Republic of the Philippines

Province of Pangasinan
Municipality of Malasiqui
BARANGAY NANCAPIAN
OFFICE OF THE PUNONG BARANGAY

Complainant/Blottery Entry No.___

Complainant/s:

Respondent/s:

AMICABLE SETTLEMENT
We, complainant/s and respondent/s in the above-captioned, do hereby agree to settle our dispute as
follows.
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They forgive each other and bind themselves to comply honesty and faithfully with the above terms of
settlement.

Entered into this ____day of ____________, 20___ at Barangay Nancapian, Malasiqui, Pangasinan.

COMPLAINANT/S RESPONDENT/S
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ATTESTATION
We hereby certify that the foregoing amicable settlement was entered into by the parties freely and
voluntarily, after we had explained to them the nature and consequences of such settlement.

Certified True and Correct:

DELILAH M. CALACSAN
Barangay Secretary

CONCURRED:

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Sangguniang Barangay Member Sangguniang Barangay Member Sangguniang Barangay Member

JOEL I. SANTOS
Punong Barangay