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Polygraph Examination

PNP sample request form for polygraph examination

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Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
_________________________________________
___________________________
MEMORANDUM
FOR

:

FROM

:

SUBJECT

:

DATE

Director, PNP Crime Laboratory

:

Request for Polygraph Examination

1.
Request conducts polygraph
__________________ (or following persons):
a)

VICTIM
SUSPECT
TDPO

person

of

:

d)

the

:

c)

on

NATURE OF CASE :

b)

examination

:

2.
Further request that this Office be furnished a copy of examination result
for our reference.
3.

For consideration.

__________________________
(CHIEF OF OFFICE)
 
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