Ltia Enhanced Forms 1 7

CY LUPONG TAGAPAMAYAPA INCENTIVES AWARDS
(LTIA)
LTIA FORM 01-PERFORMANCE EVALUATION FORM
A. IDENTIFYING INFORMATION
Lupong Tagapamayapa
City/Municipality
Region
Category
B. EVALUATION CRITERIA
CRITERIA ASSIGNED POINT

SCORE
I. EFFICIENCY IN OPERATIONS 35
A. Observance of Settlement Procedure and Settlement 15
Deadlines
B. Systematic Maintenance of Records 5
C. Timely Submission of Reports to Concerned Agencies 5
D. Conduct of monthly meetings exclusively on KP matters 10
II. EFFECTIVENESS IN SECURING THE SETTLEMENT 30

OF INTERPERSONAL DISPUTE OBJECTIVE OF THE
KATARUNGANG PAMBARANGAY (KP)
A. Quantity of settled cases against filed 10
B. Quality of Settlement of Cases 10
C. At least 80% compliance with the terms of settlement or 10
award after the cases have been settled
III. CREATIVITY AND RESOURCEFULNESS OF THE 25
LUPONG TAGAPAMAYAPA
A. Settlement Technique 5
B. Coordination with concerned agencies relating to 5
disputes filed
C. Sustained information drive to promote KP 5
E. KP Training or seminar within the assessment period 10
IV. AREA OR FACILITY FOR KP ACTIVITIES 5
V. FINANCIAL OR NON-FINANCIAL SUPPORT 5
TOTAL POINT SCORE 100
1|LTIA FORM 01-PERFORMANCE EVALUATION FOR
(LTIA)
LTIA FORM 01-PERFORMANCE EVALUATION FORM
C. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.
Chairperson - Awards Committee
Vice Chairperson - Awards Committee
Member - _Awards Committee
D. DATE ACCOMPLISHED
2|LTIA FORM 01-PERFORMANCE EVALUATION FOR

CY LUPONG TAGAPAMAYAPA INCENTIVES AWARDS (LTIA)
LTIA FORM 02-CONSOLIDATED PERFORMANCE EVALUATION
Lupong Tagapamayapa
City/Municipality
Region
Category
B. CRITERIA AND PERFORMANCE RATING
CRITERIA ASSIGNED PERFORMANCE TOTAL AVERAGE

POINT RATING POINT POINT
SCORE EVALUATOR SCORE SCORE
1 2 3 4 5
I. EFFICIENCY IN 35
OPERATIONS
A. Observance of 15
Settlement
Procedure and
Settlement
Deadlines
B. Systematic 5
Maintenance of
Records
C. Timely Submission 5
of Reports to
Concerned
Agencies
D. Conduct of 10
monthly meetings
exclusively on KP
matters
II.EFFECTIVENESS IN 30
SECURING THE
SETTLEMENT OF
INTERPERSONAL
DISPUTE OBJECTIVE OF
THE KATARUNGANG
PAMBARANGAY (KP)
A. Quantity of settled 10
cases against filed
3|LTIA FORM 02-CONSOLIDATED PERFORMANCE EVALUATIO

N
B. Quality of 10
Settlement of Cases
C. At least 80% 10
compliance with
the terms of
settlement or award
after the cases have
been settled
III. CREATIVITY AND 25
RESOURCEFULNESS OF
THE LUPONG
TAGAPAMAYAPA
A. Settlement 5
Technique
B. Coordination with 5
concerned agencies
relating to disputes
filed
C. Sustained 5
information drive to
promote
Katarungang
Pambarangay 10
D. KP Training or
seminar within the
assessment period
IV. AREA OR FACILITY 5

