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Republic of the Philippines, Barangay No.

101 Quezon City, Philippines Office of the Lupong Tagapamayapa

Michael Romero, complainant, Office Address: 274 EDSA, Quezon City Brgy. Case No. 01 Against For: Multiple Cause of Action

Mario Dinglasan, respondent, 212 Sta. Maria Street, Pasig City

CERTIFICATION TO FILE ACTION

This is to certify that: 1. There was no personal confrontation between the parties involved before the Punong Barangay, so mediation failed. 2. The Punong Barangay set the meeting of the parties and constitute a pangkat for personal confrontation of the dispute. 3. The respondent wilfully failed or refused to appear without justifiable reasons in the conciliation proceeding before the pangkat. 4. Therefore, the corresponding complaint for the dispute may now be filed in court or other government office.

This August 01, 2013 of Quezon City, certified by:

_________________________ Pangkat Secretary

________________________ Pangkat Member

Attested by:

Approved by:

__________________________ Pangkat Chairman

_________________________ Punong Barangay/Lupon Chairman