Republic of the Philippines

Department of the Interior and Local Government

Pangasinan Police Station
Pangasinan City

Republic of the Philippines

Department of the Interior and Local Government
Pangasinan Police Provincial Office
January 10,2023

The Honorable City Chief Prosecutor

Office of Pangasinan City Prosecutor
Justice Hall, Pangasinan City

(Attn: Duty Inquest Prosecutor)

Greetings :

I have the honor to refer to your Office, the records of investigation relative to the case of Parricide
committed at about 10:30 a.m. at January 9, 2023 at Golden Success Hotel Mangaldan Pangasinan City.

COMPLAINANT : Patricia Mae J Par, 45 years old, Widow, Mother of the victim and resident of Pangasinan City

VICTIM : MARILYN, 39 years old, Filipino, Married

SUSPECT (ARRESTED/DETAINED): RICHARD ACOSTA, 41 years old, Filipino , Married

EVIDENCE RECOVERED : One small tool with a knife

FACTS OF THE CASE:

Invesyigation disclosed that on or about 10:30 a.m, Parricide incidend happened at Golden Success Hotel
Mangaldan Pangasinan City. On January 8, 2023, at around 7:45 a.m., Marilyn, 39, a Filipino worker abroad, and her
41-year-old husband Richard Acosta head to the Golden Success Hotel on Mangaldan Pangasinan. Three hours
later, "Richmond," the roomboy, saw Richard Acosta leaving the couple's room with blood all over his body. The
responding policeman discovered Marilyn, the victim, under the bed with blood all over her body and 300 stab
wounds; she was taken to the Mangaldan Rural Health Unit right away, where she was pronounced dead. The police
claimed that Marilyn was killed with a small tool and a knife. The suspected was. Arrested near to the old PNP
Building and they speculated that jealousy may have been the motivation behind the crime.

ENCLOSURES :

a) Subscribed NPS Investigative Data Form

b) SS of the complainant
c) SS of witness
d) SS of witness
e) Joint Affidavit of Arrest of
f) Medico-Legal Report
g) As stated evidence recovered
g) Death Certificate of the Victim
i) Anatomical Sketch of the Victim
j) Booking and Information of the suspect
k) And others to be presented later.

This case will be presented to you by Lt. Col. Benjamin Zarate Jr of this Office during the course of inquest
proceedings. Further, request furnished this Office copy of resolution of the case and other proceedings.

For appropriate action and disposition.

 Republic of the Philippines
Department of the Interior and Local Government
Pangasinan Police Station
Pangasinan City

Lt. Col. Benjamin Zarate Jr

Chief of Police

Another Sample Format of Case Referral

Republic of the Philippines

Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
______________________________________
_______________________

(Date)
Hon. Chief, State Prosecutor
Department of Justice,
Padre Faura, Manila

Sir/Madam:

Respectfully referred to your good office for inquest proceedings are the herein
record of investigation relative to a case for Robbery committed as follows:

VICTIMS/COMPLAINANTS: MARILYN, 39 years old, Filipino, Married

RESPONDENTS: _____________

WITNESSES: ______________________________

Date/Time and Place of Occurrence:

On January 8, 2023 at about 7:45 am along

Evidences:
1. Sworn Statement of Complainant/s
2. Sworn Statement of Witnesses
3. Joint affidavit of Arresting Police Officers
4. Others to be presented later.

FACTS OF THE CASE:

(Complete brief narrative of the facts)

This case will be presented by (name of investigator-on-case).

 Republic of the Philippines
Department of the Interior and Local Government
Pangasinan Police Station
Pangasinan City

Very truly yours,

__________________________
(CHIEF OF OFFICE)