Sample Format of Spot Report
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
SURIGAO DEL NORTE POLICE PROVINCIAL OFFICE
Borromeo St., Surigao City
MEMORANDUM
FOR :
FROM : Chief of Police
SUBJECT : Spot Report
DATE :
1. Reference:
2. Brief facts of the case (5Ws)
3. How
4. Investigator on-Case (IOC)/Contact Number
5. Progress report will follow
________________________
Police Lieutenant
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
SURIGAO CITY POLICE STATION
Borromeo St., Surigao City
MEMORANDUM
FOR : Provincial Director
(Attention: C, PIDMU)
FROM : Chief of Police
SUBJECT : Spot Report on Stabbing Incident
DATE : June 13, 2019
1. Reference: Tracking Report No. / Unit Crime Case Number 13SDN-MAINI-
2019-06-415.
2. On June 12, 2019 at about 10:30PM, a non-fatal stabbing incident transpired in Purok
1, Brgy. Luna, Surigao City victimizing one Dennis Gaas Canangcaan, 43 years old, married,
driver and a resident of Purok 1, Brgy Luna, Surigao City perpetrated by a certain Tata B
Abucayon, legal age, married, laborer and one June C Kurat, legal age, married, laborer, both
are residents of Purok Daisy, Lipata, Surigao City.
3. Investigation disclosed that the victim was attending neighbor’s wake when suspects
arrived and bullied the victim that eventually resulted into a heated altercation. Suspects got
their bladed weapons and stabbed the victim hitting at the left portion of the victim’s body.
Personnel of Surigao City Police Station immediately responded at the crime scene and
arrested the suspects. Victim was rushed to Surigao Medical Hospital but declared dead on
arrival by the attending physician. Suspects were brought to Surigao City Police Station for
investigation and documentation.
4. Investigator on-Case: PMSg Felix Cagadas Paniamogan, Jr., at mobile phone number
09127442063.
5. Progress report follows.
.
PACAUTION C ABUTALAM
Police Lieutenant Colonel
Sample Format of CSI Form 1: First Responder’s Form
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
SURIGAO DEL NORTE POLICE PROVINCIAL OFFICE
Borromeo St., Surigao City
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 Weapons, 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)
Format of CSI Form 2: Request for the Conduct of SOCO
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
SURIGAO DEL NORTE POLICE PROVINCIAL OFFICE
Borromeo St., Surigao City
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)
MEMORANDUM
FOR : Provincial Chief, PCLO
FROM :
SUBJECT : Request for the Conduct of SOCO
DATE :
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.
__________________________
Police Lieutenant
Sample Format of Affidavit of Witness
Republic of the Philippines )
Province of Surigao del Norte ) S.S
City of Surigao )
AFFIDAVIT OF WITNESS
(PARRICIDE)
I, ROBERTO C NORES, Filipino, 65, male, married, and a resident of Pureza Street,
Brgy Taft, Surigao City after being sworn to in accordance with law, depose and state THAT:
1. The defendant CARLES NORES is my son residing at the same house in Pureza
Street Brgy Taft, Surigao City;
2. At around 10:00 in the evening of October 29, 2012, after dinner, my son arrived at
our house;
3. He saw my wife, Cecilia Nores in the kitchen washing the dishes, the kitchen being at
least 5 feet from the dining table;
4. Without provocation, the defendant pulled a knife from the sink and
proceeded to stab my wife with it.
5. Upon seeing what my son did, rushed to my wife’s aid and called for an ambulance at
the hospital;
6. Upon seeing that I was approaching, he left immediately without even saying
anything;
7. Upon calling for medical assistance and reaching the hospital, my wife was dead on
arrival because of severe blood loss from the stabbing;
8. After attending to my wife, I reported the said incident to the nearest police station. A
true and faithful machine copy of the police report is hereby attached here as “Annex A”;
8. This affidavit is being executed to attest to the truth of the foregoing, for the purpose
of filing a complaint against CARLES NORES for the Crime of PARRICIDE under Art. 246, of
the Revised Penal Code and all other legal intents and purposes this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 19 th day March 2019 at
Surigao City, Philippines.
ROBERTO C NORES
Affiant
SUBSCRIBED AND SWORN to before me this 19th day of March 2019 at Surigao City,
Philippines.
Sample Format of Joint Affidavit of Arrest
Republic of the Philippines )
Province of Surigao del Norte ) S.S.
