Sample Format of Complaint Sheet Carnapping Incident by HC120522065232

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									Sample Format of Complaint Sheet (Carnapping Incident)


Republic of the Philippines
Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE
______________________________________

_______________________


                                                  Date: _____________________

COMPLAINT SHEET

Name of Suspects:
______________________________________________________________________
Last Known Address:
______________________________________________________________________
Nature of Offense:
______________________________________________________________________
Place Where Offense was Committed:
______________________________________________________________________
Date/Time Offense was Committed:
______________________________________________________________________
Local Police Office First Reported:
______________________________________________________________________
Date Reported:
______________________________________________________________________
Witness:
______________________________________________________________________

Brief Statement of Complaint                Sketch
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________




Description of the Motor Vehicle
Make/Type                    Year Model                   Color

Plate Number                 Chassis Number               Engine Number

MV File Number               Registered Owner             Address


CERTIFICATION

       I, ___________________________________, after having been duly sworn to in
accordance to law do hereby depose and say:
       That I am the complainant of the aforesaid complaint;
       That I have read the essence and signed the same;
       That all the allegations contained herein are true and correct to the best of my
knowledge and hereby warrant under penalty of perjury and;
       That I will immediately inform the PNP-HPG in case the above described motor
vehicle is recovered (by us) so that alarm could be lifted.



Conformed By: _________________________              _______________________
                (Registered Owner)                         (Driver)

                                        Address: __________________________
                                        Tel/Cell No. _______________________




        SUBSCRIBED AND SWORN to before me this ______day of __________.,
affiant exhibited to me his/her Residence Certificate No.___________________ issued
at _____________ on ________________.


                                                        _________________
                                                              (Notary Public)


   Note: Person found guilty of perjury is liable under Art. 183 of the Revised Penal
         Code.

								
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