Department of the Interior and Local Government PHILIPPINE NATIONAL POLICE ______________________________________ _______________________ Picture 2x2 PNP ARREST AND BOOKING SHEET FRONT VIEW (to be accomplished by the Arresting Officer)
PERSONAL INFORMATION: ________________________________________________________________________________ (Last Name) (First Name) (Middle Name) ADDRESS: _______________________________________________________________________ TEL NO._______________________ POB ______________________ DOB ___________________ MARITAL STATUS: SINGLE WIDOW/ER SEX: MALE MARRIED SEPARATED FEMALE AGE: _____ WEIGHT (lbs): __________HEIGHT (Ft): ________EYES:___________HAIR:_________ COMPLEXION: ____________OCCUPATION: ______________NATIONALITY:_________________ ETHNIC GROUP_______________________DIALECT/LANGUAGE__________________ HIGHEST EDUCATIONAL ATTAINMENT: _______________________________________________ NAME OF SCHOOL: ________________________________________________________________ LOCATION OF SCHOOL: ____________________________________________________________ IDENTIFYING MARKS: MOLE TATOO BIRTHMARK SCAR LOCATION OF IDENTIFYING MARKS__________________________________________________ PHYSICAL DEFORMITY/DEFECT ____________________________________________________ DRIVER’S LIC NR: ________________________ISSUED AT: ______________ ON: _____________ RES CERT NR: __________________ DATE AND PLACE OF ISSUE: ________________________ OTHER ID CARDS: _______________________________________________ID NR: ____________ ARREST INFORMATION: OFFENSE CHARGE:__________________________________________ ____________________ (NATURE OF OFFENSE) (CRIM/IS NO.) MODUS OPERANDA:_______________________________________________________________ WHERE ARRESTED: _______________________________________________________________ DATE ARRESTED: ______________________________________ TIME: ____________________ ARRESTING OFFICER/S: Rank:________Name:______________________________Signature:_____________________ Rank:________Name:______________________________Signature:_____________________ Rank:________Name:______________________________Signature:_____________________ SIGNATURE___________________________________ UNIT: ______________________________
MEDICAL EXAMINATION CONDUCTED AT: ____________________________________________
BY: DR. ___________________________________________________ ON: ___________________ REMARKS:_____________________________________________________________________ FINGERPRINT TAKEN BY: __________________________________________________________ PHOTO TAKEN BY: ________________________________________________________________ INVESTIGATOR ON CASE:___________________________________________________________ BOOKED BY (RANK/NAME/SIGNATURE): ______________________________________________ SIGNATURE OF PERSON ARRESTED: _______________________________________________ (INDICATE IF SUSPECT REFUSE TO SIGN) OTHER INFORMATION: NAME OF FATHER: _____________________________________________________ AGE: _____ ADDRESS: _______________________________________________________________________ NAME OF MOTHER: ____________________________________________________ AGE: ______ ADDRESS: _______________________________________________________________________ NAME & ADDRESS OF PERSON TO BE CONTACTED IN CASE OF EMERGENCY: NAME: __________________________________________________ RELATIONSHIP: _________ ADDRESS: _____________________________________________ TEL # _____________________ LAWYER: _________________________________________ TEL #: _________________________ DOCTOR: _________________________________________ TEL #:_________________________ HEALTH PROBLEM: ________________________________________________________________
NOTE: USE THE PNPCL FORM 452-038 (STANDARD TEN PRINT CARD) TO TAKE THE TENPRINT OF THE SUSPECT FOR EVENTUAL SUBMISSION TO PNPCL-AFIS
(ATTACH THE MEDICAL EXAM RESULT; MUG SHOTS; TENPRINTS OF SUSPECT)