KP Forms

Republic of the Philippines
Province of La Union
Municipality of Agoo
BARANGAY SAN AGUSTIN EAST
NOTICE TO CONSTITUTE THE LUPON
To All Barangay Members and All Other Persons Concerned:
In compliance with Section 1 (a), Chapter 7, Title One, Book III, Local Government Code of
2091 (Republic Act No. 7160), of the Katarungang Pambarangay Law, notice is hereby given to
constitute the Lupong Tagapamayapa of this Barangay. The persons I am considering for
appointment are the following:
1. __________________________________
2. __________________________________ 14. ____________________________________
3. __________________________________ 15. ____________________________________
4. __________________________________ 16. ____________________________________
5. __________________________________ 17. ____________________________________
6. __________________________________ 18. ____________________________________
7. __________________________________ 19. ____________________________________
8. __________________________________ 20. ____________________________________
9.
10. __________________________________ 21. ____________________________________
11. __________________________________ 22. ____________________________________
12. __________________________________ 23. ____________________________________
13. __________________________________ 24. ____________________________________
25. ____________________________________
They have been chosen on the basis of their suitability for the task of conciliation considering their
integrity, impartiality, independence of mind, sense of fairness and reputation for probity in view of their
age, social standing in the community, tact, patience, resourcefulness, flexibility, open mindedness and
other relevant factors. The law provides that only those actually residing or working in the barangay who
are not expressly disqualified by law are qualified to be appointed as Lupon members. All persons are
hereby enjoined to immediately inform me and of their opposition to or endorsement of any or all the
proposed members or recommend to me other persons not included in the list but not later than the
_____________ day of _________, 20 _____ (the last day for posting this notice).
___________________________
Punong Barangay
IMPORTANT: This notice is required to be posted in three (3) conspicuous places in the
barangay for at least three
(3) weeks.
WARNING: Tearing or defacing this notice shall be subject to punishment according to law.
OFFICE OF THE PUNONG BARANGAY
____________, 20
(Date)
APPOINTMENT
TO: __________________________
Pursuant to Chapter 7, Title One, Book III, Local Government Code of 2091 (Republic Act No.
7160), you are hereby appointed MEMBER of the Lupong Tagapamayapa of this Barangay
effective upon taking your oath of office and until a new Lupon is constituted on the third year
following your appointment.
______________________________
Punong Barangay
ATTESTED:
___________________________
Barangay Secretary
____________, 20
(Date)
____________________________
____________________________
____________________________
Sir/Madam:
Please be informed that you have been appointed by the Punong Barangay as a MEMBER OF
THE LUPONG TAGAPAMAYAPA, effective upon taking your oath of office, and until a new
Lupon is constituted on the third year following your appointment. You may take your oath of
office before the Punong Barangay on ____________________________.
Very truly yours,
___________________________
Barangay Secretary
____________, 20
(Date)
LIST OF APPOINTED LUPON MEMBERS
Listed hereunder are duly appointed members of the Lupong Tagapamayapa in this
Barangay who shall as such upon taking oath of office and until a new lupon is constituted on the
third year following their appointment.
1. _________________________ 11. ________________________
2. _________________________ 12. ________________________
3. _________________________ 13. ________________________
4. _________________________ 14. ________________________
5. _________________________ 15. ________________________
6. _________________________ 16. ________________________
7. _________________________ 17. ________________________
8. _________________________ 18. ________________________
9. _________________________ 20. ________________________
10. ________________________ 20. ________________________
Punong Barangay
ATTESTED:
_______________________
Barangay/Lupon Secretary
_____________________________________________________________________
IMPORTANT: This is shall be posted in three (3) conspicuous places in the barangay for the duration of the terms
of office of those named above.
WARNING: Tearing or defacing this notice shall be subject to punishment according to law.
OATH OF OFFICE
Pursuant to Chapter 7, Title One, Book 11, Local Government Code of 2091 (Republic
Act No. 7160), I, ______________________, being duly qualified and having been duly
appointed member of the Lupong Tagapamayapa of this Barangay, do hereby solemnly swear (or
affirm) that I will faithfully and conscientiously discharge to the best of my ability my duties and
my functions as such member and as member of the Pangkat ng Tagapagkasundo in I which may
be chosen to serve; that I will bear true and allegiance to the Republic of the Philippines; that I
will support and defend its Constitution and obey the laws, legal orders, and decrees promulgated
by its duly constituted authorities; and that I voluntarily impose upon myself this obligation
without any mental reservation or purpose of evasion.
SO HELP ME GOD. (In case of affirmation the last sentence will be omitted.)
___________________
(Member)
SUBSCRIBED AND SWORN to (or AFFIRMED) before me this _______ day of

