PNP Arrest and Booking Sheet (To Be Accomplished by The Arresting Officer)

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Republic of the Philippines

Department of Interior and Local Government


National Police Commission
PHILIPPINE NATIONAL POLICE
National Capital Region Office
QUEZON CITY POLICE DISTRICT

         

PNP ARREST AND BOOKING SHEET


(To be accomplished by the Arresting Officer)

               

BLOTTER ENTRY NR: 2017-43                     DATE: March 7, 2017


PERSONAL INFORMATION:
Dimasalanta Nilberto Casupang________________
                   (Last Name)                    (First Name)                          (Middle Name)
ADDRESS: Barangay Hagonoy,Taguig
TEL NO._856-687-098_ POB: _Taguig _________________ DOB: _September 8,1982__________
MARITAL STATUS:       SINGLE                  WIDOW/ER               SEX:        MALE                                    

MARRIED SEPARATED FEMALE

AGE: __35___  WEIGHT (lbs.): __170__ HEIGHT (Ft): __5’6_ EYES: Black HAIR: Black
COMPLEXION: __ Brown______ OCCUPATION: _Tricycle Driver____ NATIONALITY: Filipino
ETHNIC GROUP__Tagalog________ DIALECT/LANGUAGE: Tagalog____
HIGHEST EDUCATIONAL ATTAINMENT: High School Graduate
NAME OF SCHOOL: _Taguig High School___________________
LOCATION OF SCHOOL: Taguig
IDENTIFYING MARKS:       MOLE                  TATOO            BIRTHMARK            SCAR
LOCATION OF IDENTIFYING MARKS: Right Leg________________________________________________________
PHYSICAL DEFORMITY/DEFECT: None_________________________________________________________________
DRIVER’S LIC NR: _CO3-29-9954______________________ISSUED AT: Taguig City ON: March 6, 2016________
RES CERT NR:098-884-234 DATE AND PLACE OF ISSUE: _January 10, 2016, Taguig City
OTHER ID CARDS: Tin Number ID NR: 444-987-0984
ARREST INFORMATION:
OFFENSE CHARGE: Homicide______ 667-09___________________
                                  (NATURE OF OFFENSE)           (CRIM/IS NO.)
MODUS OPERANDA:__HOT PURSUIT OPERATION______________________________________________________
WHERE ARRESTED: __Barangay Hagonoy____________________________________________________________
DATE ARRESTED: ___March 6, 2017__________________________________ TIME:   10:30 am_________________
ARRESTING OFFICER/S:
       Rank: PCpl. Name: Cosme Bartolome_______ Signature:________________________
       Rank: PCpl. Name: Ricardo Basao__ Signature:________________________
       Rank: PMSgt. Name: Edwardo Montano________ Signature:________________________
SIGNATURE___________________________________ UNIT: CIDG_________________________
 
MEDICAL EXAMINATION CONDUCTED AT: Taguig City General Hospital______________________________
BY: Dr. Gregorio Ammovi____________________ ON: ___March 7,2017___________
REMARKS: Drug Test Positive_________________________________________________________________________
FINGERPRINT TAKEN BY: _PSMS Benedicto Sanchez___________________________________________________
PHOTO TAKEN BY:           PCpl Kiki Olarte                                                                               _________________
INVESTIGATOR ON CASE: PMSgt Lorenzo Casuto_______________________________________________________
BOOKED BY (RANK/NAME/SIGNATURE): PSMS Vincent Villanueva_______________________________________

SIGNATURE OF PERSON ARRESTED: _______________________________________________


  
                                                                 (INDICATE IF SUSPECT REFUSE TO SIGN)
RIGHT HAND
THUMB INDEX MIDDLE RING LITTLE

LEFT HAND

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