Republic of the Philippines

NATIONAL POLICE COMMISSION

PHILIPPINE NATIONAL POLICE
LEYTE POLICE PROVINCIAL OFFICE
ALBUERA POLICE STATION
Albuera, Leyte
-oOo-

ALBPS-
CERTIFICATION

To Whom It May Concern:

THIS IS TO CERTIFY that the following is the true, correct and honest reproduction
from the original copy from the Police Blotter of the Albuera Police Station, Albuera, Leyte; to
wit:
Entry No : TIME : DATE : INCIDENT / EVENT
: 06:30 pm : 04/01/19 : Traffic Accident
OCCURRENCE: At about 06:00 o’clock of the evening of April 01, 2019 along the National
Highway of Barangay Talisayan, Albuera, Leyte.
VEHICLE: Single motorcycle SUZUKI FJ110LB color red bearing Temporary Plate No.080102
registered under CR# 186534493 dated 02/17/2017 covered under OR# 1566754906 dated
02/22/2019 registered by the name of Christian Vic B Longakit a resident of Sitio Malitbog,
Barangay Poblacion, Albuera, Leyte.
DRIVER: Christian Vic Longakit y Baronda, 22 years old, single, driver possessed Non-
professional Driver’s license No. H03-16-002737 expire on 2023/12/18 with restricted code
1,2 and a resident of Sitio Malitbog, Barangay Poblacion, Albuera, Leyte.
PEDESTRIAN: Angelo Ebano y Cabanza, 7 years old, grade 2 pupil of Talisayan Elementary
School, Son of Mr. & Mrs. Ester Ebano and resident of Barangay Talisay, Albuera, Leyte.
FACTS:
That about 6:15 in the evening of the present date this station received a call informing
this station regarding on the traffic accident involving a single motorcycle and a pedestrian.
Acted on said information personnel of this station led by PO3 Joel T Lomarda went to the
reported place, upon arrival thereat both driver and victim were left and rushed to
GATCHALIAN Hospital Ormoc City. Initial investigation conducted by the responding policemen
from the bystander/eye witness in the area revealed that while the pedestrian together with
his mother waiting at the shoulder of said road were about to cross was accidentally hit by
the aforementioned vehicle originating from Ormoc City heading to his home and both fell at
the pavement. As a result, thereof, both victim and driver who sustained injuries on their
different part of their body were brought to the above stated hospital and the vehicle involved
was brought to this station for proper disposition.

THIS IS TO CERTIFY further that the record of event was officially entered into
the Police Blotter.

ISSUED this 5th day of April 2019 at Albuera Police Station, Albuera, Leyte, for
the interested party for whatever legal purposes this may serve.

( ) Criminal Case ( ) Civil Case ( ) Admin Case

( ) Referral ( ) Insurance Claim ( X ) Others
Official Receipt: 3128240-B
Date Issued: April 5, 2019
Amount Paid: PhP. 50.00
Issued at: MTO, Albuera, Leyte

SALVADOR G APACIBLE JR
Police Captain
Acting Chief of Police