Republic of the Philippines

MANILA POLICE DISTRICT

DISTRICT MOBILE PATROL UNIT
United Nations Avenue, Ermita, Manila

COMPLAINT SHEET

1. Complaint No. 2011-11-014 November 10, 2011

Date
2. Report Through: 3. Previously Reported to Other Agency: ___ yes__X__ No if yes,
___x____ In Person a) To What Agency
________ Telephone b) By Whom
________ Others (Specify) c) Date/Time
4. Nature of Complaint/Information: 5. Place of Occurrence/Incident: 6. Date/Time:
Shooting Incident At Dimasalang cor. A. Maceda Sts., Sampaloc, November 10, 2010 /
Manila 10:00 am
7. Name of Complainant/Informer: 8. Address: 9. Tell Number:
Marites Bautista y Lozano 1015 Craig Street, Sampaloc, Manila None

10. Name/s of Victim/s: 11. Age: 12. Sex: 13. Address: 14. Tell Number:
Alexander Bautista y Perez 50 Male 1015 Craig Street, Sampaloc, None
Manila
15. Name/s of Witness/es 16. Address: 17. Tell Number:
1. Rey S. Cereneo 1.314 Sta. Teresita St., Sampaloc, Manila None
2. Eddie B. Mangrubang 2. 1025 Antipolo St., Sampaloc, Manila
18. Name/s of Suspect/s 19. Aliases: 20. Sex: 21. Age: 22. Address:
Carlo Villegas y San Pedro Caloy Male 40 1025 Craig Street, Sampaloc, Manila

23. Brief Narrative of Complaint/Information (Use Back Page, if Necessary)

On November 10, 2011 at about 10:00 o'clock in the morning a shooting incident transpired at the corner of
Diamasalang and A. Maceda Streets, Sampaloc, Manila wherein victim one ALEXANDER BAUTISTA y PEREZ, 50 yrs
old, married,driver and lastly resided at 1015 Craig Street, Sampaloc, Manila was shot several times by suspect
CARLO VILLEGAS y SAN PEDRO @ CALOY, 40 yrs. old, married, driver and a resident of 1025 Craig Street, Sampaloc,
Manila. As a consequence thereof, the victim sustained several gunshot wounds in the different parts of the body and
head and was rushed to Ospital ng Sampaloc, Geronimo Street, Sampaloc, Manila for medical treatment but was
pronounced dead on arrival (DOA) by the attending physician thereat.

24. I CERTIFY that the details of the complaint/information stated 25. Signature of Complainant/Informer:
above are true and correct to the best of my knowledge and belief.

26. SUBSCRIBED AND SWORN TO before me this __11th_
day of _November 2011_ at _Manila, Philippines.
28. Date/Time of Complaint/Information Received:
27. Printed Name/Signature of Administering Officer:
PCI EDGAR A REYES
Chief of Office
29. Printed Name/Signature of Receiving Officer:

November 11, 2011/10:05 a.m. SPO1 Rodolfo B. Agcaoili, Jr.

Desk Officer
30. Disposition:
Referred to: PO2 Jorlan O. Taluban 30. Case Number: 2011-11-014

32. Referred by: PSI RAMON DELA CRUZ 33. Date/Time: November 10, 2011/10:05 a.m.

34. Referral Number: 35. Assigned to: 36. Printed Name, Rank, Designation and Signature of
Office Making Assignment/Referral.
2011-11-014 PO2 Jorlan O. Taluban

PCI EDGAR A REYES

Chief of Police