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Republic of the Philippines

Province of Palawan
Municipality of Dr. Jose P. Rizal
BARANGAY CANDAWAGA
OFFICE OF THE PUNONG BARANGAY

BARANGAY PROTECTION ORDER

NAME OF RESPONDENT_______________________________________________________

ADDRESS: __________________________________________________________________

ORDER

________________________________ applied for a BPO on _____________________under

Oath starting that _____________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

After having heard the application and the witnesses and evidence, the undersigned hereby issue this
BPO ordering you to immediately cease and desist from causing or threatening to cause physical harm
to ________________________________________________________________________________
And his / her namely :

______________________________________ ___________________________________________
______________________________________ ___________________________________________

This BPO is effective for _____ days from receipt:

“VIOLATION OF THIS ORDER IS PUNISHUBLE BY LAW.”

JOHNNY A. SALVADOR
Punong Barangay

Copy received:

By_________________________________________________________________________
(Signature over printed name)

Date Received ______________________________________________________________


Served by: _________________________________________________________________

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