Republic of the Philippines
Province of Pangasinan
Municipality of Bani
Barangay Poblacion
OFFICE OF THE SANGGUNIANG BARANGAY
Barangay Case # :_______
For:____________________
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Complainant/s
Against
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Respondent/s
AMICABLE SETTLEMENT
We, complainant/s and respondent/s in the above-captioned case, do hereby agree to settle our
dispute as follows;
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And bind ourselves to complay honestly and faithfully with the above terms of settlement.
Entered into this ____ day of ____________,20___.
Complainant/s Respodent/s
_____________________________ ____________________________
ATTESTATION
I hereby certify that the forgoing amicable settlement was entered into by the parties freely
and voluntarily, after I had explained to them the nature and consequence of such settlement.
Bryanne Paul B. Ampler
Punong Barangay / Pangkat Chairman
