Republic of the Philippines

PHILIPPINE NATIONAL POLICE

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CHAIN OF CUSTODY FORM

Nature of Case: _______________________________________________
Name of Suspects/s: __________________________________________
Time, Date and Place of Occurrence: ____________________________
Arresting Officers / Operating Unit: ____________________________
Description of Evidence/s: _____________________________________
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TURNED OVER BY : ________________________________

(Name and Designation)
Agency / Address : ________________________________
Time and Date : ________________________________
Remarks : ________________________________

RECEIVED BY : ________________________________
(Name and Designation)

Agency / Address : ________________________________

Time and Date : ________________________________
Remarks : ________________________________

TURNED OVER BY : ________________________________

(Name and Designation)
Agency / Address : ________________________________
Time and Date : ________________________________
Remarks : ________________________________

RECEIVED BY : ________________________________
(Name and Designation)

Agency / Address : ________________________________

Time and Date : ________________________________
Remarks : ________________________________
TURNED OVER BY : ________________________________
(Name and Designation)
Agency / Address : ________________________________
Time and Date : ________________________________
Remarks : ________________________________

RECEIVED BY : ________________________________
(Name and Designation)

Agency / Address : ________________________________

Time and Date : ________________________________
Remarks : ________________________________

TURNED OVER BY : ________________________________

(Name and Designation)
Agency / Address : ________________________________
Time and Date : ________________________________
Remarks : ________________________________

RECEIVED BY : ________________________________
(Name and Designation)

Agency / Address : ________________________________

Time and Date : ________________________________
Remarks : ________________________________

TURNED OVER BY : ________________________________

(Name and Designation)
Agency / Address : ________________________________
Time and Date : ________________________________
Remarks : ________________________________

RECEIVED BY : ________________________________
(Name and Designation)

Agency / Address : ________________________________

Time and Date : ________________________________
Remarks : ________________________________