__________________, 20______.
_________________________
Punong Baranga
_____________, 20____
(Date)
WITHDRAWAL OF APPOINMENT
TO:_______________
After due hearing and with the concurrence of a majority of all Lupong Tagapamayapa
members of this Barangay, your appointment as member thereof is hereby withdrawn effective
upon receipt hereof, on the following ground/s:
- Incapacity to discharge the duties of your office as shown by _______________
____________________________________________________________________
- Unsuitability by reason of ___________________________________________

_____________________________________________________________________
(check whichever is applicable and detail or specify the act/s omission/s constituting the ground/s of
withdrawal):
____________________________
Punong Barangay/Lupon Chairman
CONFORME (Signatures):
1. ______________________ 7. ______________________
2. ______________________ 8. ______________________
3. ______________________ 9. ______________________
4. ______________________ 10. _____________________
6. ______________________ 11. _____________________
Received this _____ day of ______________, 20____.
_____________________
(Signature)
____________________________________________________________________
NOTE: The members of the lupon conforming to the withdrawal must personally affix their signature or thumb marks on the pertinent spaces
above. The withdrawal must be conformed to by more than one-half of the total number of the members of the lupon including the punong
barangay and the member concerned.
OFFICE OF THE LUPONG TAGAPAMAYAPA
____________________ Barangay Case No. ____

____________________ For: ____________________
____________________
- against - ____________________
____________________
____________________
Respondent/s
COMPLAINT
I/WE hereby complain against the above named respondents for violating my/our rights
and interests in the following manner:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
__________________________________________
THEREFORE, I/WE pray that the following relief/s be granted to me/us in accordance
with law and/or equity:
Made this ______ day of _________________, 20____.
_______________
Complainant/s
Received and filed this ______ day of ______________ 20,____.
________________________
NOTICE OF HEARING
(MEDIATION PROCEEDINGS)
TO: MAXIMA VIDUYA

JOHN PAOLO VIDUYA
You are hereby required to appear before me on the 28TH day of

FEBRUARY_, 2024 at 10 o’clock in the morning/afternoon for the hearing of your
complaint.
This 26TH day of FEBRYARY, 2024.
ISAGANI A. BULATAO
Punong Barangay
Notified this 26TH day of FEBRUARY, 2024.
Complainant /s :
ANGELO M. BALANGUE
VIANNE N. HIDALGO
Date received:
__________________
Time:
___________________
ASUNCION HOLGADO Barangay Case No. 2024-030

_______________________ For: MEDIATION
Complainant/s _________________________
_________________________
- against -
BRYNE BALDERAS
_____________________
Respondent/s
SUMMONS
You are hereby summoned to appear before me in person, together with your witnesses,
on the 5TH day of MARCH, 2024 at BARANGAY SAN AGUSTIN EAST MULTI-PURPOSE
HALL at 9 o’clock in the morning/afternoon, then and there to answer to a complaint made
before me, copy of which is attached hereto, for mediation, conciliation of your dispute with
complainant/s.
You are hereby warned that if you refuse or willfully fail to appear in obedience to this
summons, you may be barred from filling any counterclaim arising from said complaint.
FAIL NOT or else face punishment as for contempt of court.

This 4TH day of MARCH, 2024.
ISAGANI A. BULATAO
Punong Barangay/Pangkat Chairman
____________________________________________________
OFFICER’S RETURN
I served this summons upon respondent _____________________ on the ____ day of
__________________, 20___, and upon respondent on the day of ______________________,
20___, by: (Write name/s of respondent/s before mode by which he/she was/were served.)
Respondent/s
___________________ 1. Handing to him/them said summons in person
___________________ 2. Handing to him/them said summons and he/they refused to
receive it
___________________ 3. Leaving said summons at his/their dwelling with
_________________, a person or suitable age and discretion residing therein
____________________ 4. Leaving said summons at his/their office/place of business with

___________, a competent person in charge thereof.
(Name)
________________________
Officer
Received by Respondent/s Representative/s
_____________________ ________________________
(Signature over printed name) (Date)
______________________ ________________________
(Signature over printed name) (Date)
TO:MARILYN T. RIVERA LEONIDA BALLESTEROS

