PNP BOOKING FORM 2 Arrest and Booking Form

Republic of the Philippines

Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
Prieto Diaz Municipal Police Station
Bgy Perlas, Prieto Diaz, Sorsogon
Picture
2x2 PNP ARREST AND BOOKING SHEET
FRONT VIEW (to be accomplished by the Arresting Officer)

BLOTTER ENTRY NR: ____________ DATE: September 6, 2017

PERSONAL INFORMATION:

_______DOMDOM ELVIS JR GUAZIL

(Last Name) (First Name) (Middle Name)
ADDRESS: BGY LUPI, PTO DIAZ, SORSOGON
TEL NO._None POB HAPPY VALLEY, CANLUBANG, LAGUNA DOB MAY 17, 1981
MARITAL STATUS: SINGLE WIDOW/ER SEX: MALE
MARRIED SEPARATED FEMALE
AGE: 36 y/o WEIGHT (lbs): 130 lbs HEIGHT (Ft): 56 EYES:Black HAIR:Black
COMPLEXION:FAIR OCCUPATION: JOBLESS NATIONALITY:FILIPINO
ETHNIC GROUP: TAGALOG DIALECT/LANGUAGE: BICOL, FILIPINO, ENGLISH
HIGHEST EDUCATIONAL ATTAINMENT: VOCATIONAL COURSE GRADUATE
NAME OF SCHOOL:TESDA
LOCATION OF SCHOOL: BGY CUMON, MALINAO, ALBAY
IDENTIFYING MARKS: MOLE TATOO BIRTHMARK SCAR
LOCATION OF IDENTIFYING MARKS: TATTOO ON RIGHT ARM AND SHOULDER
PHYSICAL DEFORMITY/DEFECT : NONE
DRIVERS LIC NR:NONE ISSUED AT: _ ______ ON:
RES CERT NR: None DATE AND PLACE OF ISSUE:
OTHER ID CARDS: None ID NR:
ARREST INFORMATION:
OFFENSE CHARGE: ATTEMPTED MURDER
(NATURE OF OFFENSE) (CRIM/IS NO.)
MODUS OPERANDA:
WHERE ARRESTED: BGY LUPI, PTO DIAZ, SORSOGON
DATE ARRESTED: SEPTEMBER 6, 2017 TIME: 6:00 PM
ARRESTING OFFICER/S:
Rank:SPO2 Name: NOEL DESTAJO Signature:
Rank:SPO1 Name: MARK DESOLOC Signature
RankPO2 Name: RYOCEX TOLOSA Signature:
RankPO1 Name: MANUEL ALMONTE Signature:

SIGNATURE___________________________________ UNIT: Prieto Diaz MPS

MEDICAL EXAMINATION CONDUCTED AT: Prieto Diaz Municipal hospital

BY: DR. ON:
REMARKS:
FINGERPRINT TAKEN BY: SPO2 Johanes J Tayam
PHOTO TAKEN BY: SPO2 Johanes J Tayam

INVESTIGATOR ON CASE:
BOOKED BY (RANK/NAME/SIGNATURE): SPO2 Johanes J Tayam
SIGNATURE OF PERSON ARRESTED:
(INDICATE IF SUSPECT REFUSE TO SIGN)
OTHER INFORMATION:
NAME OF FATHER: ELVIS DOMEN DOMDOM SR AGE:
ADDRESS: BGY LUPI, PTO DIAZ, SORSOGON
NAME OF MOTHER: HERMENIA FLORES GUAZIL (DECEASED) AGE:
ADDRESS:
NAME & ADDRESS OF PERSON TO BE CONTACTED IN CASE OF EMERGENCY:
NAME: REYNALYN BENITEZ DELOS REYES-DOMDOM RELATIONSHIP: wife
ADDRESS: BGY LUPI, PTO DIAZ, SORSOGON TEL #
LAWYER: _________________________________________ TEL #:
DOCTOR: _________________________________________ TEL #:
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) (JAY AR O)