City of Surigao )
JOINT AFFIDAVIT OF ARREST
We, PSSG TROY CARAGAY MARCO and PCPL HAZER NAN PLEBO, both of
assigned at Surigao City Police Station, after having been sworn to in accordance with law, do
hereby depose and say that:
1. On June 12, 2019 at about 10:30PM, we were the duty mobile patrollers in the area of
Brgy Luna and other neighboring barangay of Surigao City when we received a radio
call from the Duty TOC of Surigao City PS that a stabbing incident transpired in Brgy
Luna Surigao City;
2. Upon receipt of the radio alarmed, we immediately responded at the place of incident;
3. Upon arrival at the place of incident, one of the witnesses immediately approached and
pinpointed to us the two (2) suspects responsible in the stabbing incident;
4. We arrested immediately arrested the suspects with the helped of the barangay officials
in the area and we recovered from their possession and control the two (2) bladed
weapons known as “BALISONG”;
5. During the arrest, we informed the suspects of their Constitutional Rights under the
Miranda Warning and Anti-Torture Warning;
6. We brought the suspects at Surigao City Police Station for investigation and
documentations.
7. We executed this affidavit to attest to the truth of the foregoing facts and in support for
the filing of MURDER against the suspects.
IN WITNESS WHEREOF, we have hereunto set our hands this ___day of ___________
at Surigao City, Philippines.
PSSG TWET TWET N PAPANSIN PCPL HAZER NAN PLEBO
Affiant
SUBSRCIBED AND SWORN TO before me this ___ day of ______________ at
Surigao City, Philippines.
Sample Format of Progress Report
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
SURIGAO DEL NORTE POLICE PROVINCIAL OFFICE
Borromeo St., Surigao City
MEMORANDUM
FOR :
FROM :
SUBJECT : Progress Report
DATE :
1. Reference/s (Previous related Memo)
2. Brief facts of the case (5Ws)
3. Progress/Development of case
6. Investigator on-Case (IOC)/Contact Number
4. For information
________________________
Police Lieutenant
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
SURIGAO CITY POLICE STATION
Borromeo St., Surigao City
MEMORANDUM
FOR : Provincial Director
(Attention: C, PIDMU)
FROM : Chief of Police
SUBJECT : Progress Report on Stabbing Incident
DATE : June 13, 2019
1. References:
a. Spot Report from COP, Surigao City Police Station dated June 13, 2019; and
b. SMS Report from COP, Surigao City Police Station dated June 13, 2019.
2. On June 12, 2019 at about 10:30PM, a non-fatal stabbing incident transpired in
Purok Lerio, Brgy. Quezon, Mainit, Surigao del Norte victimizing one Dennis Gaas
Canangcaan, 43 years old, married, driver and a resident of Purok, Brgy Luna, Surigao City
perpetrated by a certain Tata B Abucayon, legal age, married, laborer and one June C Kurat,
legal age, married, laborer, both are residents of Purok Daisy, Lipata, Surigao City.
3. A case for the crime of MURDER against the aforementioned suspect was already
filed in the Office of the City Prosecutor, Bayugan City ADS, docketed under NPS Docket no.
XIII-09-INQ-20A-008, dated 281341 January 2020
4. Investigator on Case: PMSg Felix Cagadas Paniamogan, Jr., at mobile phone
number 09127442063.
5. For Information.
PACAUTION C ABUTALAM
Police Lieutenant Colonel
PERFORMANCE TASKS
SCENARIO 1
You are the duty Teamleader of the Mobile Patroller of Silang
Municipal Police Station when you received a radio call from the Tactical
Operation Center of your police station that ahacking incident transpired in
Brgy Tartaria Silang Cavite. Your team responded at the place of incident
and immediately arrested the suspect. During the conduct of investigation
the following are the details:
NATURE OF INCIDENT: Hacking Incident
TIME OF INCIDENT: August 9, 2020 at about 4:30PM,
PLACE OF INCIDENT: P-4 Brgy. Tartaria, Silang, Cavite
VICTIM: REGINA MAHINAY VICENTE, 39 years old, Brgy Kagawad (DOB:
April 3, 1981), with live-in partner and a resident of P-4 Brgy. Tartaria,
Silang, Cavite (DEAD ON ARRIVAL AT THE HOSPITAL)
SUSPECT: Her brother ROGER MAHINAY VICENTE, 46 years old (DOB-
April 26, 1974), married, farmer and a P-4 Brgy. Tartaria, Silang, Cavite.
WITNESS: MALATUBA N HAZER, 25 years old, driver, half brother of the
victim and a resident of P-4 Brgy. Tartaria, Silang, Cavite
HOW:Investigation revealed that while the victim was drinking coffee inside
her house, the suspect, who was under the influence of liquor, appeared
and suddenly hacked her. The victim was able to evade and fled towards
the house of her half brother to ask for help but the suspect chased and
hacked her several times hitting on the different parts of her body which
resulted in her death. The suspect was then apprehended by the
responding PNP personnel.
EVIDENCE AT THE CRIME SCENE: sharp bladed weapon (BOLO).
Motive of incident is personal grudge.
PERFORMANCE TASK:
As the Teamleader, your Chief of Police directed you to make the following
reports:
1. Spot Report
2. Request for the Conduct of SOCO
3. Affidavit of Witness
4. Joint Affidavit of Arrest
5. Accomplish of Fill up the First Responder’s Form
