Republic of the Philippines

Province of Pangasinan
Municipality of Bautista
BARANGAY SINABAAN

OFFICE OF THE LUPONG TAGAPAMAYAPA

_______________________________ Barangay Case No. ____________________

_______________________________ For: _______________________________
Complainant/s _______________________________
-against-

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Respondent/s

AMICABLE SETTLEMENT

We, complainant/s and respondent/s in the above-captioned case, do hereby agree to settle our dispute as follows:

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And bind ourselves to comply honestly and faithfully with the above terms of settlement.

Entered into this 9th day of November, 2022.

Complainant/s Respondent/s

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ATTESTATION

I hereby certify that the foregoing amicable settlement was entered into by both parties freely and voluntarily, after I had explained
to them the nature and consequence of such settlement.

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Punong Barangay/Lupon Chairman