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DEED OF DONATION

KNOW ALL MEN BY THESE PRESENTS:

JUAN DELA CRUZ of legal age, Filipino Citizen, and a resident of Brgy Inzo Arnaldo
Village, Roxas City, Philippines,
Herein referred to as DONOR:

and

PEDERO SANTOS of legal age, Filipino Citizen, and a resident of Brgy Inzo Arnaldo
Village, Roxas City, Philippines,
Herein referred to as DONEE.

WITNESSETH

That the donor is the absolute and registered owner of:

KIND : pistol
MAKE : GLOCK 17
CALIBER : 9mm
SERIAL NO : HPL 199

That for and in consideration in the trust, fidelity, help, love and affection
shown upon the DONOR by the DONEE as his younger brother, and as an act of
gratitude on her part, the DONOR hereby donate: (1 unit GLOCK 17 with serial
number: HPL 199) and voluntary give to the DONEE;

That the DONEE hereby accepts and receives his donation made in favor by
the DONOR and hereby manifest his gratefulness for the latter’s generosity and
liberality.

IN WITNESS WHEREOF, the parties hereby set their hands this ____ of March,
2012, Philippines.

JUAN DELA CRUZ PEDRO SANTOS


DONOR DONEE

SIGNED IN THE PRESENCE OF:

Emilio D Lara Antonio B Buenvenida


Witness Witness
REPUBLIC OF THE PHILIPPINES)
CITY OF ROXAS ) S.S

BEFORE ME, this day of March 2012 in the City of Roxas, Philippines,
JUAN DELA CRUZ personally appeared before me with Res. Cert. No.
__________________issued at Roxas City on and PEDRO SANTOS
with Res. Cert. No_____________________ issued at Roxas City on ________________ .
Both known to me to be known and to be the same persons who executed the
foregoing instruments and they acknowledged before me the same is free and
voluntary act and deed swore under oath to be truth thereof.

WITNESS MY HAND AND SEAL, on the date and place first above written.
Doc.No. _______________:
Page No. ______________ :
Book No. ______________:
Series of _______________:
Deed of Donation Ord.

_______________________________
Notary Public
Republic of the Philippines)
City of Roxas________ ___)

AFFIDAVIT OF TRANSFER

I, PO2 Amie Fallaria Bulaqueña, Filipino, of legal age, single, and a resident
of Brgy, Inzo Arnaldo Village, Roxas City, Capiz, after having been sworn to in
accordance with law, do hereby depose and say;

That I am a bonafide holder of a licensed firearm known as GLOCK 17 caliber


pistol with serial number HPL199;

That I am, waving all my rights over the said firearm in favor of PO1 Randy
Fallaria Bulaqueña, of legal age, single, and a resident of Brgy, Inzo Arnaldo
Village, Roxas City, Capiz,

That I am, executing this Affidavit for the purpose of establishing the
foregoing facts.

IN WITNESS WHEREOF, I have hereunto affixed my hand this ____th day of March
2012 at Roxas City, Capiz.

PO2 Amie F Bulaqueña PO1 Randy F Bulaqueña


DONOR DONEE

Subscribed and Sworn to this day of _______________________ at


__________________________, Philippines.
Republic of the Philippines
HEADQUARTERS PHILIPPINE NATIONAL POLICE
Camp Crame, Quezon City

APPLICATION FOR SPECIAL PERMIT

THE CHIEF OF THE PHILIPPINE NATIONAL POLICE


Camp Crame, Quezon City

15 March 2012
(Date)

Sir,

I have the honor to request that a Special Permit under the provisions of
Section 879 of Revised Administrative Code and General Orders nos. 7, 7 - A and 7
- B be issued to PO1 Randy Fallaria Bulaqueña, 25 years old and employee of the
Philippine National Police for the following described firearms and ammunition:

FIREARMs and AMMUNITION


KIND MAKES CALIBER SERIAL No. QUALITY
Pistol Glock 17 9MM HPL 199

I Hereby certify that the above described arm (s) (is, are) necessesary for the
personal protection of PO1 Randy F Bulaqueña in the performance of his official
duty and for his personal protection from enemy while rendering official duties.

I further certify that I will cause PO1 Randy F Bulaqueña to surrender said
permit and firearms to the Chief of the Philippine National Police when said firearm
(is, are) no longer necessary for his personal protection in the performance of his
official duties.

I also promise that in case he loses or fails in the manner to account for the
arm, I will cause his to pay a fine of P40.00 for each arm, or if he resigns, or is
separated from the salary or any money due to his pay a fine of P40.00 for each
arm, or if he resigns or is separated from the salary or any money due to his
produce the receipt from the Chief of Philippine National Police showing that his
firearm (has, have) been deposited or Certificate of the Property Officer of her
Office stating that the Government firearm (has, have) been duly accounted for in
accordance with Executive Order 186, dated February 11, 1939.

AND I FURTHER PROMISE to notify that the Chief of Philippine National Police
in case of his change of station.

SALVADOR S DAGOON JR, PESE


Police Superintendent
Chief of Police
(Director/Head of Office/Commanding Officer)

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