Sample request Format of Polygraph Examination
Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
_________________________________________
___________________________
MEMORANDUM
FOR : Director, PNP Crime Laboratory
FROM :
SUBJECT : Request for Polygraph Examination
DATE :
1. Request conducts polygraph examination on the person of
__________________ (or following persons):
a) NATURE OF CASE :
b) VICTIM :
c) SUSPECT :
d) TDPO :
2. Further request that this Office be furnished a copy of examination result
for our reference.
3. For consideration.
__________________________
(CHIEF OF OFFICE)