6. Booking -SNATCHING

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Republic of the Philippines

Department of the Interior and Local Government


PHILIPPINE NATIONAL POLICE
POLICE REGIONAL OFFICE 9
KATIPUNAN MUNICIPAL POLICE STATION
Katipunan Zamboanga Del Norte

PNP ARREST AND BOOKING SHEET


(To be accomplished by the Arresting Officer)

BLOTTER ENTRY NR: ________0241


MARCH 20, 2014
DATE: _____________________
PERSONAL INFORMATION:
REYES JUAN LAURO N/A
(Last Name) (First Name) (Middle Name) (Qualifier)

ADDRESS :BRGY UNO, KATIPUNAN ZAMBOANGA DEL NORTE


TEL NO: ______
NONEPOB:_______________________ DOB: _________________
MARITAL STATUS: SINGLE WIDOW/ER SEX: MALE
MARRIED SEPARATED FEMALE
AGE: _____
40 WEIGHT: ______
67 HEIGHT: _____
5’5” EYES: _____ HAIR: ____
BLACK BLACK
COMPLEXION: _____
BROWN OCCUPATION: ________
UNEMPLOYED NATIONALITY: __________ FILIPINO
ETHNIC GROUP: ________
TAGALOG DIALECT/LANGUAGE: _______________
TAGALOG
HIGHEST EDUCATIONAL ATTAINMENT: __________________________
COLLEGE UNDERGRADUATE
NAME OF SCHOOL: _________________________________________
JOSE RIZAL STATE COLLEGE
LOCATION OF SCHOOL: ______________________________________
TONDO MANILA

IDENTIFYING MARKS: MOLE TATOO BIRTHMARK SCAR


LOCATION OF IDENTIFYING MARKS: _____________________
MOLE LEFT CHEEK
PHYSICAL DEFORMITY/DEFECT: _______ NONE
DRIVER’S LIC NR: ______
N/A ISSUED AT: ______
N/A ON: ______
N/A
RES CERT NR : ______
N/A DATE AND PLACE OF ISSUE: ________________
N/A
OTHER ID CARDS: ______
N/A ID NR: N/A
ARREST INFORMATION: ______________________
THEFT _____ CC#1234
OFFENSE CHARGE: (NATURE OF OFFENSE) (CRIM/IS NO.)
MODUS OPERANDA : _______
NONE
PLACE OF ARREST : ___
BRGY______________________________________
BLUMENRIT
DATE OF ARREST : __________________
MARCH 20, 2014 TIME: _______________
2:40 PM
ARRESTING OFFICER/S:
RANK: _______________________________
PAT JOHN BOGART SIGNATURE: __________________
_______________________________
PSSg RONALD KUGMO SIGNATURE: __________________
UNIT: ____________________________________
PS9 MANILA

MEDICAL EXAMINATION CONDUCTED AT: ________________________________________


TONDO HOSPITAL, MANILA
BY: DR. ______________
PEDRO AGUSTIN ON: __________ REMARKS: _______________________
MARCH 20, 2014
FINGERPRINT TAKEN BY : _______________________________
PSMS ABLERTO DIAZ
PHOTO TAKEN BY : _______________________________
PSMS ABLERTO DIAZ
INVESTIGATOR ON CASE : _______________________________
PSMS KENT TUTAN
BOOKED BY (RANK/NAME/SIGNATURE: _________________________________
PSMS ABLERTO DIAZ
SIGNATURE OF PERSON ARRESTED: ____________________________________________
(INDICATE IF SUSPECT REFUSE TO SIGN)
OTHER INFORMATION:
NAME OF FATHER: _________________________
JONATHAN REYES AGE : _______ 70
ADDRESS:________________________________
DIVISORIA, MANILA
NAME OF MOTHER:_________________________
ROSALINA REYES AGE : ______ 66
ADDRESS: ________________________________
DIVISORIA, MANILA
NAME & ADDRESS OF PERSON TO BE CONTACTED IN CASE OF EMERGENCY:
NAME : ____________________________
ROSALINA REYES RELATIONSHIP: ________ MOTHER
ADDRESS: __________________________
DIVISORIA, MANILA TEL #: _______ none
LAWYER: _______
none TEL #: _______ none
DOCTOR: _______
none TEL #: _______ none
HEALTH PROBLEM: _________
none
NOTE: USE THE PNPCL FORM 452-038 (STANDARD TEN PRINT CARD) TO TAKE THE TENPRINT OF
THE SUSPECT FOR EVENTUAL SUBMISSION TO PNPCL-AFIS
(ATTACH THE MEDICAL EXAM RESULT; MUG SHOTS; TENPRINTS OF SUSPECT)

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