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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 2
NUEVA VIZCAYA POLICE PROVINCIAL OFFICE
BAYOMBONG POLICE STATION
Camp Col Daniel C Lantion Sr., La Torre South Bayombong, Nueva Vizcaya
March 2, 2024
EXCERPT FROM THE POLICE BLOTTER
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY that the following events/incidents were recorded in the
Police Blotter to wit
Date Entered – March 2, 2024
Time Entered – 4:00 PM
Entry Number – 0013-03-02-24
At about 3:30 PM on March 2, 2024, Jake Peralta, 20 years old, single, a native
of Ifugao and currently residing at District 4, Bayombong, Nueva Vizcaya, called to this
station to report Murder which, victimizing one Jan Stanley Diozon, male, 21 years old,
single, student and a native of Washington, Solano and currently residing at Banaqueen
Subdivision, Bayombong, Nueva Vizcaya.
THIS EXCERPT is issued upon request for whatever legal purposes it may serve best.
DARYL BUYAYO
Police Captain
Chief of Police
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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 2
NUEVA VIZCAYA POLICE PROVINCIAL OFFICE
BAYOMBONG POLICE STATION
Camp Col Daniel C Lantion Sr., La Torre South Bayombong, Nueva Vizcaya
FIRST RESPONDER'S FORM
CSI Form 2: Request for the Conduct of SOCO
REQUEST FOR THE CONDUCT OF SOCO
4:00 PM of March 2, 2024
Time and Date
FOR : Chief, PMAJ DARYL BUYAYO
FROM : PEMS Jerome Leal
SUBJECT : SOCO Assistance
1. Request for the availability of SOCO Team to process the crime scene located at
SMU Campus, Ponce Street, Bayombong, Nueva Vizcaya.
NATURE OF CASE : Murder
NAME OF VICTIM : Jan Stanley Diozon, male, 21 years old, single,
student and a native of Washington, Solano and currently residing at Banaqueen
Subdivision, Bayombong, Nueva Vizcaya.
TDPO : On or about 5:00 pm of March 2, 2024 SMU
Campus, Ponce Street, Bayombong, Nueva Vizcaya.
2. This request is made with the assurance that the Duty Investigator/ Investigator-
On-Case, being in-charge of the Crime Scene shall remain and provide all the
necessary security and support to the SOCO Team during the whole process
until after the crime scene is released.
3. Further request that this Office be furnished a copy of the list of evidence
gathered and the result of the examination conducted thereon.
4. For consideration and approval.
PSMS GEOFF GULAPAN
Investigator-On-Case
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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, FORENSIC GROUP
PROVINCIAL FORENSIC UNIT
NUEVA VIZCAYA FORENSIC UNIT
Bayombong, Nueva Vizcaya
MEMORANDUM
FOR : The Provincial Chief Nueva Vizcaya Provincial Forensic Unit
Bayombong, Nueva Vizcaya
FROM : SOCO Team Leader
SUBJECT : Request for Medico-Legal Examination
DATE : March 2, 2024
1. Request for medico-legal (autopsy) examination accompanying specimen to
determine the cause of death.
a. NATURE OF THE CASE: Murder
b. VICTIM/S: Jan Stanley Diozon, male, 21 years old, single, student and a
native of Washington, Solano and currently residing at Banaqueen
Subdivision, Bayombong, Nueva Vizcaya.
c. SUSPECT/S: Samuel y Gabriel Dacumos, male, 21 years old, single, student,
a native of Solano and currently residing at Banaqueen Subdivision
Bayombong, Nueva Vizcaya.
d. TDPO: On or about 5:00 pm of March 2, 2024 SMU Campus, Ponce Street,
Bayombong, Nueva Vizcaya.
2. Further request that his office be furnished a copy of medico-legal
examination result for our reference.
