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Republic of the Philippines )

____________, ________ ) s.s.

x- - - - - - - - - - - - - - - - - - - - - -x


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

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

1. We are among the members of the

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

2. 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. __________________________, __________________;

3. On the complaint dated _______________, (state the act and the

crime committed).

4. 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;

5. 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
6. 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;

7. 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.

8. 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


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