Philippine National Police

INCIDENT RECORD FORM

IRF ENTRY NUMBER: TYPE OF INCIDENT: COPY FOR:
051901 Alleged Serious Physical Injuries Incident Violation of Article 263 of the RPC

INSTRUCTIONS: Refer to PNP SOP on Recording of incidents in the Police Blotter in filling up this form. This incident Record Form (IRF) may be reproduced, photocopied,
and/or downloaded from the DIDM website, www.didm.pnp.gov.ph.
DATE AND TIME REPORTED: DATE AND TIME OF INCIDENT: PLACE OF INCIDENT:
May 10, 2023 at 8:40 PM May 10, 2023 at 8:25 PM Centro Cangawa, Buenavista, Bohol

ITEM “A” – REPORTING PERSON

FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
Dakogulo Ayawkol Del Kol

CITIZENSHIP SEX/GENDER CIVIL DATE OF BIRTH AGE PLACE OF BIRTH HOME MOBILE PHONE
FILIPINO Male STATUS (MM/DD/YY) 22 Cangawa, Buenavista, Bohol PHONE 09304280112
Single 05/19/01

CURRENT ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

NUMBER/STREET) Centro Cangawa Buenavista Bohol

OTHER ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

NUMBER/STREET)

HIGHEST EDUCATIONAL OCCUPATION ID CARD PRESENTED EMAIL ADDRESS (If Any)

ATTAINMENT Student Philippine National ID [email protected]
College Level

ITEM “B” – SUSPECT’S DATA

FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
1. Warriors 1. Joren 1. Damulag 1. Ren
2. Warriors 2. Junie 2. Damulag 2. Jun
3. Warriors 3. Nicko 3. Damulag 3. Ko
CITIZENSHIP SEX/GENDER CIVIL DATE OF BIRTH AGE PLACE OF BIRTH HOME MOBILE PHONE
1. Filipino 1. Male STATUS (MM/DD/YY) 1. 20 1. Dait, Buenavista, Bohol PHONE 1. 09128945123
2. Filipino 2. Male 1. Single 1. 01/02/03 2. 28 2. Dait, Buenavista, Bohol 2. 09873412099
3. Filipino 3. Male 2. Single 2. 01/25/95 3. 25 3. Dait, Buenavista, Bohol 3. 09548921432
3. Single 3. 01/12/98
CURRENT ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
NUMBER/STREET) 1. Dait 1. Buenavista 1. Bohol
2. Dait 2. Buenavista 2. Bohol
3. Dait 3. Buenavista 3. Bohol
OTHER ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
NUMBER/STREET)

HIGHEST EDUCATIONAL OCCUPATION ADDRESS RELATION TO VICTIM EMAIL ADDRESS (If Any)
ATTAINMENT 1. None 1. None
1. College Level 2. Bus Driver 2. None
2. College Level 3. None 3. None
3. College Level
IF AFP/PNP PERSONNEL: RANK UNIT ASSIGNMENT GROUP WITH PREVIOUS CRIMINAL STATUS OF PREVIOUS CASE
AFFILIATION RECORD?
( ) Yes (/) No
(If Yes, Pls. Specify)

HEIGHT WEIGHT SWUIL COLOR OF EYES DESCRIPTION OF COLOR OF DESCRIPTION OF UNDER THE INFLUENCE?
1. 1.58 cm 1. 59 kg 1. Brown EYES HAIR HAIR □ NO □ DRUGS
2. 1.60 cm 2. 62 kg 2. Brown 1. “Singkit” 1. Black 1. Straight □LIQUOR □ OTHERS
3. 1.65 cm 3. 64 kg 3. Brown 2. “Singkit” 2. Black 2. Straight
3. “Singkit” 3. Black 3. Curly
FOR CHILDREN IN CONFLICT WITH THE LAW
NAME OF GUARDIAN GUARDIAN ADDRESS HOME PHONE MOBILE PHONE

