CASEFILE
CASEFILE
Initial Report:
CRIME AND INCIDENT REPORT
C.R NO:
DATE: JULY 5, 2024 TIME:
OFFENCE:
(A.) DIVISION
(B) POLICE STATION
(C.) REPORTING DATE AND TIME
(D.) DATE AND TIME OFFENCE WAS COMMITTED
(E.) LOCATION SUB-LOCATION
SPECIFIC PLACE WHERE THE CRIME WAS COMMITTED
MAP REFERENCE:
(F.) NAME OF THE VICTIM: JAYSON CALBUGAN
NATIONALITY: FILIPINO
GENDER: MALE
AGE: 15YO
OCCUPATION: N/A
(G.) ALL RELEVANT PARTICULARS OF THE CRIME
(H.) NAMES OF THE ACCUSED
LENA ROBREDO
NATIONALITY: FILIPINO
GENDER: FEMALE
AGE: 28
OCCUPATION: RESELLER
RIGOR MAGSAYSAY
NATIONALITY: FILIPINO
GENDER: MALE
AGE: 32
OCCUPATION: COMPUTER TECHNICIAN
RELATIONSHIP IF THE VICTIM
(I.) POLICE STATION
(J.) ANY PREVIOUS REPORT
(K.) PERSON PASSING
(L.) INVESTIGATING OFFICER
(M.) RECEIVING
SIGNAL – INFORMING HEADQUARTERS
POLICE STATION:
1. Name of place where crime occurred or where the victim was found (state
which).
2. Distance and direction from Police Station.
3. Date and time of the victim was seen and the circumstances leading to the
discovery.
4. Name, father's name and residence of victim.
5. Nationality.
6. Sex and probable age.
7. Religion
8. Occupation.
9. Names and residence of two or more persons, relatives, if possible, who identify
the victim.
10. Expression of countenance.
11. Injuries, marks of violence, wounds and bruises, show position, length and
breadth.
12. Amount, position and probable source of any blood visible.
13. In what manner or by what weapon or instrument the visible wounds and bruises
appear to have been caused.
14. Was there any foreign matter, such as weeds, straw, etc. the hair of clenched in
the hands of the deceased, or attached to any part of the body?
15. Is the body well-nourished and vigorous of emaciated and feeble?
16. Is it stout, thin?
17. Height by measurement from head to foot.
18. Distinguishing marks-position and appearance of moles, scars, etc.
A. NATURE OF CASE:
B. VICTIM:
C. SUSPECT :
D. TDPO:
E. SPECIMEN SUBMITTED:
2. further request that this Office be furnished a copy of medico legal examination result for our
reference
3.For Consideration
CHIEF OF POLICE
CASE :
SUSPECT : __________________
VICTIM:_____________________
SPECIMENS SUBMITTED :
FINDINGS:
CONCLUSION:
REMARKS :
EXAMINE BY:
VERIFY BY:
APPROVED BY:
SUB-FILE C
SPECIMEN SUBMITTED :
FINDINGS:
Q1 and S1
Q1 and S2
Q1 and S3
Q1 and S4
CONCLUSION:
REMARKS :
SUB-FILE D
WITNESS STATEMENT
CASE NO.
INCIDENT:
WITNESS FULL NAME:
ADDRESS:
WITNESS STATEMENT
I, ________________________, age, civil status, resident of
__________________________, _________, after having sworn in accordance with
law, do hereby depose and state THAT:
01. I was present and personally saw that accused, __________, committed the
crime of ___________________________ against the victim _______________;
02. (State other circumstances and the relation either to the victim or accused
or both);
03. (State the details of the acts committed by the accused against the victim.
04. (State the acts done by the witness and the reason thereof);
I executed this affidavit to attest the truthfulness of the foregoing facts and to
support the filing of Criminal Cases against _______________________________
for violations of ________________________.
_____________________
Notary Public
SUB-FILE E