FOR KP ACTIVITIES
V. FINACIAL OR NON- 5
FINANCIAL SUPPORT
GRAND TOTAL POINT

SCORE
100
OVERALL
PERFORMANCE RATING

N

N
LTIA FORM 03 [C/M]-COMPARATIVE PERFORMANCE EVALUATION
City/Municipality
Province
Region
Category
B. COMPARATIVE EVALUATION RESULTS
LUPONG TAGAPAMAYAPA (LT) OVERALL ADJECTIVAL RANK

PERFORMANC RATING
E RATING
1.
2.
3.
4.
5.
n
6|LTIA FORM 03 [C/M]-COMPARATIVE PERFORMANC

E
LTIA FORM 03 [P]-COMPARATIVE PERFORMANCE EVALUATION
Province
Region
Category

PERFORMANCE RATING
RATING
1.
2.
3.
4.
5.
n
7|LTIA FORM 03 [P]-COMPARATIVE PERFORMANCE EVALUATIO

N
LTIA FORM 03 [R]-COMPARATIVE PERFORMANCE EVALUATION
Region
Category

PERFORMANCE RATING
RATING
1.
2.
3.
4.
5.
n
8|LTIA FORM 03 [R]-COMPARATIVE PERFORMANCE EVALUATIO

N
(LTIA)
1. VALIDEE LT 1. VALIDEE LT
2. FINDINGS 2. FINDINGS
3. RECOMMENDATION(S)
4. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.
DATE ACCOMPLISHED
9|LTIA FORM 04 -PERFORMANCE VALIDATION REPORT FOR

(LTIA)
April 11, 2017
Mr. CATALINO S. CUY

Undersecretary/ OIC Secretary
Chairperson
National Awards Committee
Lupong Tagapamayapa Incentives Awards
DILG-NAPOLCOM Center, Quezon City
Sir:
We are pleased to transmit the list of Regional Finalists for CY 2017 Lupong
Tagapamayapa Incentives Awards (LTIA) together with their respective documentation
reports, as follows:
Highly Urbanized Cities Category –BRGY. DOONGAN, BUTUAN CITY

Component Cities Category - BRGY. TELAJE, TANDAG CITY, SURIGAO DEL
SUR 1 -3 Class Municipalities Category - BRGY. URBIZTONDO, CLAVER,
st rd
SURIGAODEL NORTE 4th-6th Class Municipalities Category - BRGY. QUEZON, MAINIT,

SURIGAODEL NORTE
Please find the following enclosures:

(1) Original copy of LTIA Form 03 [R]-Comparative Performance Evaluation Form
duly accomplished and signed by the Regional Awards Committee;
(2) Certified true copies of LTIA Forms 03 [P] and 03 [C/M]-Comparative
Performance Evaluation Forms duly accomplished and signed by the
Provincial/City/Municipal Awards Committee;
(3) Original copy of LTIA Form 06-Summary of Cases duly accomplished and signed
by the Lupon Secretary, Lupon Chairman, C/MLGOO and LTIA Regional Focal
Person;
(4) Original copy of LTIA Form 07-Performance Highlights with required
attachments duly accomplished and signed by the Lupon Secretary, Lupon
Chairman, C/MLGOO and LTIA Regional Focal Person; and
(5) Original copy of LTIA Form 07-A-List of Cases duly accomplished and signed by
the Lupon Secretary and Lupon Chairman.
Very truly yours,
LILIBETH A. FAMACION, CESO III
10 | L T I A F O R M 0 5 - O F F I C I A L E N T R Y F O R
(LTIA)
Chairperson, Regional Awards Committee (RAC)
(LTIA)
ATTY. CLEMENTINO C. RABOR MS. BERNADETTE C. ONCINES, LLB

Vice Chairperson, RAC Member, RAC
PCI MARIFE M FAROL MR. ARNOLD L. TAPERE

Member, RAC Member, RAC
MS. MARY MAY R. CADOSALES-DIAZ

Member, RAC
(LTIA)
The Chairperson
National Awards Committee
Sir/Ma’am:
We would like to inform you that based on the assessment of the different Awards
Committees, Barangay Lupons under the Category did not qualify in the selection of
LTIA nominees for the national level. Listed below are the following reason/s for the
non-submission of nominees:
REASON/S:
Please find the following enclosures:

