Republic of the Philippines

NATIONAL POLICE COMMISSION

PHILIPPINE NATIONAL POLICE
LEYTE POLICE PROVINCIAL OFFICE
ORMOC CITY POLICE STATION 1
Cogon, Ormoc City

OCPS1INVST
RECEIPT/ INVENTORY FOR PROPERTY SEIZED

THIS IS TO CERTIFY that the inventory was conducted in connection with the POLICE
OPERATION (BUY BUST). to wit:
PERSON/s ARRESTED: NOLY BUSCAY 32 years old, male, married, driver and GONSALO
CRUZ 29 years old,male, single, laborer and both resident of Brgy. Mejia Ormoc City.
DATE/TIME ARRESTED: JUNE 8, 2021/ 10:00 A.M
PLACE OF ARREST: BRGY. MACABUG, ORMOC CITY
NATURE OF ARREST: INCIDENTAL TO A LAWFUL ARREST
This certifies further that the following item(s) property (ies) was/were purchased and
seized/recovered during the Police Operation to wit:

ITEM NO. DESCRIPTION MARKINGS

1 1 One(1) unit of deadly knife MRD and ADM -1 to 8
recoverd
2 Two(2) PCs plastic sachet MRD and ADM- 9 to 10
shabu containing white
crystalize

CHAIN OF CUSTODY
Turned Over By: PAT Signature:
PAT Police Poseur Buyer/Seizing
Officer
Received By: PAT Signature:
Evidence Custodian
DATE: June 8, 2021 TIME: 1:00 pm

Signed and Received a Copy:

Korena Sanchez RICHARD GOMEZ

Media Representative Elected Officials

SUBSCRIBE and SWORN to before me in the City of Ormoc, Philippines this 8th day of June
2021.

PROs: MONDELO, ERICA LYN N.

Administering Office
Freely and voluntarily narrated by NANCY CABAHUG during the investigation of police chief
inspector MONDELO, ERICA LYN N. Here inside the Ormoc district hospital this 5th of
September 2021 at 3:00 pm in front of some witnesses in by questions and answers:
1. Question: What happened to you ma'am?
Answer: Sir, I was shot.
2. Question: Who shot you?
Answer: They are two sir Mato Rambo Demillo and Albert Dimal Martinez of Brgy. Macabug,
Ormoc City.
3. Question: When and where were you hit?
Answer: Just now sir about 10 minutes ago (2:50 PM September 5, 2021) on the river bank of
Macabug Ormoc City.
4. Question: What was the reason or cause and why were you shot?
Answer: Sir, the two men both flirted with me and I didn't answer because they don't have jobs
(suspect)
5. Question: What is your name? Who is your spouse and where do you live?
Answer: I am Maria Leonora Dimas of Brgy. Macabug Ormoc City, I have no husband and our
house is just near the river bank.
6 .Question: Do you tell the truth and believe in god?
Answer: Yes sir
7. Question: Can you still heal your wound
Answer: Yes sir, but I'm getting weaker sir, my vision is blurred, please help me sir.
8. Question: Are you ready to sign this statement of yours?
Answer: Yes sir

Protacio Eclionil Boholst

&
Jose Eclionil Boholst
WITNESS

Police Chief Ins.: MONDELO, ERICA LYN N.

INVESTIGATOR

NANCY CABAHUG
DECLARANTS

VERIFICATION
This is to prove that I took the statement of NANCY CABAHUG inside the hospital of ormoc
district hospital, ormoc city today the 5th of September 2021 at 3:00 pm.

Police Chief Ins : MONDELO, ERICA LYN N.

INVESTIGATOR