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  • Small Claims 1

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    Natsu Dragneel
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    Copyright:

    © All Rights Reserved
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    10 views5 pages

    Small Claims 1

    Uploaded by

    Natsu Dragneel
    ccto

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 5
    Civil Case No. For Cole cum ok O08) ‘Tis FORMS} ‘AND MAY BE PRODUCED (Ang FORM na fo ay LIBRE at manaring kopyahin) ‘STATEMENT OF CLAIM. {HABLA NG PAGSINGIL) 1. -Thepeal reuse of hepa eas fons ‘Rg ona paigoy nomena) i a WA Ny wA@orianras ox NE RE STARS Finestorng Hoga) anon) en ane (Pata check on ay oie allowing) Peeing manmade PR) INDIVIDUAL veonronarion PARTNERSHIP (snd) ‘worn ‘paso © COOPERATIVE ‘SOLE PROPRIETORSTIP ‘operas (olor Parmar) HOME ADDRESS: (City) Agus a 4 (Pahatirang Sulat sa Bahay) [12 | ZIP code Province if applicable) i ZAP code (Lalawigan, kung meron) ‘Telephone No, (2) $32-FF4 Celiphone No. 16241 23.521 (Telepono Big) (Selpon Big) ‘ PLACE OF WORK N/R (Lugar ng Pinagtal TatephoneNo (1) 424 321 cellphone No. He2F1.0 122806 ‘(Selpon Big.) (Cetepono Ble) peacorwore W/o (agar ng Pnaguanakaiohor) Ab OF REPRESENTATIVE epee N/A Pangan me Kinnowan ng mer) HOME ADDRESS: (Cio) eS — (Paharirang Sulat sa Bahay) Lamgsod] ZIP code (Province if applicable) SS — alaigan, keg meron) oP “Telephone No. Calishone No. Celepoo Big] (Selon Big) coe rrr (gr ng Pinagiatabaaon) Telephone No. wae, (Telepono Big) (Selpon Blg,) Note: Ifyou need more space, you can write at the back of this form. whe (*Tala: Kung kailangan mo ng ‘orm na ito.) (0 Wy doesnt meat foney? (Bakit ang Hinahabla ay nagkautang na ‘salapi sa Naghahabla?) ‘you need more space, please use the back page ) (Kung kailangan mo ns karagdagang patlang. maaring gamitin fang likod ng painang it.) (6) When did this happen? (Kalan ito nangyari?) 2,20 Date. (Passa) Ino specific date give the time period (Kang walang tiyak na peta, sbigay ang tantiyang panahon) Date Satrted (Petsa nagsimula) ‘Through (Hangeang) (@) How did you compate the money owed te yu? (Do notin ag eG fees) Ho int foal 04 tase tele cal echt ‘Pano mo kinuwenta ang salapin inatang sa iyo?) (Hind kasama ang dayad pegpapatala sa hukuman.) 5. @ Did you ask the defendant to pay you before you fled this case? {Sinngl mo ba ang Hinahablabago ka nagsampang kasong #07) Yes No (00) (Hindi) (b) How did you ask (Pano mo siningil Zin Person (Sa kanya mismo) _(Satelepono) ein Writing co Others (Please speeif)___—— {ba pa (Pakisulat kung P2800] (©) When di you do this? _ Feburary 20 4 ‘Kailan so ginawa ito) 4 wats your prof nan owes you money? eC ut Seo wong et isos esc rowan ang Hiaaaa may ange S10) 8 iyo?) 5, Did you attach your proof to this form? Pa Kang infakp ang katbaya oprowebs sa Form nat?) aves No (00) (Hindi) 6, Was this claim refered tothe barangay? {Daman ba sa barangay ang panning nao) TINo TLNot Covered Byes (00) (Hint) (Hindi sakop) State Reason: (Gsulat ang dahilan) cea Cetfcate to File Action of a Compromise Agreement executed se tyes, do you hav before the vi (Kung 00, meron ka bang patunay

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