CASE FOLDER

(Violation of Art. 170, RPC- FALSIFICATION OF DOCUMENT)

SUSPECT/S JAMES PAGALILAUAN y ADEJUKE

RESPONDENT/S

STATUS OF CASE REFERRED THRU INQUEST

INQUEST NR. 18-0444

INVES ON CASE PSSg DWIGHT P RAMOS

PROSECUTOR ATTY.ANGELA M. GANELA

35
 TABLE OF CONTENTS

1. Investigation Data Form-------------------------------------------------------------------“A”

2. Case Referral---------------------------------------------------------------------------------“B”

3. Investigation Report------------------------------------------------------------------------“C”

4. Joint Affidavit of Arrest---------------------------------------------------------------------“D”

6. Spot Report dated October 16,2022---------------------------------------------------“E”

7. Progress Report ----------------------------------------------------------------------------“F”

8. Blotter/Incident Report Form (IRF)------------------------------------------------------“G”

9. Inventory of Property Seized-------------------------------------------------------------“H”

10. Booking/ Information Sheet with mug shots and fingerprint dated

October 16,2022--------------------------------------------------------------------------------“I”

11. Other Reports-----------------------------------------------------------------------------“J”

36
 Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
Philippine National Police
Santiago City Police Office
SANTIAGO CITY POLICE STATION 2
Santiago City, Isabela
MEMORANDUM

FOR : City Director

(Attn; C, PIDMB)

FROM : Chief of Police

SUBJECT : Spot Report re: Violation of Article 170 (Falsification of Documents)

DATE : October 16, 2022

1. Spot report on Falsification of Document incident committed on October 16, 2021 at

about 01:00 PM at Dubinan East, Santiago City, Isabela.

2. The arrested suspects were identified as Reigien Pagalilauan , 25 years old, single and a
resident of Bungad, San Pablo Isabela.

3. Investigation revealed that on October 16, 2022 at about 1:00 PM at Dubinan East,
Santiago City, Isabela, the suspect approach the two officers by James Pagalilauan y Adejuke who
claims she was asked by Police Officer Ederelina Galiza of the City Police Office warrant section
handed a copy of warrant of arrest (for Estafa) for PMSg Mauricio Zipagan. The suspect presented
the allegedly fake warrant of arrest of PMSg Zipagan to patrolman Manny Noel Pagulayan, Balubal
and Patrolman Arnold Pamittan y Pagulayan while conducting patrol. The two patrol officer verified
the authencity of the said warrant of arrest to the duty investigator and confirmed that no existing
record to be found thereof. Afterwhich, the duty patrollers approach the suspect that the warrant of
arrest is not genuine then the suspect suddenly run and the two duty patrollers immediately arrested
the suspect and apprised the suspects of his Miranda rights and thereafter, the suspect brought to the
police station for further investigation.

4. Necessary documents needed have been readied for the conduct of inquest against the
suspect.

5. Progress report to follow.

Prepared by: Noted by:

PSSg Dwight P Ramos PMAJ CHARLY B BARTOLOME

Investigator On Case Chief of Police

37
 Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
Philippine National Police
Santiago City Police Office
SANTIAGO CITY POLICE STATION 2
Santiago City, Isabela
MEMORANDUM

FOR : City Director

(Attn; C, PIDMB)

FROM : Chief of Police

SUBJECT : Progress Report re: Violation of Article 170 (Falsification of

Documents)

DATE : October 17, 2022

1. Reference: Spot Report re: Falsification of Document incident committed on

October 16, 2022 at about 01:00 PM at Dubinan East, Santiago City, Isabela.

2. Please be informed that a Falsification of Documents case was already referred to

the City Prosecutors Office against the arrested suspect through inquest proceeding on
October 17, 2022 conducted by Assistant Prosecutor Angela N Ganela docketed under NPS
Docket no. 18-0444. The respondents are ordered to be placed temporarily under the
custody of the Santiago City Police Station 2 pending the issuance of a commitment order.