3. For consideration and request acknowledgment.
JERRY G ROSALES
Police
Major
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Republic of the Philippines
REGIONAL TRIAL COURT
2nd Judicial Region
Branch 30
Bayombong, Nueva Vizcaya
PEOPLE OF THE PHILIPPINES,
Plaintiff,
CRIMINAL CASE NO. 1234
FOR: MURDER
-Versus-
Samuel G Dacumos
(Detained at Bayombong Municipal jail)
Accused,
x------------------------------------------x
INFORMATION
The undersigned Provincial Prosecutor accuses Samuel y Gabriel Dacumos,
male, 21 years old, single, student, a native of Solano and currently residing at
Banaqueen Subdivision Bayombong, Nueva Vizcaya. Philippines of the crime of
Murder, defined and penalized under Article 248 of the Revised Penal Code as follows:
That on or about 3:30 pm of March 2, 2024, in the province of Nueva Vizcaya
and within the jurisdiction of this Honorable Court, the above named accused, with
Murder did these, willfully, unlawfully, armed with a firearm, with force and violence shot
the person of Jan Stanley Diozon y Fernandez at his neck and back with the use of a
licensed firearm, inflicting upon the latter one gunshot wound to his neck and one
gunshot wound to his back, which directly caused his death.
CONTRARY TO LAW
Nueva Vizcaya, Philippines, March 4, 2024
ATTY. JULIUS BABAO
Provincial Prosecutor
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Republic of the Philippines
Department of Justice
Regional Trial Court Branch 29
Bayombong Nueva Vizcaya
People of the Philippines CRIMINAL CASE NO. 1234
Complainant, For: Murder
-versus-
Samuel y Gabriel Dacumos
Banaqueen Subdivision Bayombong,
Nueva Vizcaya.
Accused.
xx----------------------------------------xx
COMPLAINT AFFIDAVIT
I, Jake Peralta Y Echevere, 20 years old, single, a native of Ifugao and currently
residing at District 4, Bayombong, Nueva Vizcaya, after having been duly sworn to in
accordance with law do HEREBY depose and say;
That on or about 3:30 pm of March 2, 2024 SMU Campus, Ponce Street,
Bayombong, Nueva Vizcaya an incident of alleged Murder transpired the victim
identified as Jan Stanley Diozon y Fernandez, a. 21 years old, single, student and
a native of Washington, Solano and currently residing at Banaqueen Subdivision,
Bayombong, Nueva [Link] shot in the neck (1) and was shot in his back (1) by
the suspect identified as Samuel Dacumos y Gabriel, male, 21 years old, single,
student, a native of Solano and currently residing at Banaqueen Subdivision
Bayombong, Nueva Vizcaya.
On that said afternoon that the victim was playing volleyball when suddenly
Samuel G. Dacumos has misunderstood the actions of Jan Stanley Diozon. The
suspect went to their house and to get the gun. Then the suspect goes into the
volleyball court then pointed the gun to Jan Stanley Diozon while arranging his things
after a volleyball game which the suspect belongs to the opponent team. Armed with a
short firearm identified as a 9mm Glock 17. As it investigator of the PNP I and Jan
Stanley Diozon y Fernandez was pointed by the gun without knowing that the suspect is
behind him. With the essence of treachery which is the swift and unexpected attack on
the unarmed victim without the slightest provocation on the victim's part.
The suspect immediately left the scene going south of Colocol Street San Nicolas
Bayombong. The residents of the said Location said that they saw Samuel G Dacumos
going south, as the police conducted search for the suspect which was about to escape
and about to call a tricycle driver. The suspect was arrested and licensed one (1) 9mm
Glock 17 with serial number 3697345 was recovered. The victim was already Dead on
the Spot.
That I attest that the foregoing statements and the submitted supporting
documents are true and correct to the best of my knowledge and belief and I commit
myself to be liable for perjury and/or dishonesty as a result of any fraud, false or
misrepresentation in this affidavit.
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IN TRUTH HISEOF, I hise unto affix my signature this 4th day of March 2024, at RTC
Branch 29, Bayombong, Nueva Vizcaya.
Jake E. Peralta
Affiant
SUBSCRIBED AND SWORN to before me this 4th day of March, at RTC Branch 29,
Bayombong, Nueva Vizcaya.
Atty. Ezekiel B. Videz
Administering Officer
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Republic of the Philippines)
Province of Nueva Vizcaya) S.S.
Municipality of Bayombong)
x- - - - - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF WITNESS
I, Jake Peralta y Echevere, 20 years old, single, a native of Ifugao and currently
residing at District 4, Bayombong, Nueva Vizcaya, after having sworn in accordance
with law, do HEREBY depose and state THAT:
01. I was present at the crime scene during the commission of the crime
committed by the suspect against the victim and I was able to personally see the act of
the suspect firing shots towards the victim.