(1) Original copy of LTIA Form 03 [R]-Comparative Performance Evaluation
Form duly accomplished and signed by the Regional Awards Committee;
(2) Certified true copies of LTIA Forms 03 [P] and 03 [C/M]-Comparative
Performance Evaluation Forms duly accomplished and signed by the
Provincial/City/Municipal Awards Committee;
Very truly yours,
Chairperson, Regional Awards Committee (RAC)
Vice Chairperson, RAC Member, RAC
13 | L T I A F O R M 0 5 - A : N O N - S U B M I S S I O N O F 0 F F I C I A L E N T R
(LTIA)
CATEGORY:
FINALIST LUPONG TAGAPAMAYAPA : POPULATION :
PUNONG BARANGAY: LAND AREA :
CITY/MUNICIPALITY : TOTAL NO. OF CASES:
MAYOR: NUMBER OF LUPONS:
PROVINCE: MALE :
REGION: FEMALE :
General Instruction: Please read the Technical Notes at the back before accomplishing this form. Supply only the number.
NATURE OF CASES ACTION

TAKEN
(1) SETTLE NOT OUTSIDE BUDGET
TOTAL
D (2) SETTLED (3) THE ALLO-
(cases
CERTIFIE DROP- JURISDICTION CATED
filed)
CRIMI- MEDIA- CONCI ARBIT PEN- DIS- REPU- D PED/ OF THE (6)
CIVIL OTHERS TOTAL TOTAL TOTAL BARANGAY
NAL TION - - DING MISSED DIATED TOFILE WITH--
(1b) (1c) (1D) (2D) (3F) (5)
(1a) (2a) LIATION RATION (3a) (3b) (3c) ACTIONI DRAW
(2b) (2c) N N
COURT (3e)
(3d)
***Total Number of Lupons excluding Lupon Chairman and Lupon Secretary

***Please attached Form 06-A “LIST OF CASES”
14 | L T I A F O R M 0 6 - S U M M A R Y O F C A S E S
(LTIA)
Guidance on counting: (NOT INCLUDED IN THE SUBMISSION)
(LTIA)
Settled Cases arethose cases that undergone KP process such as Mediation, Conciliation and Arbitration without repudiation and
recurrence of cases settled by the Lupon.
Unsettled Cases aredefined as follows:

