Republic of the Philippines )

Province of Southern Leyte )

City of Maasin ) s.s.
x- - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF APPREHENDING OFFICER

We, the UNDERSIGNED Police Officers, both members of the Philippine

National Police, presently assigned at the __________________________, _________,
_____________, do hereby depose and state THAT:

01. We are among the members of the

___________________________________ who conducted entrapment operations at
_______________________ located along ________________________________,
_______________;

02. Said operation stemmed from the complaint of _____________ for

violation of ______________________________________ which was referred to our
office by the ______________________________ against _____________________,
(age), (civil status), (nationality) and residing at No. __________________________,
__________________;

03. On the complaint dated _______________, (state the act and the
crime committed).

04. Upon receipt of their said complaint, our office planned out an
entrapment operation against the suspect. At about ______________ of
______________, the undersigned together with the complainant proceeded at the pre-
arranged pay off _________________________ located along
____________________________, __________ to give the money being asked by the
respondent;

05. Upon arrival thereat, complainants waited for the suspect to arrive
while we the undersigned seated near the table of the complainants. At about
________, suspect arrived and approached the complainants and after few
conversation, complainants handed over the marked money to the suspect that minutes
of prompted the undersigned to immediately effect arrest;
06. Seized and recovered in the possession and control of the arrested
person were the following, to wit:

a.) Marked Money, (state the denomination and serial numbers);

b.) (Name of documents promised);

c.) (type of CP and SIM Card); and

 d.) Other evidence confiscated;

07. Suspect together with the seized and recovered evidence was brought
to the ___________________________________, ____________, ___________ for
booking and proper disposition. Likewise, the arrested person was apprised of their
rights as provided for under the Constitution of the Philippines.

08. The report of the PNP Crime Laboratory Group Physical Identification
Report No. ___________ dated __________, revealed that suspect
______________________ was POSITIVE for the presence of Bright Yellow Ultraviolet
Fluorescent powder on both palm and right dorsal portion of the hands.

We executed this joint 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, we hereunto affixed our signature this ___day of

____________ at ____________, _______________.

_______________________________ ____________________________
Affiant 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.

_____________________
Administering Officer