Republic of the Philippines

National Police Commission

PHILIPPINE NATIONAL POLICE, NATIONAL CAPITAL REGION POLICE OFFICE
SOUTHERN POLICE DISTRICT
PATEROS MUNICIPAL POLICE STATION
Investigation and Detective Management Section
E. Ragas St., Brgy. Sta. Ana, Pateros, MM
Tel No. 423-2598

CERTIFICATION
This is to certify that quoted hereunder is an Excerpt from the DAILY INCIDENT
REPORT (Police Blotter) as follows:

ENTRY No …………… 2022-680

PAGE NO…………….. 708
DATE…………………. June 14, 2022
TIME………………….. 1:45 PM

RE: LOSS VISA AND PASSPORT CLAIM STUB

REPORTEE: SHIRLEY-ANN BADONGEN ‘Y BOMOGAO, 29 years old, female, single,

accountant, born on August 26, 1993 in Baguio City and presently residing at No.94 Capt.
Musni St., Barangay Ligid Tipas, Taguig, City.

DTPO: Discovered at about 1:30 pm June 2, 2023 along P. Rosales St., Barangay Sta.
Ana, Pateros, Metro Manila.

LOSS ITEMS: Visa and Passport claim stub issued by Embassy of the Republic of Korea
Consular Department Visa section, Manila, Philippines.

BRIEF FACTS:

Reportee personally appeared before this office and requested to put into official
record the above captioned incident. Accordingly, while she was riding a motorcycle and
traversing along P. Rosales St., Barangay Sta. Ana, Pateros, Metro Manila, she noticed
that the plastic passport cover containing the above-mentioned stub was already missing.
She exerted diligent effort to searched/locate the said stub but to no avail and she believe
that she lost it during her travel. Hence, it is now considered loss, destroyed and beyond
recovery.

THIS CERTIFICATION is being issued upon the request of Ms. Shirley-Ann

Badongen for whatever legal purposes it may serve her best.

PCMS Ricky T Ramos

Duty Investigator