02. On March 2, 2024 at around 3:30 pm in the afternoon
03. At 3 o’clock on the same day and the same place, while I was reviewing
for my exams and the victim was arranging his things after the volleyball game, the
suspect then pointed the gun to the victim while the victim didn’t notice him.
04. The suspect shot the victim which led his to fall immediately to the
volleyball court.
05. The suspect immediately left the scene going going south of Colocol
Street San Nicolas Bayombong without any mode of transportation
06. Shocked by the incident, I hid behind the tree near the mini forest
because of the fear of getting killed. When the suspect left the scene I rushed to the
victim who was shot in the back and neck which led to excessive bleeding.
07. I shouted for help and the called the police. The residents of the said
Location said that they saw the suspect going south, the police conducted search for
the suspect which was about to escape and about to call a tricycle driver. He was
caught immediately.
I executed this affidavit to attest the truthfulness of the foregoing facts and to
support the filing of Criminal Cases against Samuel Dacumos y Gabriel for violations of
Murder.
IN WITNESS WHEREOF, I hereunto affixed my signature this 4th day of March, 2024 at
RTC Branch 29, Bayombong, Nueva Vizcaya.
Jake E. Peralta
Affiant
SUBSCRIBED AND SWORN to before me this 4th day of March 2024 at RTC Branch
29, Bayombong, Nueva Vizcaya. I HEREBY CERTIFY that I have personally examined
the herein affiants and I am satisfied that they voluntarily executed and understood their
given affidavit.
Atty. Ezekiel B. Videz
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Notary Public
Republic of the Philippines)
Province of Nueva Vizcaya) S.S.
Municipality of Bayombong)
x- - - - - - - - - - - - - - - - - - - - - -x
JOINT AFFIDAVIT OF ARREST
We, Pat Miguel Madrid (Madrid for Brevity) and PCpl Jerry Bond (Bond for
Brevity), both legal of age and members of the Philippine National Police, presently
assigned at the Police Station of Bayombong, Nueva, Vizcaya, after having been sworn
to in accordance with law, do HEREBY depose and state THAT:
01. We are among the members of the Bayombong Police Station who
conducted an arrest warrant located along Colocol Street San Nicolas Bayombong;
02. Said operation stemmed from the complaint of JAKE ECHEVERE
PERALTA for violation of Murder (RPC) which was referred to our office by the
complainant against Samuel Dacumos y Gabriel, male, 21 years old, single, student, a
native of Solano and currently residing at Banaqueen Subdivision Bayombong, Nueva
Vizcaya.
03. On the complaint date that on or about 3:30 pm of March 2, 2024, SMU
Campus, Ponce Street, Bayombong, Nueva Vizcaya an incident of alleged Murder
transpired wherein the victim identified as Jan Stanley Diozon y Fernandez, 21 years
old, single, student and a native of Washington, Solano and currently residing at
Banaqueen Subdivision, Bayombong, Nueva Vizcaya was shot in the neck (1) and was
shot in his back (1) by the suspect identified as Samuel Dacumos y Gabriel, male, 21
years old, single, student, a native of Solano and currently residing at Banaqueen
Subdivision Bayombong, Nueva Vizcaya.
04. Upon receiving the call of residents, our office send police officers to conduct
an arrest in the said location at about 4:00 pm, March 2, 2024
05. Upon arrival, luckily the suspect was there about to ride a tricycle. The
undersigned together with the police officers immediately arrested the suspect and
informing his rights, while commencing the arrest.
06. Seized in the possession and control of the arrested person was the
following, to wit;
a. 9mm Glock 17 (serial number 3697345-licensed); and
07. Suspect together with the seized evidence was brought to the Bayombong
Police Station, for booking and proper disposition. Likewise, the arrested person was
apprised of their rights as provided for under the Constitution of the Philippines.
We executed this joint affidavit to attest the truthfulness of the foregoing facts and
to support the filing of Criminal Case against Samuel Dacumos y Gabriel for violations
of Murder penalized under Article 248 of the Revised Penal Code (RPC)
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AFFIANTS SAYETH NAUGHT.
IN WITNESS WHEREOF, we hereunto affixed our signature this 4th day of
March 2024 at RTC Branch 29, Bayombong, Nueva Vizcaya.