 Dismissed Cases –cases where complainant and/or respondent after due notice, refuses or willfully fails to appear without
justifiable reason on the date set for mediation, conciliation or arbitration. Such dismissal ordered by the Punong
Barangay/Pangkat Chairman after giving the complainant and/or respondent an opportunity to explain his non-appearance
shall be certified by the Lupon or Pangkat Secretary as the case may be, and shall barthe complainant and/or respondent from
seeking judicial recourse for the same cause of action as that dismissed.
 Pending - those cases which have been filed within assessment period but was not able to settle within the assessment period.
 Dropped/Withdrawn - cases where either party shows no intention to continue the process of settling their dispute and
decided to withdraw or dropped the case in the Barangay level. This should be proven by a written document signed by both
parties stating their lack of intention to continue the case.
 Repudiated is where one of the parties refused to perform the settlement or the arbitration award and file a repudiationto the
Punong Barangaywithin the prescribed period set under the Revised Katarungang Pambarangay Law. Within 10 days from
the date of settlement in case of settlement agreement while within five (5) days from the date of the arbitration award.
Outside the Jurisdiction of the Barangay. These are cases which may be brought to the Barangay level but shall only be recorded in the
Barangay and later on endorsed to the proper office which can give it the appropriate action. This is not included in the total number
of cases filed.
(LTIA)
Category
Name of the Lupong Tagapamayapa
Punong Barangay
City/Municipality
Mayor
Province Barangay Logo Here
Region
IRA
Land Area
Population
LTIA Awards Received (all levels)
GENERAL INSTRUCTION: Kindly fill-out this form by following the instructions stated per sub-criteria.
CRITERIA
I. EFFICIENCY IN OPERATIONS
A). Observance of
Settlement
Procedure  Describe how the Lupon Secretary records every dispute and attach two (2) photos of the record book and sample
and entries in the record book with caption.
Settlement
Deadlines NOTE: Record Book entries should contain docket number, names of the parties, date and time filed, nature of the case and
disposition.
1) a) Proper
Recording
of every dispute
17 | L T I A F O R M 0 7 - P E R F O R M A N C E H I G H L I G H T
(LTIA)
2) Settlement and
 Briefly describethe actual experience of the Lupong Tagapamayapa in handling the cases filed in the Barangay.
Award Period
(Note: Please do not state the provision of the KP Law re: settlement and award period.)
 Kindly fill-out the table below. First line is filled-out as guide.
 Provide how many case/s is settled through Mediation, Conciliation, Conciliation with Extendible Period,
Arbitration and Conciliation beyond 46 days.
 Attach four (4) photos with caption of on-going settlement of dispute.
SETTLEMENT AND AWARD
PERIOD
C46+ -Conciliation beyond 46
LEGEND: M-Mediation C-Conciliation A-Arbitration C w/ EP-Conciliation with Extendible Period
days
CASE CASE TITLE COMPLAINT NATURE DATE DATE OF ACTION DATE OF
NO. TITLE FILED INITIAL TAKEN SETTLEM
CONFRONTATIO (M, C, C w/ EP, ENT
N OF PARTIES A and C46+)
2016-01 Juan Dela Cruz vs. Collection of January January 25, 2016 M January 28,
Juana Change Sum of Money Civil 22, 2016 2016
(LTIA)
B. Systematic  Describe the techniques the Lupon Secretary used in keeping a systematic maintenance of records.
Maintenance of  Provide two (2) Photos with caption of each:
Records a) Record Books in reference to the assessment year
b) Computerized records of cases
c) Compilation of the Notices of Meetings, Minutes of Lupon Meetings with Attendance Sheets
d) Compilation of Copies of Reports submitted to the Court and to the DILG
e) Filing cabinet/s
C. Timely Submission  Kindly fill-out the table below and attach transmittal letters of reports submitted to the concerned agencies. First line is
of Reports to filled-out to serve as guide.
Concerned TIMELY SUBMISSION OF
Agencies REPORTS
DATE OF REPORT/S AGENCY
SUBMISSION SUBMITTED
April 4, 2016 KP Quarterly Consolidated Reports DILG
Monthly Transmittal of Final Reports MTC
(LTIA)
A. Conduct of  Please provide the information needed in the table below and attach the following: (Please see sample in the first line)
Monthly Meetings a) Copy of Notices of Meetings
Exclusively on b) Minutes of Lupon Meetings
Katarungang c) Three (3) photos with caption of on-going meeting.
Pambarangay (KP)
Matters SUMMARY OF LUPON
MEETINGS
DATE OF NOTICE OF DATE OF THE MEETING
MEETING MEETING AGENDA
February 1, 2016 February 6, 2016  Number of cases on January 2016.
 On-going cases.
II. EFFECTIVENESS IN SECURING THE SETTLEMENT OF
LTIA FORM 07-PERFORMANCE HIGHLIGHTS
INTERPERSONAL DISPUTE OBJECTIVE OF THE KATARUNGANG PAMBARANGAY

