Republic of the Philippines

Department of the Interior and Local Government

NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
TABACO CITY POLICE STATION
Brgy. Pawa, Tabaco City

CERTIFICATION

TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that based on the Police Blotter of this Police

Station, as shown on page 1, under entry No. 021, dated May 08, 2023, the
following entries of events exists, to wit:

May 08, 2023/1600H/C2023-021

SLIGHT PHYSICAL INJURY

On or about 4:00 o'clock in the afternoon of May 8, 2023, Mr. Carl Vincent
Camano, of legal age, married, and a resident of Zone 1 Panal, Tabaco City,
reported to this station that his son, Jaymark Camano, 19 years old, a student of
Tabaco College, and a resident of the aforementioned address, was allegedly
boxed by a bystander named Jericho Madrilejos. The incident transpired at Zone
1 San Roque, Tabaco City, at approximately 3:00 o'clock in the afternoon on the
same date. While the victim was on his way home, he was blocked by the
suspect and got punched in the face. A witness known as Justin Celso came to
stop the suspect, after which the latter fled away. The victim sustained a black
eye and was immediately brought to a clinic.

The reporter has affixed his signature this 8 th day of May 2023.

CARL VINCENT F. CAMANO

(Reporter)

This certification is issued upon the request of PLT Joy San Pascual for
whatever legal purposes and intents it may serve.

Prepared by:

JUSTINE M. BARRAMEDA
PMSg PNP
Officer -on- Case

NOTED BY:

JOY SAN PASCUAL

Police Lieutenant
Chief of Police
Republic of the Philippines )
Tabaco City, Albay Province) s.s.
x- - - - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF WITNESS
I, Justin Celso, 23 years old, single, resident of Barangay Amtic, Ligao
City, after having sworn in accordance with law, do hereby depose and state
THAT:

1. I was present and personally saw that the accused, Jericho Madrilejos,
committed the crime of slight physical injury against the victim, Jaymark
Camano.

2. On May 8, 2023, at about 3:00 o’clock in the afternoon, while I was

walking, I saw the suspect, Jericho Madrilejos, blocking the way of the
victim, Jaymark Camano, and uttering the words against the latter, "NATA
BAYA TA HAMBUGON KA?"

3. There I saw the suspect giving the victim fistic blows. I came between the
two and grabbed the suspect’s arms. After which, Jericho Madrilejos fled
away with his motorcycle.

4. The victim sustained a black eye, and that is when I immediately brought
him to the nearest clinic.

I executed this affidavit to attest the truthfulness of the foregoing facts and
to support the filing of Criminal Cases against Jericho Madrilejos, the suspect.

AFFIANTS SAYETH NAUGHT.

IN WITNESS WHEREOF, I hereunto affixed my signature this 8 th day of
May 2023 at Pawa, Tabaco City.

JUSTIN M. CELSO
Affiant

SUBSCRIBED AND SWORN to before me this 8th day of May, 2023 at

Pawa, Tabaco City. 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. LYRA B. TUDLISAN

Notary Public
Republic of the Philippines )
____________, ________ ) s.s.
x- - - - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF WITNESS
I, ________________________, age, civil status, resident of
__________________________, _________, after having sworn in accordance
with law, do hereby depose and state THAT:

01. I was present and personally saw that accused, __________,

committed the crime of ___________________________ against the victim
_______________;

02. (State other circumstances and the relation either to the victim or
accused or both);

03. (State the details of the acts committed by the accused against the
victim.

04. (State the acts done by the witness and the reason thereof);

I executed this affidavit to attest the truthfulness of the foregoing facts and
to support the filing of Criminal Cases against
_______________________________ for violations of
________________________.

AFFIANTS SAYETH NAUGHT.

IN WITNESS WHEREOF, I hereunto affixed my signature this ___day of

____________ at ____________, _______________.

__________________________
_____
Affiant

SUBSCRIBED AND SWORN to before me this ___ day of _______ at

_______________. I HEREBY CERTIFY that I have personally examined the
herein affiants and I am satisfied that they voluntarily executed and understood
their given affidavit.

_____________________
Notary Public