Barangay case No.

: 19-LT03-068
Nature of Complaint: Forcible Entry

Complainant
Vs.
Jesus Caballeda
Purok Progreso,
Barangay Sum-ag, Bacolod City
Respondent

CERTIFICATE TO FILE ACTION

This is to certify that: ( cross whichever is not applicable)

/X/ Respondent:

Jesus Caballeda
Failed or refused to obey summons or to appear for hearing.

/ / no settlement
/ X / settlement repudiated
/ X / non-compliance of amicable settlement.

And therefore the corresponding complaint for the dispute may now be
filed in court or government office.

Given this 7th day of August, 2018 at Barangay Sum-ag, Bacolod City,
Negros Occidental, Philippines.

Lupon secretary

Attested by:

Lupon Chairman