A. Quantity of Settled Please provide brief explanation and the computation based on the definition provided.
cases against filed
Formula: Total Number of Settled Cases X 100
Total number of cases filed
Please attach Form 7-A, List of Cases
B. Quality of
Settlement of Please supply the necessary information and briefly explain how the Lupong Tagapamayapa achieved such quality of settlement
Cases of cases.
Out of the (Total number of Settled Cases), there is only (Percentage of repudiated case/s).
i.e. Out of the 200 settled cases, there is only 2% of repudiated cases.
Out of the (total number of settled cases), there is only (Percentage of non-recurrence) of cases settled by the Lupon.
i.e. Out of the 200 settled cases there is norecurrence of cases settled by the Lupon.
(LTIA)
C. At least 80%  Please supply the necessary information and briefly explain how the Lupong Tagapamayapa achieved such quality of
compliance with settlement of cases.
the terms of
For (validation year), Barangay (name of Barangay), achieved (Percentage) compliance with the terms of settlement or award
settlement or award
after the case have been settled.
after the case have
been settled i.e. For 2016, Barangay Putingkahoy, achieved 90% compliance with the terms of settlement or award after the case have been
settled.
 Kindly fill-out the information needed in the table.

 Attached at least 5 samples of proof of compliance.
MONITORING OF COMPLIANCE TO SETTLEMENT or

AWARD
C46+ -Conciliation beyond 46
LEGEND: M-Mediation C-Conciliation A-Arbitration C w/ EP-Conciliation with Extendible Period
days
ACTION
CASE TITLE SETTLEMENT OR AWARD
TAKEN MAIN POINT STATUS OF
CASE (COMPLAINAN COMPLAIN
(M, C, DATE DATE OF OF COMPLIANC REMARKS
NO. T VS. T TITLE
Cw/EP, AGREED EXECUTION AGREEMENT E (C or NC)
RESPONDENT)
A
and C46+)
2016-01 Juan Dela Cruz Collection of M January 28, February 5, 2016 Respondent C Respondent paid
vs. Juana Sum of 2016 agreed to pay Complainant the
Change Money ComplainantP amount of PhP
hP 500.00 per 500.00 on:
month starting February 5,
February to March 6, April 7
pay for the and May 5, 2016.
total debt
amount of
PhP 2,000.00.
(LTIA)
III. CREATIVITY AND RESOURCEFULNESS OF THE LUPONG TAGAPAMAYAPA

A. Settlement
Technique Describe the settlement technique used by the Lupong Tagapamayapa and explain briefly how each settlement technique helps
in the speedy settlement of disputes and attached two (2) photoswith caption of application of each settlement technique.
B. Coordination with  Please fill out the table provided with the information needed.
Concerned  Explain briefly how the Lupong Tagapamayapa coordinates with concerned agencies relating to disputes filed.
Agencies relating  Attach proofs of coordination such as any form of communication such as letters, emails or any written or verifiable
to disputes filed means of communication, two (2) Photos with caption, Visitor's Log Book dated within the assessment period.
(PNP, DSWD,
DILG, DAR, DENR, COORDINATION WITH
Office of the AGENCIES
Prosecutor, Court/s, Date of Agency Subject Matter Proof of Coordination
DOJ, CHR, Coordination Coordinated Coordinated
volunteer June 15, 2016 MSWDO Case involving a child (Please attached here proof of
groups/organization Coordination)
s, NGOs, CSOs,
Barangay Justice
Advocates)
(LTIA)
C. Sustained  Identify and briefly explain each information drive strategies practiced by the Lupong Tagapamayapa to create
information drive greater awareness to the community in promoting Katarungang Pambarangay (KP)
to promote  Attached two (2) photos with caption of the information drive used by the Lupong Tagapamayapa in the promotion
Katarungang of KP in their community.
Pambarangay
Note: Innovative Campaign Strategy Examples: Use of social media such as FB and other innovative strategies like distribution
of flyers, installation of tarpaulins or information board about KP.
(LTIA)
D. Katarungang
Pambarangay Kindly fill-out the information needed in the table below. Provide brief explanation about the training and attached two (2)
Training or Seminar photos with caption of each training conducted and attended.
within the
Assessment Period First line is filled-out as guide.
1. Conducted by
the Barangay
2. Training
conducted by
government or
non-
government KP TRAINING or
organizations SEMINAR
DATE TITLE OF THE TRAINING or SEMINAR VENUE SPONSOR/S PARTICIPANTS
participated by
April 14-15, 2016 Training on Gender-Responsive, Child-Friendly and 8 Floor Robredo
th
DILG-RO Lupon Chairman, Lupon
Lupon Indigenous Peoples-Relevant Katarungang Pambarangay Hall, Quezon City Secretary and at least 2
members Lupong Tagapamayapa
members of all
Barangays in Quezon
IV. AREA OR FACILITY FOR KATARUNGANG PAMBARANGAY ACTIVITIES City
(LTIA)
Building structure or  Please describe briefly the building structure or space provided by the Barangay exclusively for KP and Lupong
space Tagapamayapa concerns and attachthree (3) photos with caption.
Note: Area or Facility should have table and chairs to accommodate the parties and the Lupon and record book or computer for
documentation purposes. It should also have a filing cabinet/s where KP documents are maintained.
V. FINANCIAL OR NON-FINANCIAL SUPPORT