_____________________
Complainant/s Respondent/s
NOTICE OF HEARING
(CONCILIATION PROCEEDINGS)
Your are hereby required to appear before the pangkat on the 30 TH day of
JANUARY, 2024, at NINE (9) o’clock in the morning/afternoon for a hearing of
the above-entitled case.
This 24 day of JANUARY, 2024.
___________________
Pangkat Chairman
Notified this 24TH day of JANUARY 20, 24.
Complainant/s: Respondent/s:
ALMALYN SAPGUIAN LEONIDA BALLESTEROS
JACINTO SAPGUIAN ___________________
Date received:
__________________
Time:
___________________
_AGNES DIAZ _ Barangay Case No.2024-017

____________________ For: HEARING OF AGNES VS.
Complainant/s ELIZABETH_______
____________________
- against -
ELIZABETH RIVERA
____________________
Respondent/s
SUBPOENA
TO:
AGNES DIAZ Witness MARYLYN JACABAN

____________________ NELIA VALETE
You are hereby commanded to appear before me on the 2ND day of FEBRUARY, 20 24,
at 1 o’clock in the morning/afternoon, then and there to testify in the hearing of the above-
captioned case.
This 31ST day of JANUARY, 20 24.
ISAGANI A. BULATAO
____________________ Barangay Case No. __

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
AGREEMENT FOR ARBITRATION
We hereby agree to submit our dispute for arbitration to the Punong Barangay/Pangkat ng
Tagapagkasundo (please cross out whichever is not applicable) and bind ourselves to comply
with the award that may be rendered thereon. We have made this agreement freely with a full
understanding of its nature and consequences.
Entered into this ____ day of ______________, 20 ___.
_____________________ _____________________
_____________________ _____________________
ATTESTATION:
I hereby certify that the foregoing Agreement for Arbitration was entered into by parties
freely and voluntarily, after I had explained to them the nature and consequences of such
agreement.
_____________________________
(Cross out whichever is not applicable)
____________________ Barangay Case No. ___

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
ARBITRATION AWARD
After hearing the testimonies given and careful examination of the evidences presented in
this case, award is hereby made as follows:
_______________________________________________
_______________________________________________
_______________________________________________
Made this ___ day of ____________, 20 ___ at _______________.
___________________________
Punong Barangay/PangakatChairman*
__________________
Member
__________________
Member
ATTESTED:
____________________________
Punong Barangay/Lupon Secretary**
_______________________________________________________________________
* To be signed by either, whoever made the arbitration award.

** To be signed by the Punong Barangay if the award is made by the Pangkat Chairman,a nd by the Lupon Secretary if
the award is made by the Punong Barangay.
REMBERT RIVERA, ELIZABETH RIVERA Barangay Case No. 2024-014

JOHN DEXTER PALMERO For: MEDIATION
Complainant/s ____________________
____________________
- against -
MARYLYN JACABAN, NELIA BALETE,

IRISH DIAZ JACABAN, AGNES DIAZ
Respondent/s
AMICABLE SETTLEMENT
We, complainant/s and respondent/s in the above-captioned case, do hereby agree to

settle our dispute as follows:
THE RESPONDENT AND THE COMPLAINANT AGREED THAT THE LAND OF

AGNES DIAZ WILL BE DONATED TO JOHN DEXTER PALMERO, THE WATER
SUPPLY/BUBON WILL NOT BE REMOVED AT THE EASTERN PART OF AGNES
DIAZ’S LAND. DEXTER WILL BE INCHARGE OF THE PROCESSING OF THE DEED OF
DONATION. THE SOCIAL MEDIA POSTING WILL STOP (FOR BOTH PARTIES, ALSO
GOSSIPING WILL BE PROHIBITED IN CONNECTION TO THIS ISSUE. THIS
AGREEMENT SHOULD BE FO0LLOWED IF NOT THIS SETTLEMENT WILL BE USED
IIS THE COURT OF LAW.
and bind ourselves to comply honestly and faithfully with the above terms of settlement.
Entered into this 30th day of January , 2024.
REMBERT RIVERA,
ELIZABETH RIVERA MARYLYN JACABAN,
NELIA BALETE,
JOHN DEXTER PALMERO _ IRISH DIAZ JACABAN,
AGNES DIAZ
ATTESTATION:
I hereby certify that the foregoing amicable settlement was entered into by the parties freely and
voluntarily, after I had explained to them the nature and consequence of such settlement.
ISAGANI A. BULATAO
____________________ Barangay Case No. _______

