Republic of the Phillipines

Province of Cagayan
MUNICIPALITY OF AMULUNG
Barangay LA SUERTE

OFFICE OF THE PUNONG BARANGAY

TO:
, AMULUNG, CAGAYAN

(Complainant)
-Against-

(Respondent)

You are hereby advise to appear before me in person on the day of

20 at o’clock at Barangay Hall of La Suerte,Amulung, Cagayan then and there to
answer to a complainant of of
, Cagayan made before me for mediation and conciliation.

You are hereby warned that if you refuses or willfully fail to appear in obedience to this
summon, you may be barred from filling any counterclaim arising from said complaint.
Fail not or face punishment as for contempt of court.

Issued this day of 20 at LA SUERTE, Amulung, Cagayan.

HON. MELVIN P. BALIGAT

Punong Barangay

NOTE;
THIS BARANGAY HAS OFFICIAL DRY SEAL