Pat Miguel Madrid PCpl Jerry Bond
Affiant Affiant
SUBSCRIBED AND SWORN to before me this 4th day of March 2024 at RTC
Branch 29, Bayombong, Nueva Vizcaya. I HEREBY CERTIFY that I have personally
examined the herein affiants and I am satisfied that they voluntarily executed and
understood their given affidavit.
Atty. Ezekiel B. Videz
Administering Officer
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SWORN STATEMENT
MALAYA AT KUSANG LOOB NA SALAYSAY NI JAKE PERALTA Y ECHEVERE,
RESIDENTE NG , DISTRICT 4, BAYOMBONG, NUEVA VIZCAYA NA IBINIGAY SA
PAGSISIYASAT NI PEMS UNO BARNACHEA DITO SA TANGGAPAN NG
BAYOMBONG MUNICIPAL POLICE STATION NGAYON IKA- 3 NG MARSO, 2024 SA
GANAP NA IKA-10:00 NG UMAGA, SA HARAP NINA ANDY LIM AT JOHN WICK, SA
PAMAMAGITAN NG MGA TANONG AT SAGOT.
(Ang nagsasalaysay ay pinahiwatigan o pinaalalahanan ng lahat ng kanyang mga
karapatan alinsunod sa itinatadhana ng ating Bagong Saligang Batas).
MGA TANONG AT SAGOT
01. TANONG - Ginoong Jake Echevere Peralta, ikaw ba ay magsasabi ng
buong katotohanan at pawang katotohanan lamang sa
pagsisiyasat na ito?
SAGOT - Opo sir.
02. TANONG - Ikaw ba ay handang magbigay ng iyong malaya at kusang loob
na salaysay?
SAGOT - Opo sir.
03. TANONG - Maaari mo bang sabihin sa pagsisiyasat na ito ang iyong tunay
na pangalan at iba pang mapagkikilanlan sa iyong tunay na
pagkatao?
SAGOT - Ako po si Jake Echevere Peralta, 20 anyos, studyante, tubong
Bayombong at kasalukuyang naninirahan sa District 4,
Bayombong Nueva Vizcaya.
04. T - Ano naman ang dahilan at ikaw ay naririto sa aming tanggapan at
nagbibigay ng iyong malaya at kusang loob na salaysay?
S - Ako po ay napaparito sa inyong tanggapan upang isalaysay at
isumbong ang ginawa nang suspek sa akin at sa biktimang si Jan
Stanley Diozon, sa kadahilanan na siya ay binaril ng dalawang
beses ng walang kalaban-laban habang siya ay naglalaro ng
volleyball.
05. T - Saan at kailan nangyari ang naturang insidente?
S - Habang ako ay kasalukuyang nagrereview ay nakarinig ako ng
dalawang beses na putok ng baril at nasaksihan ito. Nangyari ito
noong ika-2 ng Marso bandang 3:30 PM. Nangyari ito mismo sa
loob ng campus
06. T - Sinu-sino ang may kinalaman sa naganap na pamamaril?
S - Isa lang po sir. Siya po ay si Samuel Dacumos.
07. T - Paano naman nangyari ang pagbaril?
S - Ang suspect na si Samuel Dacumos po ay pumuwesto sa likod ng
biktima at biglang binaril ito, Hindi ito nakita ng biktima sapagkat ito
ay naglalaro ng volleyball.
08. T - Kilala mo ba itong mga biktima?
S - Opo sir.
09. T - Sa ikaliliwanag ng pagsisiyasat na ito, maaari mo bang isalaysay o
P a g e | 11
sabihin kung ano ang tunay na nangyari sa naganap na pamamaril?
S - Ganito po ang nangyari sir. Mga bangang 2:00 Pm ang naturang
suspect at biktima ay naglalaro ng volleyball at ang kupunan ng
suspect ay natalo. Pagkatapos kong nanood ng kanilang Laro ay
naisipan kong mag review ng bandang 3:20 Pm at mga sampung
minuto ang nakalipas ay bumalik ang suspect na si Samuel
Dacumos Noong makita kong humandusay ang biktima ay hindi na
ako nakaimik sa sobrang takot sa pangyayari kaya akoy nagtago sa
likod ng puno. Mabilis naman itong tumakas papuntang Timog.
10. T - Sa iyong pagkakaalam, ilan ang dala ni Samuel Dacumos na baril at
anu-ano ang mga kalibre nito?
S - Hindi ko po mawari ang dala niyang baril ngunit ang pagkakaalam
ko po ito ay kalibre 9mm Glock 17.