3. For reference and request acknowledgement.

PMAJ CHARLY B BARTOLOME

Chief of Police

38
 Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
Philippine National Police
Santiago City Police Office
SANTIAGO CITY POLICE STATION 2
Santiago City, Isabela
October 17, 2022
CASE REFERRAL
The Honorable City Prosecutor
Santiago City Prosecutor’s Office
Santiago City, Isabela
(Attn: Duty INQUEST Prosecutor)
Sir/ Madam:
Respectfully referred to your good office for inquest are the pertinent records of investigation
relative to a case for violation of Art. 170 of the Revised Penal Code committed on October 16, 2022,
at about 1:00PM at Dubinan east, Satiago City, Isabela by the following suspect/s;
a. James Pagalilauan y Adejuke, 25 years old, single, resident of Bungad, San Pablo
Isabela (detained)

ARRESTING OFFICERS: a. Patrolman Manny Noel Pagulayan y Balubala

b. Patrolman Arnold Pamittan y Pagulayan

FACTS OF THE CASE

On or about 1:00 PM of October 16, 2022 at Dubinan East, Santiago City, Isabela, the
suspect approach the two officers by James Pagalilauan y Adejuke who claims he was asked by
Police Officer Ederlina Galiza of the City Police Office warrant section handed a copy of warrant of
arrest (for Estafa) for PMSg Mauricio Zipagan. The suspect presented the allegedly fake warrant of
arrest of PMSg Zipagan to patrolman Manny Noel Pagulayan, Balubal and Patrolman Arnold Pamittan
y Pagulayan while conducting patrol. The two patrol officer verified the authencity of the said warrant
of arrest to the duty investigator and confirmed that no existing record to be found. Afterwhich, the
duty patrollers approach the suspect that the warrant of arrest is not genuine then the suspect
suddenly run and the two duty patrollers immediately arrested the suspect and apprised the suspects
of his Miranda rights and thereafter, the suspect brought to the police station for further investigation.

EVIDENCE/ EXHIBIT:
A. Spot Report dated October 16,2022 F. Joint Affidavit of Arrest
B. Progress Report G. Affidavit of Witness
C. Investigation Report H. Blotter/Incident Report Form
D. Complaint Affidavit of the Victim Referral I. Inventory of Property Seized
E. Booking/ Information Sheet with mug shots J. Referral
and fingerprint dated October 16, 2022

This case will be presented by PSsg Dwight P Ramos, investigator-on-case of this unit.

Very truly yours,

PMAJ CHARLY B BARTOLOME

Chief of Police

39
BOOKING MUGSHOTS OF SUSPECT
JAMES ADEJUKE PAGALILAUAN

FINGERPRINT

40
Republic of the Philippines )
Province of Isabela ) s.s
City of Santiago )
-------------------------------------

JOINT AFFIDAVIT OF ARREST

We, Patrolman Manny Noel Pagulayan y balubal and Patrolman Arnold Pamittan y
Pagulayan, both of legal age, bonafide members of the Philippine National Police and presently
assigned at Santiago City Police Station 2, after having been duly sworn to in accordance with law, do
hereby depose and declare the following:

1. That we were the operatives tasked to conduct beat patrol along Dubinan East,
Santiago City, Isabela;

2. That on October 16, 2022 at around 1:00 PM, while we were patrolling, the suspect
approach us and presented the alleged warrant of arrest;

3. That we verified the authencity of alleged warrant of arrest to the duty investigator
and;
4. We confirmed that the alleged warrant of arrest is not genuine;

5.That we are executing this affidavit to attest the truth of the foregoing.

IN WITNESS WHEREOF, we have hereunto affixed our signaturesbelow this 16 th day

of October 2022 in Santiago City, Isabela.

Pat Arnold P Pamittan Pat Manny Noel B Pagulayan

Affiant Affiant

SUBSCRIBED AND SWORN TO before me this 16th day of October 2022, Santiago City,
Isabela.

ANGELA M GANELA
Assistant City Prosecutor

41
 Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
Philippine National Police
Santiago City Police Office
SANTIAGO CITY POLICE STATION 2
Santiago City, Isabela

Date: October 16,2022

REQUEST FOR MEDICAL EXAMINATION OF ARRESTED SUSPECTS

The Duty Physician

Santiago City Health Office

GREETINGS:

The undersigned respectfully request the conduct of Physical Examination to the following
arrested suspects named below, to wit:

1. James Pagalilauan y Adejuke

Further requests issue medical result for our reference.

Thank you for your favorable cooperation.

