Republic of the Philippines

PROVINCE OF ZAMBALES
MUNICIPALITY OF IBA

OFFICE OF THE LUPON TAGAPAMAYAPA

OFFICER’S RETURN

I served this Notice of Hearing upon respondent/s ____________________________

on the _________ day of MAY, 2023, by:

________1. Handing to him/them said summons in person; or,

________2. Handing him/them said summons and he/they refuse to receive it; or,

________3. Leaving said summons as his/ their dwelling with ___________________________

(name)
A person of suitable age and discretion residing therein; or

________4. Leaving said summons at his/their office of business with _____________________

(name)
A competent person in charge thereof.

_____________________
Warrant Officer

Received by representative/s of the respondent/s:

___________________________ ____________________
(Signature) (Date)