Pahina 2. Karugtong ng malaya at kusang loob na salaysay ni JAKE PERALTA Y
ECHEVERE, ngayong ika-2 ng Marso, 2024
11. T - Bukod sa iyo, may mga alam ka bang mga tao na nakakita ng
naturang pagbaril?
S - Wala po dahil sa mga oras na iyon ay nakauwi na ang mga
studyante dahil pagkatapos ng pagsusulit ay maari ng umuwi at ang
mga kasamahan nilang naglaro ng volleyball ay nakauwi narin.
12. T - Ano naman ang iyong ginawa matapos mong masaksihan ang
naturang insidente?
S - Nilapitan ko po ang biktima para tignan ang kalagayan niya, ako po
ay sumigaw nang saklolo at tumawag ng Pulis.
13. T - Pansamantala ay wala na akong itatanong sa iyo, mayroon ka bang
ibang ibig idagdag o bawasan sa salaysay mong ito?
S - Wala na po sir.
15. T - Ikaw ba ay tinakot, pinangakuan, o binigyan ng pabuya sa
pagbibigay mo ng salaysay na ito?
S - Hindi po sir.
16. T - Handa mo bang lagdaan ang salaysay mong ito na binubuo ng
dalawang pahina?
S - Opo sir.
WAKAS NG SALAYSAY: March 3, 2024 at 10:00 AM
JAKE ECHEVERE PERALTA
Nagsalaysay
SUBSCRIBED AND SWORN TO before me this March 3, 2024 at Bayombong
Municipal Police Station
ATTY EZEKIEL B. VIDEZ
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Administering Officer
CERTIFICATION
I HEREBY CERTIFY THAT I have personally examined the herein affiant under
oath and that I am fully satisfied that he/she voluntarily executed and understood his/his
statement.
ATTY EZEKIEL B. VIDEZ
Administering Officer
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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, FORENSIC GROUP
PROVINCIAL FORENSIC UNIT
NUEVA VIZCAYA FORENSIC UNIT
Bayombong, Nueva Vizcaya
MEDICO-LEGAL REPORT REPORT [Link]-25-2023
(AUTOPSY)
CASE: Alleged Murder SUSPECT/S: Samuel G Dacumos
VICTIM/S: Jan Stanley Diozon
TIME AND DATE RECEIVED: 5:00 PM March 2, 2024
REQEUSTING PARTY/UNIT: Station Commander
Bayombong Police Station
Bayombong, Nueva Vizcaya
SPECIMEN SUBMITTED:
Victim’s cadaver
PURPOSE OF LABORATORY EXAMINATION:
To determine the cause of death.
FINDINGS:
(CONTINUED AT THE BACK)
CONCLUSION:
The cause of death is a gunshot wound located at the center of the suspects’
back and neck which damaged the heart and major blood vessels which caused
excessive bleeding.
REMARKS: The original copy of this report and the specimen submitted are retained in
this laboratory for future reference.
TIME AND DATE COMPLETED: 7:00 PM March 2, 2024
EXAMINED BY: HANNAH ADRIANO
Police Lieutenant Colonel
Medico-Legal Examiner
APPROVED:
NOTED: RITOSH AFALLA
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Police Lieutenant Colonel
Provincial Chief
(CONTINUATION…)
FINDINGS:
GENERAL:
Fully developed fairly nourished previously embalmed male cadaver with
embalming incision at the abdomen.
HEAD AND NECK:
1. Gunshot wound with point of entry at the Splenius capitis measuring 1 x 1 cm
making a point of exit at the cheek region.
THORAX AND BACK REGION:
1. Gunshot wound, with point of entry at the Interscapular region, measuring 1 x
0.8, making a point of exit at the Thoracic region, measuring 2 x 1 cm.