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
REPUDIATION
I/WE hereby repudiate the settlement/agreement for arbitration on the ground that my/our consent was
vitiated by:
(Check out whichever is applicable)

- Fraud. (State details) __________________________________________________
___________________________________________________________________
- Violence. (State details) ________________________________________________

___________________________________________________________________
- Intimidation. (State details) _____________________________________________

____________________________________________________________________
This ____ day of ________________, 20 ___.
___________________________ __________________________
___________________________ __________________________
SUBSCRIBED AND SWORN TO before me this ____ day of ______________,

20 ___ at _________________
________________________
Punong Barangay/
Pangkat Chairman/Member
Received and filed * this _____ day of _______________, 20 ____.
_____________________
Punong Barangay
______________________________________________________________________________________* Failure
to repudiate the settlement or the arbitration agreement within the time limits respectively set [ten (10) days
from date of settlement and (5) days from the date of arbitration agreement] shall be deemed a waiver of the right to
challenge on said grounds.
ANGELO M. BALANGUE Barangay Case No.

VIAN N. HIDALGO For: MEDIATION
Complainant/s ____________________
____________________
- against -
JERICHO U. VIDUYA
JOHN PAOLO VIDUYA
MAXIMA U. VIDUYA
Respondent/s
NOTICE OF HEARING
(RE: FAILURE TO APPEAR)
TO: JERICHO U. VIDUYA

JOHN PAOLO VIDUYA
MAXIMA U. VIDUYA
You are hereby required to appear before me/the Pangkat/ Punong Barangay on the day
of 28TH , 2024, at 10 o’clock in the morning/afternoon to explain why you failed to appear for
mediation/conciliation scheduled on FEBRUARY 24, 2024 and why your complaint should not
be dismissed, a certificate to bar the filling of your action in court/government office should not
be issued, and contempt proceedings should not be initiated in court for willful failure or refusal
to appear before the Punong Barangay/Pangkat ng Tagapagkasundo.
This 26TH day of FEBRUARY, 2024.
Notified this 26TH day of FEBRUARY, 2024.
ANGELO M. BALANGUE
VIAN N. HIDALGO JERICHO U. VIDUYA
JOHN PAOLO VIDUYA
MAXIMA U. VIDUYA
ALAMLYN SAPGUIAN Barangay Case No. 2024-005

____________________ For: CONCILIATION
Complainant/s ____________________
____________________
- against -
LEONIDA BALLESTEROS
____________________
Respondent/s
NOTICE OF HEARING
(RE: FAILURE TO APPEAR)
TO: LEONIDA BALLESTEROS
___________________
Respondent/s
You are hereby required to appear before me/the Pangkat on the 22ND day of FERUARY, 20 24,
at 10 o’clock in the morning/afternoon to explain why you failed to appear for mediation/conciliation
scheduled on FEBRUARY 15, 2024, and why your counterclaim (if any) arising from the complaint
should not be dismissed, a certificate to bar the filling of said counterclaim in court/government office
should not be issued, and contempt proceedings should not be initiated in court for willful failure or
refusal to appear before the Punong Barangay/Pangkat ng Tagapagkasundo.
This 15TH day of FEBRUARY, 20 24.
RODRIGO M. AQUINO
Pangkat Chairman
Notified this 15TH day of FEBRUARY, 20 24.
ALAMLYN SAPGUIAN LEONIDA BALLESTEROS
___________________ ____________________
____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
CERTIFICATION TO FILE ACTION
This is to certify that:
1. There has been a personal confrontation between the parties before the Punong
Barangay/Pangkat ng Tagapagkasundo.
2. A settlement was reached.
3. The settlement has been repudiated in a statement sworn to before the Punong Barangay
by _____________________ on ground of ______________________.
4. Therefore, the corresponding complaint for the dispute may now be filed in
court/government office.
This ____ day of _______________, 20 ___.
__________________
Lupon Secretary
ATTESTED:
____________________
Lupon Chairman
ALMALYN SAPGUIAN Barangay Case No. ________

____________________ For: FILLING OF CASE
Complainant/s ____________________
____________________
- against -
LEONIDA BALLESTEROS
____________________
Respondent/s
CERTIFICATION TO FILE ACTION
1. There has been a personal confrontation between the parties before the Punong Barangay
but mediation failed.
2. The Pangkat ng Tagapagkasundo was constituted but the personal confrontation before
the Pangkat likewise did not result into a settlement.
3. Therefore, the corresponding complaint for the dispute may now be filed in
This 27TH day of FEBRUARY, 20 24.
BEA JUSTINE M. PURISIMA