Respectfully yours,

PMAJ CHARLY B BARTOLOME

Chief of Police

SANTIAGO CITY MEDICAL CENTER

Department of Health 42
Purok 4, Rizal, Santiago City, Isabela
Email: CCDH_ hospital @gmail.com
Tel No. (075) 697 -7343
NOTE: NO REQUIRED MEDICAL TREATMENT
MEDICAL CERTIFICATE CONDUCTED at City Health Office, Santiago City, Isabela.

DR. ARIES C CASTILLO, MD ON: October 16,2022

Attending Physician

Republic of the Philippines

Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
Philippine National Police
Santiago City Police Office
SANTIAGO CITY POLICE STATION 2
Santiago City, Isabela

INVENTORY OF PROPERTY SEIZED

THIS IS TO CERTIFY that the following items were seized from the possession and control of
James Pagalilauan y Adejuke, to wit:

1. WARRANT OF ARREST (FAKE)

Confiscating Officers:

Pat Manny Noel B Pagulayan Pat Arnold P Pamittan

43
 PHOTOGRAPHS OF FALSIFICATED DOCUMENT ITEMS/EVIDENCES

MAURICIO ZIPAGAN
Aka, “MAU”

Republic of the Philippines

Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
Philippine National Police
Santiago City Police Office
SANTIAGO CITY POLICE STATION 2
Santiago City, Isabela

October 16, 2022

CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that the following are the excerpt of the police blotter of this office to wit:

NATURE OF INCIDENT: Falsification of Document

BLOTTER ENTRY NR: 18-0001
DATE/TIME/PLACE OF INCIDENT: 1:00PM October 16, 2022
Dubinan East, Santiago City, Isabela
44
FACTS:

At about 1:00 PM of October 16, 2022 at Dubinan East, Santiago City, Isabela, the suspect
approach the two officers by James Pagalilauan y Adejuke who claims he was asked by Police
Officer Ederlina Galiza of the City Police Office warrant section handed a copy of warrant of arrest
(for Estafa) for PMSg Mauricio Zipagan. The suspect presented the alleged warrant of arrest of
PMSg Zipagan to patrolman Manny Noel Pagulayan, Balubal and Patrolman Arnold Pamittan y
Pagulayan while conducting patrol. The two patrol officer verified the authencity of the said warrant of
arrest to the duty investigator and confirmed that no existing record to be found. Afterwhich, the duty
patrollers approach the suspect that the warrant of arrest is not genuine then the suspect suddenly
run and the two duty patrollers immediately arrested the suspect and apprised the suspects of his
Miranda rights and thereafter, the suspect brought to this station for proper disposition.

---------------------------------------------------NOTHING FOLLOWS-------------------------------------------------------

Prepared by: Noted by:

PO3 Jetro B Timmongnin PSUPT CHARLY B BARTOLOME

Investigator On Case Chief of Police

Philippine National Police

FOR POLICE BLOTTER ENCODER USE ONLY

BLOTER ENTRY NUMBER

INCIDENT RECORD FORM
18-0001

TYPE OF INCIDENT

FALSIFICATION OF DOCUMENT

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: ITEM “A” - REPORTING PERSON
1;00 PM OF OCTOBER 16, 2022 1;00 PM OF OCTOBER 16, 2022 Pat Manny Noel B Pagulayan

FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME

ZIMAPAGAN MAURICIO N/A MAU
CITIZENSHIP SEX/GENDER CIVIL STATUS DATE OF BIRTH (DD/MM/YY) AGE PLACE OF BIRTH HOME PHONE MOBILE PHONE
FILIPINO MALE SINGLE 08/12/1983 39 PUROK 5, MINANTE 1, CAUAYAN CITY,
ISABELA

CURRENT ADDRESS (HOUSE NUMBER/STREET) VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

PUROK 5 MINANTE 1 CAUAYAN CITY ISABELA

OTHER ADDRESS (HOUSE NUMBER/STREET) VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

45
HIGHEST EDUCATIONAL ATTAINMENT OCCUPATION ID CARD PRESENTED EMAIL ADDRESS (If Any)
COLLEGE GRADUATE N/A PRC ID Gizelle24@yahoo.com

ITEM “B” - SUSPECT DATA

CHECK HERE IF THERE IS NO SUSPECT INVOLVED AND THEREAFTER PROCEED TO ITEM “C”.
CHECK HERE IF THERE ARE TWO OR MORE SUSPECTS. THEREAFTER, USE ADDITIONAL INCIDENT REPORT FORM SHEETS FOR EACH OF THE SUSPECTS.
FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
PAGALILAUAN JAMES ADEJUKE JAMES
CITIZENSHIP SEX/GENDER CIVIL STATUS DATE OF BIRTH (DD/MM/YY) AGE PLACE OF BIRTH HOME PHONE MOBILE PHONE
FILIPINO MALE SINGLE 08/21/1993 25 TUGUEGARAO CITY, CAGAYAN

