Philippine National Police

INCIDENT RECORD FORM

IRF ENTRY NUMBER: TYPE OF INCIDENT: COPY FOR:
7412 Violation of Qualified Piracy Article 123 RPC

INSTRUCTIONS: Refer to PNP SOP on Recording of incidents in the Police Blotter in filling up this form. This incident Record Form (IRF) may be reproduced, photocopied,
and/or downloaded from the DIDM website, www.didm.pnp.gov.ph.
DATE AND TIME REPORTED: DATE AND TIME OF INCIDENT: PLACE OF INCIDENT:
April 1, 2023 at 11:00 AM April 1, 2023 at 10:00 AM Between the islands of Cuaming and Cabul-an in the Dutch East Indies

ITEM “A” – REPORTING PERSON

FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
Kolokoy Brader Kalma

CITIZENSHIP SEX/GENDER CIVIL DATE OF AGE PLACE OF BIRTH HOME MOBILE PHONE
FILIPINO Male STATUS BIRTH 27 Cabul-an, Loon, Bohol PHONE 09090011321
Single (MM/DD/YY)
01/01/96

CURRENT ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

NUMBER/STREET) Cabul-an Loon Bohol

OTHER ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

NUMBER/STREET)

HIGHEST EDUCATIONAL ATTAINMENT OCCUPATION ID CARD PRESENTED EMAIL ADDRESS (If Any)
College Level Fisherman

ITEM “B” – SUSPECT’S DATA

FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
Hab Mam Del
Pantar Kol May
CITIZENSHIP SEX/GENDER CIVIL DATE OF AGE PLACE OF BIRTH HOME MOBILE PHONE
Filipino Male STATUS BIRTH 35 Cuaming, Loon, Bohol PHONE
Filipino Male Single (MM/DD/YY) 35 Cuaming, Loon, Bohol
Single 01/25/88
02/11/88
CURRENT ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
NUMBER/STREET) Cuaming Loon Bohol
Cuaming Loon Bohol
OTHER ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
NUMBER/STREET)

HIGHEST EDUCATIONAL ATTAINMENT OCCUPATION ADDRESS RELATION TO EMAIL ADDRESS (If Any)
College Graduate Veterinarian VICTIM
N/A

IF AFP/PNP PERSONNEL: RANK UNIT ASSIGNMENT GROUP AFFILIATION WITH PREVIOUS STATUS OF PREVIOUS CASE
CRIMINAL RECORD?
( ) Yes (/) No
(If Yes, Pls. Specify)

HEIGHT WEIGHT SWUIL COLOR OF DESCRIPTION COLOR OF DESCRIPTION OF UNDER THE INFLUENCE?
5’6 68 EYES OF EYES HAIR HAIR □ NO □ DRUGS
4’6 57 Brown Black Curly □LIQUOR □ OTHERS
Brown Black Curly

FOR CHILDREN IN CONFLICT WITH THE LAW

NAME OF GUARDIAN GUARDIAN ADDRESS HOME PHONE MOBILE PHONE

ITEM “C” – VICTIM’S DATA

FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
CITIZENSHIP SEX/GENDER CIVIL DATE OF AGE PLACE OF BIRTH HOME MOBILE PHONE
STATUS BIRTH PHONE
(MM/DD/YY)
CURRENT ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
NUMBER/STREET)

OTHER ADDRESS (HOUSE VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

NUMBER/STREET)

HIGHEST EDUCATIONAL ATTAINMENT OCCUPATION WORK ADDRESS EMAIL ADDRESS (If Any)
 ITEM “D” – NARRATIVE OF INCIDENT
TYPE OF INCIDENT DATE/TIME OF INCIDENT PLACE OF INCIDENT
Qualified Piracy April 1, 2023 at 10:00 AM Between the islands of Cuaming and Cabul-an in the
Dutch East Indies

On or about 10:00 o’clock in the morning of April 1, 2023, a boat, in which there were 11 men, women, and children,
arrived between the islands of Cuaming and Cabul-an in the Dutch East Indies. There the boat was surrounded by six vintas manned
by 24 Moros all armed. The Moros first asked for food, but once on the boat, took for themselves all of the cargo, attacked some of
the men, and brutally violated two of women by methods too horrible to be described. All of the persons on the boat, with the
exception of the two young women, were again placed on it and holes were made on it, with the idea that it would submerge, but
after 11 days of hardship and privation they were succored. Two of the Moro marauders were Mam-Hab and Pantar who later
returned to their home in Cuaming, Philippines. There were arrested and were charged in the Court of First Instance of Cuaming
with the crime of piracy.

I HEREBY CERTIFY TO THE CORRECTIONS NAME OF REPORTING PERSON SIGNATURE OF REPORTING PERSON
OF THE FOREGOING TO THE BEST OF MY Brader Kolokoy
KNOWLEDGE AND BELIEF.

SUBSCRIBED AND SWORN TO BEFORE ME NAME OF ADMINISTERING OFFICER (DUTY OFFICER) SIGNATURE OF ADMINISTERING OFFICER (DUTY
PCPL Jer Win OFFICER)

RANK, NAME AND DESIGNATION OF POLICE OFFICER (WHETHER HE/SHE IS THE DUTY SIGNATURE OF REPORTING PERSON
INVESTIGATOR, INVESTIGATION ON CASE OR THE ASSISTING POLICE OFFICER)
PCPL Jer Win

INCIDENT RECORDED IN THE BLOTTER BY: RANK /NAME OF DESK OFFICER: SIGNATURE OF DESK BLOTTER ENTRY NR.:
PCPL Jer Win PCPL Win Jer OFFICER: 7215

REMINDER TO REPORTING PERSON

Keep the copy of this Incident Record Form (IRF). An update of the progress of the investigation of the crime or incident that you reported will be
given to you upon presentation of this IRF. For your reference, the data below is the contact details of this police station.
Name of Police Station Valencia Police Station Telephone 09334453333
Investigator-on-Case PCPL Jer Win Mobile Phone 09112231111

Name of Chief/Head of Office PLT Jerwin Melencion Mobile Phone 092233412312