Pangkat Secretary
ATTESTED BY:
ISAGANI A. BULATAO
Pangkat Chairman
____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
CERTIFICATE TO FILE ACTION
1. There has been a personal confrontation between the parties before the Punong Barangay
but mediation failed.
2. The Punong Barangay set the meeting of the parties for the constitution of the Pangkat.
3. The respondent willfully failed or refused to appear without justifiable reason at the
conciliation proceedings before the Pangkat.
4. Therefore, the corresponding compliant for the dispute may now be filed in
__________________
Pangkat Secretary
ATTESTED:
___________________
Pangkat Chairman
____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
CERTIFICATION TO BAR ACTION
This is to certify that the above-captioned case was dismissed pursuant to the Order dated
_________________, for complainant/s __________________ and
(Name)
_____________________willful failure or refusal to appear for hearing before the
(Name)
Punong Barangay/Pangkat ng Tagapagkasundo and therefore complainant/s is/are barred form
filing an action in court/government office.
This _____ day of ________________, 20 ___.
____________________________
Lupon Secretary/Pangkat Secretary
ATTESTED:
_____________________________
Lupon Chairman/Pangkat Chairman
____________________________________________________________________
IMPORTANT: If the Lupon Secretary makes the certification, the Lupon Chairman attests. If the Pangkat
Secretary makes the certification, the Pangkat Chairman attests.
KP Form No. 22
____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
CERTIFICATION TO BAR COUNTERCLAIM
This is to certify that after prior notice and hearing, the respondent/s
_____________________ and ______________________ have been found
(Name) (Name)
to have willfully failed or refused t appear without justifiable reason before the Punong
Barangay/Pangkat ng Tagapagkasundo and therefore respondent/s is/are barred from filing
his/their counterclaim (if any) from the complaint in court/government office.
This ___ day of ________________, 20 ___.

____________________________
Lupon Secretary/Pangkat Secretary
ATTESTED:
_____________________________
Lupon Chairman/Pangkat Chairman
_____________________________________________________________________
IMPORTANT: If the Lupon Secretary makes the certification, the Lupon Chairman attests. If the
Pangkat Secretary makes the certification, the Pangkat Chairman attests.
KP Form No. 23
____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
MOTION FOR EXECUTION
Complainant/s Respondent/s state as follows:
1. On ___________________, 20 ___, the parties in this case signed an amicable

settlement/received the arbitration award rendered by the Lupon/Chairman/Pangkat ng
Tagapagkasundo.
2. The period of ten (10) days from the above-stated date has expired without any of the
parties filings a sworn statement of repudiation of the settlement before the Lupon
Chairman a petition for nullification of the arbitration award in court.
3. The amicable settlement/arbitration award is now final and executory.
WHEREFORE, Complainant/s/Respondent/s request/s that the corresponding writ of

execution be issued by the Lupon Chairman in this case.
____________
(Date)
________________________
Complainant/s/Respondent/s
____________________ Barangay Case No. ________

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
NOTICE OF HEARING
(RE: MOTION FOR EXECUTION)
TO: _____________________ _____________________

_____________________ _____________________
You are hereby required to appear me on ___ day of _____________________, 20 ____

at _________________ o’clock in the morning/afternoon/evening for the hearing of the motion
for execution, copy of which is attached hereto, filed by ____________________________.
(Name of complainant/s/respondent/s)
____________________
(Date)
_____________________________
Notified this ___ day of _________________, 20 ___.
_________________ _________________
_________________ _________________
(Signature) (Signature)
___________________ Barangay Case No. ________

___________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s
NOTICE OF EXECUTION
WHEREAS, on _________________, 20 ___, an amicable settlement was signed by the parties

in the above-entitled case [or an arbitration award was rendered by the punong barangay/pangkat ng
tagapagkasundo];
WHEREAS, the terms and conditions of the settlement, the dispositive portion of the award, read:
__________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
The said settlement/award is now final and executory;
WHEREAS, the party obliged ____________________ has not complied

(Name)
voluntarily with the aforestated amicable settlement/arbitration award, within the period of five (5) days
from the date of hearing on the motion for execution;
NOW, THEREFORE, on be half of the Lupong Tagapamayapa and by virtue of the powers
vested upon me and the Lupon by the Katarungang Pambarangay Law and Rules, I shall cause to be
realized from the goods and personal property of _____________________the sum of
__________________________ agreed upon in the
(Name of party obliged) (State amount of settlement or award)
said amicable settlement [or adjudged in the said arbitration award], unless voluntary compliance of said
settlement or award shall have been made upon receipt hereof.
Signed this ____ day of ______________, 20 ___.
__________________
Punong Barangay
Copy furnished:
__________________ ______________
Complainant/s Respondents/s