1. City, Municipal  Kindly fill-out the information needed in the table below. Explain briefly how the Lupong Tagapamayapa was able to
or Provincial acquire such grant from those provided in the criteria.
Government
 Please attach proof of granting a support such as Deed of Donation, MOA, Resolution, Appropriation Ordinance of
and NGAs
higher Sanggunian, Acknowledgment Receipt, Vouchers, etc.
2. People’s
Organization, FINANCIAL OR NON-FINANCIAL
SUPPORT
NGOs or
SUPPORT
Private Sector
FINANCIAL NON-FINANCIAL DATE GRANTED/GIVEN DONOR/SPONSOR
and
(Please provide the
others
amount)
PhP 15,000.oo March 25, 2016 Gerry Roxas Foundation,
Inc.
1 Desktop set February 12, 2016 Quezon City Government
(LTIA)
Prepared by: Approved by:
(LTIA)
Lupon Secretary Lupon Chairman

Signature over Printed Name Signature over Printed Name
Verified by:
C/MLGOO RFP
Signature over Printed Name Signature over Printed Name
LTIA FORM 07-A: LIST OF CASES
Punong Barangay
City/Municipality Barangay Logo
Province Here
Region
LIST OF
CASES
DATE OF STATUS OF
DATE OF
DATE OF EXECUTION MAIN POINT COMPLIANCE
CASE CASE COMPLAINT DATE INITIAL ACTION
NATURE SETTLEMENT OF OF ON THE REMARKS
NO. TITLE TITLE FILED CONFRON- TAKEN
OR AWARD SETTLEMENT AGREEMENT SETTLEMENT
TATION
OR AWARD OR AWARD
2016- Juan Dele Collection Civil January January 25, M January 28, February 5, Respondent Complete Respondent paid
01 Cruz vs. of Sum 22, 2016 2016 2016 agreed to pay Complainant the
Juana of 2016 Complainant amount of PhP
Change Money PhP 500.00 per 500.00 on:
month starting February 5,
February to March 6, April 7
pay for the and May 5, 2016.
total debt
amount of
PhP 2,000.00.
Signature over printed Signature over printed

name name

name name
LTIA FORM 07-A: LIST OF CASES
Punong Barangay
Province Here
Region
LIST OF
CASES
DATE OF STATUS OF
DATE OF
DATE OF EXECUTION MAIN POINT COMPLIANCE
CASE CASE COMPLAINT DATE INITIAL ACTION
NATURE SETTLEMENT OF OF ON THE REMARKS
NO. TITLE TITLE FILED CONFRON- TAKEN
OR AWARD SETTLEMENT AGREEMENT SETTLEMENT
TATION
OR AWARD OR AWARD

name name
name name
(LTIA)