CURRENT ADDRESS (HOUSE NUMBER/STREET) VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

CENTRO SUR TUGUEGARAO CITY CAGAYAN
OTHER ADDRESS (HOUSE NUMBER/STREET) VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

HIGHEST EDUCATION ATTAINMENT OCCUPATION WORK ADDRESS RELATION TO EMAIL ADDRESS (If
VICTIM Any)
IF AFP/PNP PERSONNEL: RANK UNIT ASSIGNMENT GROUP WITH PREVIOUS CRIMINAL RECORD? [ ] YES [ ] NO STATUS OF PREVIOUS CASE
AFFILIATION (If Yes, Pls. Specify)
HEIGHT WEIGHT COLOR OF DESCRIPTION OF EYES COLOR OF HAIR DESCRIPTION OF HAIR UNDER THE INFLUENCE?
EYES NO DRUGS LIQUOR
OTHERS
FOR CHILDREN IN CONFLICT WITH THE LAW

NAME OF GUARDIAN GUARDIAN ADDRESS HOME PHONE MOBILE PHONE

DIVERSION MECHANISM

OTHER DISTINGUISHING FEATURES (DESCRIBE IN DETAIL CLOTHES, VEHICLE, SUNGLASSES, WEASPON/S, SCARS, AND OTHER DATA OR ACTIVITY OF THE SUSPECT/S WHICH WERE OBSERVED BY THE
REPORTING PERSON AND/OR WITNESS/ES TO IDENTIFY THE SUSPECT/S. THESE ARE IMPORTANT AND MAY BECOME EVIDENCE TO IDENTIFY, AND LINK TO THE CRIME, THE SUSPECT/S. USE
ADDITIONAL SHEET/S IF NECESSARY)

Annex “F”

BLOTTER ENTRY NUMBER: 18-0001

INCIDENT RECORD TRANSACTION RECEIPT

THIS CERTIFIES THAT

NAME OF REPORTING PERSON: Pat Manny Noel B Pagulayan ADDRESS OF REPORTING PERSON: PUROK 4, SAN ISIDRO IGUIG, CAGAYAN

REPORTED AN INCIDENT TO BE

TYPE OF INCIDENT: FALSIFICATION OF DOCUMENTS

WHICH INVOLVES

DATE/TIME OF REPORT: 1:00PM October 16, 2022 DATE/TIME OF INCIDENT: 1:00PM October 16, 2022

PLACE OF INCIDENT: Arellano st, Dubinan East, Santiago City , Isabela

RECORDED BY:

RANK/NAME/SIGNATURE

Annex “F”

PNPM-DO-DS-3-2-13

ITEM “C” - VICTIM DATA

CHECK HERE IF THERE ARE TWO OR MORE VICTIMS. USE ADDITIONAL INCIDENT REPORT FORM SHEETS FOR THE DATA OF THE ADDITIONAL VICTIMS.
FAMILY NAME FIRST NAME MIDDLE NAME QUALIFIER NICKNAME
ZIPAGAN MAURICIO N/A MAU

CITIZENSHIP SEX/GENDER CIVIL STATUS DATE OF AGE PLACE OF BIRTH HOME PHONE MOBILE PHONE
FILIPINO MALE SINGLE BIRTH 39 PUROK 5, MINANTE 1, CAUAYAN CITY, ISABELA
08/12/1983
CURRENT ADDRESS (HOUSE NUMBER/STREET) VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE
PUROK 5 MINANTE 1 CAUAYAN CITY ISABELA

OTHER ADDRESS (HOUSE NUMBER/STREET) VILLAGE/SITIO BARANGAY TOWN/CITY PROVINCE

HIGHEST EDUCATIONAL ATTAINMENT OCCUPATION WORK ADDRESS EMAIL ADDRESS (If Any)
COLLEGE GRADUATE N/A Gizelle24@yahoo.com

ITEM “D” - NARRATIVE OF INCIDENT

BLOTTER ENTRY NUMBER TYPE OF INCIDENT TIME DATE PLACE OF INCIDENT
18-001 FALSIFICATION OF DOCUMENTS 01:00PM OCTOBER 16, 2022 ARELLIANO ST., DUBINAN EAST, SANTIAGO CITY, ISABELA

