KP Form No.

10
Republic of the Philippines
Province of Camarines Sur
Municipality of Lupi
Barangay ______________________
OFFICE OF THE LUPONG TAGAPAMAYAPA
NOTICE FOR CONSTITUTION OF PANGKAT
TO: ______________________
______________________
Complainant/s

______________________
______________________
Respondent/s

You are hereby required to appear before me on the _________ day of

____________, 19 ____, at _______ oclock in the morning/afternoon for the constitution of the
Pangkat ng Tagapagkasundo which shall conciliate your dispute. Should you fail to agree on the
pPangkat membership or to appear on the aforesaid date for the constitution of the Pangkat, I shall
determine the membership thereof by drawing lots.
This _________ day of _________, 20 ___.

_________________________
Punong Barangay
Notified this ______ day of __________,20 ___.
TO: _________________________
___________________________
_________________________
___________________________
Compliant/s

Respondent/s