Republic of the Philippines

NATIONAL POLICE COMMISSION

PHILIPPINE NATIONAL POLICE
Pagalungan Municipal Police Station
Poblacion, Pagalungan, Maguindanao
mpspagalungan@yahoo.com

September 24, 2022

TURN-OVER OF ARRESTED SUSPECT

BLOTTER ENTRY NO:____________________ Date: ______________

This is to certify that the following arrested suspect/s identified as indicated:

Name: _____________________________________________________________
Address: ___________________________________________________________
Sex:_________ Age: ___ DOB:_____________POB:_________________________

Name: _____________________________________________________________
Address: ___________________________________________________________
Sex:_________ Age: ___ DOB:_____________POB:_________________________

Name: _____________________________________________________________
Address: ___________________________________________________________
Sex:_________ Age: ___ DOB:_____________POB:_________________________

Name: _____________________________________________________________
Address: ___________________________________________________________
Sex:_________ Age: ___ DOB:_____________POB:_________________________

Who was/were arrested on ____________________ at

__________________________________________________________________

This further certifies that the arrested suspect/s have been examined by Dr.
________________________ on _______________ at ______________________.

RANK/NAME/SIGNATURE OF DUTY INVESTIGATOR RANK/NAME/SIGNATURE OF ARRESTING OFFICER

____________________________________ ____________________________________
____________________________________ ____________________________________

Received by:
_____________________________
Rank/Name/Signature of Duty Jailer
Time/Date:____________________