Punong Barangay
Province Here
Region
LUPONG TAGAPAMAYAPA
PROFILE
Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon
Member here Member here Member here Member here Member here Member here
Name Name Name Name Name Name

Date of Birth Date of Birth Date of Birth Date of Birth Date of Birth Date of Birth
Terms of Office Terms of Office Terms of Office Terms of Office Terms of Office Terms of Office
Educational Background Educational Background Educational Background Educational Background Educational Background Educational Background
Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon
Member here Member here Member here Member here Member here Member here
Name Name Name Name Name Name

Date of Birth Date of Birth Date of Birth Date of Birth Date of Birth Date of Birth
Terms of Office Terms of Office Terms of Office Terms of Office Terms of Office Terms of Office
Educational Background Educational Background Educational Background Educational Background Educational Background Educational Background
(LTIA)

Punong Barangay
Province Here
Region
LUPONG TAGAPAMAYAPA
PROFILE
Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Chairman here
Member here Member here Member here Member here
LUPON CHAIRMAN
Name Name Name Name Name
Date of Birth Date of Birth Date of Birth Date of Birth Date of Birth
Terms of Office Terms of Office Terms of Office Terms of Office Terms of Office
Educational Background Educational Background Educational Background Educational Background Educational Background
Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Photo of Lupon Secretary here
Member here Member here Member here Member here
LUPON SECRETARY
Name Name Name Name Name
Date of Birth Date of Birth Date of Birth Date of Birth Date of Birth
Terms of Office Terms of Office Terms of Office Terms of Office Terms of Office
Educational Background Educational Background Educational Background Educational Background Educational Background
(LTIA)

Punong Barangay
Province Here
Region
LUPONG TAGAPAMAYAPA
PROFILE
Gro
Group Photo of the Lupong Tagapamayapa

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CY LUPONG TAGAPAMAYAPA INCENTIVES AWARDS

CRITERIA ASSIGNED POINT

II. EFFECTIVENESS IN SECURING THE SETTLEMENT 30

C. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.

Chairperson - Awards Committee

Vice Chairperson - Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

2|LTIA FORM 01-PERFORMANCE EVALUATION FOR

B. CRITERIA AND PERFORMANCE RATING

CRITERIA ASSIGNED PERFORMANCE TOTAL AVERAGE

3|LTIA FORM 02-CONSOLIDATED PERFORMANCE EVALUATIO

IV. AREA OR FACILITY 5

GRAND TOTAL POINT

4|LTIA FORM 02-CONSOLIDATED PERFORMANCE EVALUATIO

C. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.

Chairperson - Awards Committee

Vice Chairperson - Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

5|LTIA FORM 02-CONSOLIDATED PERFORMANCE EVALUATIO

B. COMPARATIVE EVALUATION RESULTS

LUPONG TAGAPAMAYAPA (LT) OVERALL ADJECTIVAL RANK

C. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.

Chairperson - Awards Committee

Vice Chairperson - Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

6|LTIA FORM 03 [C/M]-COMPARATIVE PERFORMANC

B. COMPARATIVE EVALUATION RESULTS

LUPONG TAGAPAMAYAPA (LT) OVERALL ADJECTIVAL RANK

C. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.

Chairperson - Awards Committee

Vice Chairperson - Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

7|LTIA FORM 03 [P]-COMPARATIVE PERFORMANCE EVALUATIO

B. COMPARATIVE EVALUATION RESULTS

LUPONG TAGAPAMAYAPA (LT) OVERALL ADJECTIVAL RANK

C. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.

Chairperson - Awards Committee

Vice Chairperson - Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

8|LTIA FORM 03 [R]-COMPARATIVE PERFORMANCE EVALUATIO

4. WE CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.

Chairperson - Awards Committee

Vice Chairperson - Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee

Member - _Awards Committee