of the Philippines
Department of the Interior and Local Government
National Police Commission
PHILIPPINE NATIONAL POLICE
________________________
________________________
RELEASE OF THE CRIME SCENE
TO WHOM IT MAY CONCERN:
This is to certify that a Crime Scene Investigation was conducted at
_____________________________________________________________
_____________________________________________________________
From _____(time/date)______ to _______(time/date) __ by the members
of the___________________________________ Police Station and SOCO Team
in connection with the ____________________________ incident.
This is to further certify that a final crime scene survey was conducted on
Or about ________________ and that the CSI was concluded and the cordon was
Officially lifted and crime scene was officially released at around
______(time)__________.
SIGNED:
_________ _______________ _______________________
(Chief of Police/IOC) (Time and Date)
________________________ _______________________
(SOCO Team Leader) (Time and Date)
Conformed by:
___________________________________________
Owner of the Property/Local Authority/Representative
________________________
(Time and Date)
Witness:
_____________________________ _______________________________
_____________________________ _______________________________
_____________________________ _______________________________
Annex G- CSI Form 6: IOC/Investigator’s CSI Form
Republic of the Philippines
Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
______________________________________
_______________________
IOC/INVESTIGATOR’S CSI FORM
(This Form shall be brought by the IOC/Investigator at the Crime Scene and shall be
Accomplished by the IOC/Investigator-on-Case at the On-Scene Command Post
(OSCP)
___________
Date
Primary Place of Occurrence:
___________________________________________________________________
____________________________________________ _______________________
Secondary Place of Occurrence or Finding Place: ___________________________
Type/Nature of Incident: ________________________________________________
Time IOC/Investigator’s arrived at the Crime Scene: __________________________
____________________________________________________________________
Weather Condition ____________________________________________________
Time Flash Alarm/Request for Support Relayed by IOC to TOC: ________________
__________________________________________________________________
Time SOCO Team Arrived: ____________________________________________
__________________________________________________________________
A. Names of Victims and Status (Safe/Injured/Hospitalized/Deceased, etc.,):
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
B. Names of Persons Found at (inside) the Crime Scene by the IOC/Investigator
(Address/Contact Nrs):
__________________________ ________________________________
__________________________ ________________________________
__________________________ _________________________________
__________________________ _________________________________
C. Names of Suspects and Status (Arrested/At-large, etc..) and Weapons, if any:
__________________________ ___________________________________
__________________________ ___________________________________
__________________________ __________________________________
__________________________ __________________________________
__________________________ ___________________________________
D. Name of Person Found Near or at the Vicinity of CS by the IOC/Investigator
(Address/Contact Nr):
__________________________ ___________________________________
__________________________ ___________________________________
__________________________ ___________________________________
__________________________ ____________________________________
__________________________ ____________________________________
E. Names of Persons Interviewed by the IOC/Investigator (Address/Contact Nr):
__________________________ ___________________________________
__________________________ ___________________________________
__________________________ ___________________________________
__________________________ ___________________________________
__________________________ ___________________________________
F. Names of Persons Who Entered the CS in the presence of the IOC (Medics, Local
Officials, etc) (Address/Contact Nr):
_________________________ __________________________________
_________________________ __________________________________
_________________________ ___________________________________
_________________________ ____________________________________
G. List of Evidence That May Have Been Seized or Collected by the IOC/Investigator
(If Any):
Description Disposition
________________________ ____________________________________
_________________________ ____________________________________
_________________________ ___________________________________
_________________________ ___________________________________
H. Areas where Initial Search were conducted:
________________________________________________________________
________________________________________________________________
________________________________________________________________
On-Scene Command Post (OSCP) established at:
________________________________________________________________
Names of Other PNP Personnel who participated in the CSI:___________________
Initial Assessments and Impression of the Crime and the Crime Scene:
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Possible Motive:____________________________________________________
Other Significant Information Gathered: __________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Prepared by:
__________________________________________________________________
Rank/Name/Designation of IOC/Investigator
Signature over Printed Name