ITEM “C” – VICTIM’S DATA

FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
1. Dakogulo 1. Turikmaw 1. Del 1. Amaw
2. Dakogulo 2. Ayawkol 2. Del 2. Kol
CITIZENSHIP SEX/GENDER CIVIL DATE OF BIRTH AGE PLACE OF BIRTH HOME MOBILE PHONE
1. Filipino 1. Male STATUS (MM/DD/YY) 1. 23 1. Cangawa, Buenavista, Bohol PHONE 1. 09776611000
2. Filipino 2. Male 1. Single 1. 01/01/00 2. 22 2. Cangawa, Buenavista, Bohol 2. 09304280112
2. Single 2. 05/19/01
CURRENT ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
NUMBER/STREET) 1. Centro 1. Cangawa 1. Buenavista 1. Bohol
2. Centro 2. Cangawa 2. Buenavista 2. Bohol
OTHER ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
NUMBER/STREET)
HIGHEST EDUCATIONAL OCCUPATION WORK ADDRESS EMAIL ADDRESS (If Any)
ATTAINMENT 1. Student 1. [email protected]
1. College Level 2. Student 2. [email protected]
2. College Level

ITEM “D” – NARRATIVE OF INCIDENT

TYPE OF INCIDENT DATE/TIME OF INCIDENT PLACE OF INCIDENT
Alleged Serious Physical Injuries Incident May 10, 2023 at 8:25 PM Centro Cangawa, Buenavista, Bohol

Initial investigation disclosed that on the said TDPO, while the two brothers named Turikmaw and Ayawkol Dakogulo
walking on the said place when the incident happens along the road in Centro Cangawa, Buenavista, Bohol. The group of drunk
people consist of three persons are walking towards them, when suddenly punch, kick, and hit them with the 2x2 wood that resulted
to a fractured right arm of Turikmaw. After that, the suspects run quickly away from the scene. The residents help the two brothers
and brought them to the police station.

Further, at about 8:40 PM Turikmaw and Ayawkol D. Dakogulo arrive at the police station 1 in Buenavista. The police
officer conducted a report and brought Turikmaw D. Dakogulo to hospital for medical attention. After that, the police officers
conduct a follow up operation together with Ayawkol D. Dakogulo to arrest the suspects.

The victims Turikmaw and Ayawkol D. Dakogulo was examined by Dr. Andres Bonifacio for physical examination. The
initial findings of the medical examination are that the two victims received a multiple contusion in their heads and bodies. One of
the victims Turikmaw D. Dakogulo also receive a bone fracture in his right arm located at his wrist.

I HEREBY CERTIFY TO THE CORRECTIONS NAME OF REPORTING PERSON SIGNATURE OF REPORTING PERSON
OF THE FOREGOING TO THE BEST OF MY Ayawkol D. Dakogulo
KNOWLEDGE AND BELIEF.

SUBSCRIBED AND SWORN TO BEFORE ME NAME OF ADMINISTERING OFFICER (DUTY OFFICER) SIGNATURE OF ADMINISTERING OFFICER (DUTY
PLT Seijorey Logrosa OFFICER)

RANK, NAME AND DESIGNATION OF POLICE OFFICER (WHETHER HE/SHE IS THE DUTY SIGNATURE OF REPORTING PERSON
INVESTIGATOR, INVESTIGATION ON CASE OR THE ASSISTING POLICE OFFICER)
PLT Seijorey Logrosa

INCIDENT RECORDED IN THE BLOTTER BY: RANK /NAME OF DESK OFFICER: SIGNATURE OF DESK BLOTTER ENTRY NR:
PLT Seijorey Logrosa SPO1 Rey Sebusa OFFICER: 010-519

REMINDER TO REPORTING PERSON

Keep the copy of this Incident Record Form (IRF). An update of the progress of the investigation of the crime or incident that you reported will be
given to you upon presentation of this IRF. For your reference, the data below is the contact details of this police station.
Name of Police Station Buenavista Police Station Telephone 09192939444

Investigator-on-Case PLT Seijorey Logrosa Mobile Phone 09281838555

Name of Chief/Head of Office PLTCOL John Rey Logrosa Mobile Phone 09271737111