Republic of the Philippines

National police commission
National Headquarters Philippine National Police
PROVINCIAL HIGHWAY PATROL TEAM-BULACAN
Camp Gen. Alejo S Santos, Malolos City
Tel. No. (044) 796-2054 Email Add: bulacan_hpg3@yahoo.com

IMPOUNDING RECEIPT OF MOTOR VEHICLE

The motorcycle described herein was apprehended at about _____ AM/PM of

___________, 2019 along _________________________________, for violations of

1. _____________________________ 4. _____________________________
2. _____________________________ 5. _____________________________
3. _____________________________ 6. _____________________________

while being driven by _________________________________________________

of _________________________________________________________________.

Make / Type : ________________________________

Motor No. : ________________________________

Chassis No. : ________________________________

Plate No. : ________________________________

Color : ________________________________

MV File No. : ________________________________

Apprehending Officer/s:
________________________________
________________________________
________________________________
________________________________
Conformed by:
______________________________
Owner/Driver/Possessor
Date Signed ____________________
LTO Driver’s License No. ________________________
Contact Number:______________________________

“To Serve and Protect”

 Republic of the Philippines
National police commission
National Headquarters Philippine National Police
PROVINCIAL HIGHWAY PATROL TEAM-BULACAN
Camp Gen. Alejo S Santos, Malolos City
Tel. No. (044) 796-2054 Email Add: bulacan_hpg3@yahoo.com

TECHNICAL INSPECTION AND INVENTORY REPORT

MOTORCYCLE / TRICYCLE DESCRIPTION

Make/ Series/ Type MV File Number:
Motor Number: Plate Number:
Chassis Number: Color:
Registered Owner: Model/Year:
Owners Address: Fuel

FEATURES
Shift Pedal Dimmer Switch
Center Stand Fuel Tank Cap
Fuel Tap Turn Signal Switch
Rear Shock Absorber Throttle Grip
Rear Break Light Switch Fuel Tank
Kick Pedal Front Fork (Shock)
Air Cleaner Tire (Front & Rear)
Rear Brake Pedal Engine
Steering Lock Engine Block
Cowling Body (Wind Shield) Spark Plug
Clutch Lever Spark Plug Wire
Choke Lever Left Engine Cover
Clutch Cable Right Engine Cover
Choke Cable Muffler
Ignition Switch Drive Seat
Speedometer Luggage Carrier
Front Break Cable Chain
Front Break Lever Chain Cover
Rear Break Cable Side Stand
Rear Brake Lever Head Light
Horn Botton Signal Light
REMARKS GENERAL CONDITION
Newly Painted
Paint Discoloring
Good Body Shape
Body in Bad Shape
For Major Body Repair
For Engine Repair
INSPECTED BY: WITNESSED BY: NOTED BY:

____________________________ ______________________________ ____________________________

Recovering / Apprehending Officer Registered Owner / Possessor Head of Office
___________________________ _________________________ ___________________________
Date Date Date