A. Case Referral Format

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Republic of the Philippines

Department of the Interior and Local Government


PHILIPPINE NATIONAL POLICE
POLICE REGIONAL OFFICE-CORDILLERA
LA TRINIDAD MUNICIPAL POLICE STATION
La Trinidad, Benguet

May ,2023

The Honorable Provincial Chief Prosecutor


Office of the Provincial Prosecutor- Benguet
Hall of Justice, La Trinidad, Benguet

(Attn: Duty Inquest Prosecutor)

Greetings :

I have the honor to refer to your Office, the records of investigation relative to the case of Robbery with
Homicide, committed at about 11:30 in the morning of Sunday, May 7,2023 transpired at the residence of Mr. Sam
De Castro Sabbang located at Brgy. Lubas, La Trinidad, Benguet.

COMPLAINANT : Annie Lee Depayso, Filipino, Single and residing at Lubas, La Trinidad, Benguet

VICTIM : Sam De Castro Sabbang, Filipino, Single, and residing at Lubas, La Trinidad, Benguet

SUSPECT : Jeric ‘Abdul’ Tano Fakayan, Filipino, Single and residing at Betag, La Trinidad, Benguet
(ARRESTED)

EVIDENCE RECOVERED : One (1) kitchen knife


A single white slipper
Sample blood of the victim
Fingerprints

FACTS OF THE CASE:

Investigation disclosed that on or about 11:30 o’clock in the morning of May 7,2023 a robbery with homicide
incident transpired at Brgy. Lubas, La Trinidad, Benguet particularly at the residence of Sam De Castro Sabbang who
was robbed and killed by unidentified person. The suspect gained entry to the house by passing through the main
door and entered freely inside the room of the victim. Suspect took away a wallet and an android phone with a total
worth of more or less nineteen to twenty-one thousand pesos (PHP 19,000.00 – 21,000.00). Abovementioned
evidences are recovered at the crime scene which include a single white slipper left by the suspect on hurry. The
responding police immediately made a hot pursuit operation and was able to apprehend the suspect identified as
Jeric ‘Abdul’ Tano Fakayan, 26 years old and a resident of Brgy. Betag, La Trinidad, Benguet.

ENCLOSURES :

a) Subscribed NPS Investigative Data Form


b) Police Blotter
c) Incident Record Form
d) Spot Report
e) Progress Report
f) Investigation Report
g) Crime Scene Investigation Report
g) After Operation Report
i) Affidavit Complaint
j) First Responder’s Form
k) Investigator’s Form
l.) Sworn Statement of the Witness
m.) Affidavit of Arrest
n.) PNP Arrest and Booking Sheet
o.) Booking Mug Shots
p.) Request for Medical Examination of the Suspect
q.) Medico-Legal Certificate
r.) Inventory Receipt of Pieces of Evidence
s.) Result of Fingerprint Examination
t.) Release of Crime Scene
u.) Preliminary Disposition
v.) Rough and Final Sketch of the Crime Scene

This case will be presented to you by PEMS GRACE LIN SAYA-AO of this Office during the course of
inquest proceedings. Further, request furnished this Office copy of resolution of the case and other proceedings.

For appropriate action and disposition.

EUNICE NEFYU CELINO


Police Captain
Chief of Police

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