Page ____ of 50 Sheets

Book No. ___________

RECORD BOOK OF BARANGAY CASES

(Under Chapter 7, Title One, Book III. Local Government Code of 1991 (RA 7160)

I – TITLE
_________________________________________ Barangay Case No. ________
_________________________________________ Date Filed:________________
(Complainants)
- against - - For -
________________________________________ ___________________________________________
________________________________________ ___________________________________________
(Respondent) ___________________________________________

II – MEDIATIONAL/CONCILIATIONAL FUNCTIONS
Summons served by: ________________________________ Date Served: ___________________
Subpoena served by: ________________________________ To : __________________________
Answer filed by: ____________________________________
Counter-Claim filed on: _______________________________
Cross-Party complaint filed on: _________________________
Third-Party complaint filed on: _________________________
Date (s) for Mediation: ________________________________________________________
Date (s) for Conciliation: ______________________________________________________
Date (s) for Arbitration :________________________________________________________

III – DISPOSITION OF THE CASE (Please check)

____ Mediated by Punong Barangay ____ Conciliated by Pangkat

____ Arbitrated by Punong Barangay ____ Arbitrated by Pangkat
____ Settlement/Arbitration Agreement Repudiated ____ Petitioned for Annulment of Award
____ Issued Certification to File Action ____ Settlement/Arbitration Agreement Repudiated
____ Case Dismissed ____ Issued Certification to File Action
____ Pangkat Constituted ____ Case Dismissed
Gist of Settlement/Award: _______________________________________________________________________
____________________________________________________________________________________________

IV – MONITORING (Please check)

Nature of Case: Status of Case:

Month: _____________ ___ Criminal ___ Mediated ___ Executed
___ Civil ___ Conciliated ___ Dismissed
___ Others ___ Arbitrated ___ Certified
___ Repudiated ___ Pending
Remarks: ____________________________________________________________________________________

CERTIFIED CORRECT: ATTESTED:

_______________________ ____________________________
Lupon Secretary Lupon Chairman