Katarungang Pambarangay Form No.

4
Republic of the Philippines
Province of _______________
City / Municipality of _______
Barangay _________________
OFFICE OF THE PUNONG BARANGAY
__________ , 20
____
LIST OF APPOINTED LUPON MEMBERS
Listed hereunder are the duly appointed members of the Lupong Tagapamayapa
in this Barangay who shall serve upon taking their oath of office and until a new lupon is
constituted on the third year following their appointment.
1. _______________________

9. _______________________

_
2. _______________________

_
10. _______________________

3. _______________________
_
4. _______________________
_
5. _______________________
_
6. _______________________
_
7. _______________________
_
8. _______________________
_

11.
________________________
12.
________________________
13.
________________________
14.
________________________
15.
________________________

16. _______________________
_

19. _______________________
_

17.

20. _______________________

________________________

18. _______________________
_
_______________________
Punong Barangay
ATTESTED:
__________________________
Barangay / Lupon Secretary

IMPORTANT:

This list shall be posted in three (3) conspicuous places in the

barangay for the duration of the terms of those named above.

WARNING:

Tearing or defacing this notice shall be subject to punishment

According to law.