ENTER IN DETAIL THE NARRATIVE OF THE INCIDENT OR EVENT, ANSWERING THE WHO, WHAT, WHEN, WHERE, WHY AND HOW OF REPORTING. (USE ADDITIONAL SHEET/S IF NECESSARY)

46
 At about 1:00 PM of October 16, 2022 at Dubinan East, Santiago City, Isabela, the suspect approach the two officers by James
Pagalilauan y Adejuke who claims he was asked by Police Officer Ederlina Galiza of the City Police Office warrant section handed a copy
of warrant of arrest (for Estafa) for PMSg Mauricio Zipagan. The suspect presented the alleged warrant of arrest of PMSg Zipagan to
patrolman Manny Noel Pagulayan, Balubal and Patrolman Arnold Pamittan y Pagulayan while conducting patrol. The two patrol officer
verified the authencity of the said warrant of arrest to the duty investigator and confirmed that no existing record to be found. Afterwhich,
the duty patrollers approach the suspect that the warrant of arrest is not genuine then the suspect suddenly run and the two duty patrollers
immediately arrested the suspect.

AUTHENTICATION
NAME/SIGNATURE OF REPORTING PERSON NAME/SIGNATURE OF DESK OFFICER
I HEREBY CERTIFY TO THE CORRECTNESS OF THE
FOREGOING TO THE BEST OF MY KNOWLEDGE AND
BELIEF.

CASE DISPOSITION (For Chief/Head of Office Use Only)

CHIEF OF STATION/OFFICE INSTRUCTIONS NAME OF DESIGNATED INVESTIGATOR-ON-CASE NAME OF CHIEF OF STATION/OFFICE

INSTRUCTIONS TO REPORTING PERSON

Keep this Incident Record Transaction Receipt (IRTR). 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 IRTR. For your reference,
the data below is the contact details of this police station.
Name of Police Station Telephone

Investigator-on-Case Mobile Phone

Name of Chief/Head of
Office Mobile Phone

47
NPS Investigation Form No.01, s.2008

Republic of the Philippines

Department of Justice
National Prosecution Service

INVESTIGATION DATA FORM

To be accomplished by the office
DATE RECEIVED NPS DOCKET NO.
(Stamped and initiated): Assigned to:
Time Received: Date assigned:

To be accomplished by complainant/counsel/law enforcer

(Use back portion if space is not sufficient)

COMPLAINANT/S: Name, Sex, Age, Address RESPONDENT/S: Name, Sex, Age, Address
N/A JAMES A. PAGALILAUAN
MALE
25 YEARS OLD
BUNGAD, SOLANA, CAGAYAN

LAW/S Violated ARRESTING OFFICER/S: Name &Address

FALSICATION OF DOCUMENTS Pat Manny Noel B Pagulayan
Purok 4,San Isidro Iguig, Cagayan
Pat Arnold P Pamittan
Purok 7, Bliss Village, Ilagan City,Isabela

DATE and TIME of COMMISSION PLACE of COMMISSION

JANUARY 15, 2018 SAN FERMIN AMUSEMENT PARK

6:00PM CAUAYAN CITY, ISABELA

1.Has a similar complaint been filed before any other office? YES_NO X
2.Is this complaint in the nature of counter-charge? YES_NO X
If yes, indicate details below.
3.Is this complaint related to another case before this office? YES_NO X

I.S No.:
Handling Prosecutor: Atty. ANGELA M. GANELA

CERTIFICATION

I CERTIFY, under oath, that all information in this sheet are true and correct to the best of
my knowledge and belief, that I have not commenced any action or filed any claim involving the same
issues in any court, tribunal, or quasi-judicial agency, and the if I should thereafter learn that a similar
action has been filed and/or is pending, I shall report that the fact to this honorable office within five
(5) days form knowledge thereof.
PSSg Dwight P Ramos

(Signature over Printed Name)

SUBSCRIBED AND SWORN TO before me this court thisday of

,2018 inCauayan City, Isabela. .

ANGELA M. GANELA

Prosecutor Administering Oath

*1,2,3, and certification need not be accomplished for inquest case.
48