VAWC Form #4 CTRL NO.

2023-001

BARANGAY PROTECTION ORDER

NAME OF RESPONDENT: ALASAN M. CABITIN

ADDRESS: BARANGAY 8 POBLACION, TIGBAUAN, ILOILO

ORDER
REBECCA W. DERLA applied for BPO on MARCH 27, 2023 , under oath stating
that:

Ginabuyayaw nya ako kag ginahambalan nga “alpot”, “biga-on”, ukon “kaplog”. Kag ginpahandaman nya
ako nga hindi ako magpuli sa amon balay kay labu-on nya ako kag tadtadon nya ang balay ko. Ginhampak nya man
ako sang 2x2 nga kahoy kag naigo ako sa right forearm. Gusto ko guid nga pahalinon ko da sya kag hindi na
magpalapit sa akon.

After having heard the application and the witnesses and evidence, the undersigned hereby issues this BPO
ordering you to immediately cease and desist from causing or threatening to cause physical harm to REBECCA
W. DERLA and/or her child/children namely:

_________________________ ___________________________
_________________________ ___________________________

This BPO is effective 15 days from receipt.

VIOLATION OF THIS ORDER IS PUNISHABLE BY LAW

ELENA JAYME TITULAR

Punong Barangay

Date Issued: __MARCH 27, 2023_______

Copy received by: ____ALASAN M. CABITIN_____

Signature Over Printed Name
Date received: ____________________ _

Served by: __RONNEL P. BUSAYONG____ _

Signature Over Printed Name
 ATTESTATION
(In case the Punong Barangay is unavailable)

I hereby attest that Punong Barangay _______________________________ was unavailable to act

On application for Barangay Protection Order No. ________ filed by _______________________________
On __________________ at __________________ a.m/ p.m and issue such order.

_____________________
Barangay Kagawad
Signature Over Printed Name