EXTREMITIES:
- No other injury noted at the time of examination.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
PLTCOL HANNAH ADRIANO
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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, FORENSIC GROUP
PROVINCIAL FORENSIC UNIT
NUEVA VIZCAYA FORENSIC UNIT
Bayombong, Nueva Vizcaya
FIREMARMS IDENTIFICATION REPORT NO. FAIS-02-2024
CASE: Murder SUSPECT/S: Samuel G. Dacumos xxx
VICTIM/S: Jan Stanley F. Diozon. xxx
TIME AND DATE RECEIVED: 8:00 AM March 4, 2024
REQUESTING PARTY/UNIT: Team Leader, Scene of the Crime Operation
Nueva Vizcaya Provincial Forensic Unit
Bayombong, Nueva Vizcaya
SPECIMEN SUBMITTED:
1. Two (2) 9mm fired cartridge cases marked ‘’AP-1 and AP-2 03/02/24’’
2. One (1) 9mm Glock 17 with serial number 3697345 marked as “GLOCK-
17 03/02/24”
PURPOSE OF LABORATORY EXAMINATION:
1. To determine whether or not the specimen marked AP-1 and AP-2 were fired from
one and the same 9mm firearm.
2. To determine whether or not the specimen marked GLOCK-17 is serviceable.
FINDINGS:
1. Microscopic examination and comparison of the specimen marked AP-1 and AP-2
revealed the same individual characteristics with each other.
2. Physical examination and actual test firing of the aforementioned firearm marked
GLOCK-17 revealed it can load and fire as it fired 9mm cartridges.
CONCLUSIONS:
1. The specimen marked AP-1 and AP-2 were fired from one and the same 9mm
firearm.
2. The 9 mm pistol with serial number 3697345 marked GLOCK-17 is serviceable.
REMARKS: The original copy of this report and the specimen submitted are retained in
this Laboratory for future purposes.
TIME AND DATE COMPLETED: 10:00 AM March 4, 2024
EXAMINED BY: KENNETH B SY
Police Major
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Forensic Firearms
Examiner
APPROVED:
NOTED: JOHN D CRUZ
Police Major
Provincial Chief
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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, CIVIL SECURITY GROUP
REGIONAL CIVIL SECURITY UNIT 2
Camp Marcelo A Adduru, Tuguegarao City, Cagayan
MEMORANDUM
TO : PMAJ DARYL BUYAYO
Chief of Police, Bayombong PS
FROM : OIC, RCSU2
SUBJECT : Initial Firearms Record Verification Result
DATE : March 5, 2023
1. Reference: Memorandum from above office dated March 4, 2024 with subject
Request for Firearm Verification.
2. In view of the above reference, be informed that as per databased of Record
Section, Firearms Licensing Division (FLD) Firearms and Explosives Office
(FEO) as of this data a certain Samuel Dacumos y Gabriel resident of
Banaqueen Subdivision, Bayombong, Nueva Vizcaya have a License to Own
and Possess Firearms (LTOPF) licensed one (1) 9mm Glock 17 with serial
number 3697345
3. For information.
PCpl James A. Red
Firearms Record Verifier
Louie B. Sarminto
Police Lieutenant Colonel
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Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, FORENSIC GROUP
PROVINCIAL FORENSIC UNIT
NUEVA VIZCAYA FORENSIC UNIT
Bayombong, Nueva Vizcaya
CHAIN OF CUSTODY FORM
Nature of Case : Alleged Murder
Name of suspect/s : Samuel y Gabriel Dacumos, male, 21 years old, single, student, a
native of Solano and currently residing at Banaqueen Subdivision Bayombong, Nueva
Vizcaya..
Time, date, and place of occurrence: on or about 3:30 Pm of March 2, 2024 SMU
Campus, Ponce Street, Bayombong, Nueva Vizcaya.
Arresting officers/operating unit: Nueva Vizcaya Provincial Forensic Unit
Description of evidence:
a. One (1) caliber 9mm fired cartridge case tagged as “Evidence 1” marked as
“BJS-1 07/23/23”;
b. One (1) caliber 9mm fired cartridge case tagged as “Evidence 2” marked as
“BJS-2 07/23/23”;
c. One (1) shirt with blood which the victim has worn tagged as “BS-A 03/02/24”
d. One (1) 9mm Glock 17 with serial number 3697345 marked as “GLOCK-17
03/02/24”
TURNED OVER BY: PMSG Primo O. Bas, Evidence Collector
(Name and Designation)
Agency/Address NVPFU, Bayombong Nueva Vizcaya
Time and Date 2:00 PM March 4, 2024
Remarks: ___________________
___________________
___________________
RECEIVED BY: PMAJ KENNETH B SY
Firearms Examiner
Agency/Address NVPFU, Bayombong, Nueva Vizcaya
Time and Date 2:00 PM March 4, 2024
Remarks: ___________________
___________________
___________________
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