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Republic of the Philippines

NOTICE TO CONSTITUTE THE LUPON

To All Barangay Members and All Other Persons Concerned:

OFFICE OF THE PUNONG BARANGAY

OFFICE OF THE PUNONG BARANGAY

Very truly yours,

OFFICE OF THE PUNONG BARANGAY

LIST OF APPOINTED LUPON MEMBERS

1. _________________________ 11. ________________________

2. _________________________ 12. ________________________

3. _________________________ 13. ________________________

4. _________________________ 14. ________________________

5. _________________________ 15. ________________________

6. _________________________ 16. ________________________

7. _________________________ 17. ________________________

8. _________________________ 18. ________________________

9. _________________________ 20. ________________________

10. ________________________ 20. ________________________

SUBSCRIBED AND SWORN to (or AFFIRMED) before me this _______ day of

- Incapacity to discharge the duties of your office as shown by _______________

- Unsuitability by reason of ___________________________________________

Received this _____ day of ______________, 20____.

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ____

Made this ______ day of _________________, 20____.

Received and filed this ______ day of ______________ 20,____.

OFFICE OF THE LUPONG TAGAPAMAYAPA

TO: MAXIMA VIDUYA

You are hereby required to appear before me on the 28TH day of

This 26TH day of FEBRYARY, 2024.

Notified this 26TH day of FEBRUARY, 2024.

OFFICE OF THE LUPONG TAGAPAMAYAPA

ASUNCION HOLGADO Barangay Case No. 2024-030

FAIL NOT or else face punishment as for contempt of court.

____________________ 4. Leaving said summons at his/their office/place of business with

OFFICE OF THE LUPONG TAGAPAMAYAPA

TO:MARILYN T. RIVERA LEONIDA BALLESTEROS

This 24 day of JANUARY, 2024.

Notified this 24TH day of JANUARY 20, 24.

ALMALYN SAPGUIAN LEONIDA BALLESTEROS

JACINTO SAPGUIAN ___________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

_AGNES DIAZ _ Barangay Case No.2024-017

AGNES DIAZ Witness MARYLYN JACABAN

This 31ST day of JANUARY, 20 24.

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. __

AGREEMENT FOR ARBITRATION

Entered into this ____ day of ______________, 20 ___.

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ___

Made this ___ day of ____________, 20 ___ at _______________.

* To be signed by either, whoever made the arbitration award.

OFFICE OF THE LUPONG TAGAPAMAYAPA

REMBERT RIVERA, ELIZABETH RIVERA Barangay Case No. 2024-014

MARYLYN JACABAN, NELIA BALETE,

We, complainant/s and respondent/s in the above-captioned case, do hereby agree to

THE RESPONDENT AND THE COMPLAINANT AGREED THAT THE LAND OF

Entered into this 30th day of January , 2024.

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _______

(Check out whichever is applicable)

- Violence. (State details) ________________________________________________

1. _ 11.

2. _ 12.

3. _ 13.

4. _ 14.

5. _ 15.

6. _ 16.

7. _ 17.

8. _ 18.

9. _ 20.

10. 20.

Received this _ day of ______, 20.

________________ Barangay Case No.

Made this day of _______, 20.

Received and filed this day of ____ 20,.

__________________ Barangay Case No.

Entered into this day of ________, 20 _.

__________________ Barangay Case No. _

Made this _ day of ________, 20 _ at _______________.

______________ Barangay Case No. _

This day of __________, 20 _.

SUBSCRIBED AND SWORN TO before me this day of __________,

Received and filed * this _ day of _______, 20 .

________________ Barangay Case No. _

This day of _________, 20 _.

________________ Barangay Case No. _

________________ Barangay Case No. _

This _ day of __________, 20 _.

________________ Barangay Case No. _

This _ day of ____________, 20 _.

________________ Barangay Case No. _

1. On _________________, 20 _, the parties in this case signed an amicable

____________ Barangay Case No.

TO: _ _

You are hereby required to appear me on _ day of _______________, 20

Notified this _ day of _____________, 20 _.

___________ Barangay Case No.

WHEREAS, on _______________, 20 _, an amicable settlement was signed by the parties

Signed this day of ________, 20 _.