Page _____

Book No. ____

RECORD BOOK OF BARANGAY CASES

(Under Katarungang Pambarangay/PD NO. 1508)

I – TITLE

____________________ Barangay Case No. ________

__________________________ Date Filed: _______________

(Complainant/s)
-for –

- against - ______________________

___________________________
(Respondent/s)

II – MEDIATIONAL/CONCILIATION FUNCTIONS

Summons served by: ________________ Date served: _________________________

Subpoena served by: ________________________________
Answer filed on: ____________________________________
Counter-claim filed on: _______________________________
Cross-party complaint filed on: _________________________
Third-party complaint filed on: _________________________
Date (s) for Mediation : _____________________________
Date (s) for Conciliation : _____________________________
Date (s) for Arbitration : _____________________________
To: __________________________________
By: __________________________________
By: __________________________________
By: __________________________________
By: __________________________________

III – DISPOSITION OF CASE (Please Check appropriate box)

Mediated by Barangay Captain ______Notice to Choosen Pangkat Member

_____Arbitrated by Barangay Captain ______Conciliated by Pangkat
_____Settlement Repudiated ______Arbitrated by Pangkat
_____Certification to file Action ______Petitioned for Annulment of Award
_____ Forwarded to court/Gov’t. Office ______Certification to bar action/Counter-claim
_____ Case dismissed ______Others (See remarks)
Gist of Settlement/Arbitration Award: ________________________________________________________
__________________________________________________________________________________________

IV – MONITORING

Monitored: Nature of Case Status of Case

____________ ____Criminal _ __Mediated ____ Conciliated

Month ____Civil ____ Arbitrated ____ Dismissed
____Others ____Pending ____ Forwarded to
Court/Gov’t. Office

Remarks: ___________________

CERTIFIED CORRECT:

MARIVIC SAYSON-RULLODA
Lupon Secretary
ATTESTED:

LYZANDER CEDRIC D. MAANDIG

Lupon Chairman
 Page _____
Book No. ____

RECORD BOOK OF BARANGAY CASES

(Under Katarungang Pambarangay/PD NO. 1508)

I – TITLE

___________________________ Barangay Case No. __________

____________________________________ Date Filed: _________________

(Complainant/s)
-for –

- against - __________________________________

____________________________
_____________________________________
(Respondent/s)

II – MEDIATIONAL/CONCILIATION FUNCTIONS

Summons served by: ________________________________ Date served: __________________________

Subpoena served by: ________________________________
Answer filed on: ____________________________________
Counter-claim filed on: _______________________________
Cross-party complaint filed on: _________________________
Third-party complaint filed on: _________________________
Date (s) for Mediation : _____________________________
Date (s) for Conciliation : _____________________________
Date (s) for Arbitration : _____________________________
To: __________________________________
By: __________________________________
By: __________________________________
By: __________________________________
By: __________________________________

III – DISPOSITION OF CASE (Please Check appropriate box)

Mediated by Barangay Captain ______Notice to Choosen Pangkat Member

_____Arbitrated by Barangay Captain ______Conciliated by Pangkat
_____Settlement Repudiated ______Arbitrated by Pangkat
_____Certification to file Action ______Petitioned for Annulment of Award
_____ Forwarded to court/Gov’t. Office ______Certification to bar action/Counter-claim
_____ Case dismissed ______Others (See remarks)
Gist of Settlement/Arbitration Award: ________________________________________________________
__________________________________________________________________________________________

IV – MONITORING

Monitored: Nature of Case Status of Case

____________ ____Criminal ____Mediated ____ Conciliated

Month ____Civil ____ Arbitrated ____ Dismissed
____Others ____Pending ____ Forwarded to
Court/Gov’t. Office

Remarks: _____________________________

CERTIFIED CORRECT:

_____________________
Lupon Secretary
ATTESTED:

_____________________
Lupon Chairman