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Republic of the Philippines

NATIONAL POLICE COMMISSION


PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 4A
BATANGAS POLICE PROVINCIAL OFFICE
NASUGBU MUNICIPAL POLICE STATION
Escalera st. Barangay 2, Nasugbu, Batangas
nasugbumunicipalpolicestation@yahoo.com/09275001199

CHAIN OF CUSTODY FORM


(DRUG EVIDENCE)

Name of Case: _________________________________________________________

Name of Suspect/s: ____________________________________________________

Time, Date, Place of Occurrence:


______________________________________________________________________

Seizing Officers / Operating Unit: _________________________________________

Description of Evidence/s: _______________________________________________


______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

TURNED OVER BY: ________________________________


(Name and Designation)
Agency / Address: ________________________________
Time and Date: ________________________________
Remarks: ________________________________

Received By: ________________________________


(Name and Designation)
Agency / Address: ________________________________
Time and Date: ________________________________
Remarks: ________________________________
TURNED OVER BY: ________________________________
(Name and Designation)
Agency / Address: ________________________________
Time and Date: ________________________________
Remarks: ________________________________

RECEIVED BY: ________________________________


(Name and Designation)
Agency / Address: ________________________________
Time and Date: ________________________________
Remarks: ________________________________
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 4A
BATANGAS POLICE PROVINCIAL OFFICE
NASUGBU MUNICIPAL POLICE STATION
Escalera st. Barangay 2, Nasugbu, Batangas
nasugbumunicipalpolicestation@yahoo.com/09275001199

Date:
CHAIN OF CUSTODY FORM
(FOR LABORATORY)

DESCRIPTION OF EVIDENCE ITEM QUANTITY REMARKS

Delivered By: ________________________ / Arresting Officer


(Name and Designation)

Agency/Address: Nasugbu MPS/Nasugbu, Batangas

Date and Time: ______________________________

Received By: ________________________________


(Name and Designation)

Acknowledgement Receipt No. ____________ Date: ___________ Time: _________

Remarks: ____________________________________________________________

Examined By: ______________________________________


(Name and Designation)

Lab Case No. ______________________________ Date: _____________________

Chemistry Report No. _______________________ Date: _____________________

Turn Over Receipt No. ____________________ Date: ____________ Time: _______

Received by Evidence Custodian: ________________________________________


(Name and Designation)

Acknowledgement Receipt No. ____________ Date: ___________ Time: ________

Remarks:______________________________________________________________

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