KATARUNGANG PAMBARANGAY - LGRC DILG 10

Respondent/s:
Complainant/s:
____________________ ______________________
____________________ ______________________
KP FORM # 20: CERTIFICATION TO FILE ACTION (FROM LUPON
SECRETARY)
Republic of the Philippines
Province of __________
CITY/MUNICIPALITY OF ______________
Barangay _________________
OFFICE OF THE LUPONG TAGAPAMAYAPA
___________________ 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
______________; and
4. Therefore, the corresponding complaint for the dispute may now be
filed in court/government office.
This _________ day of __________, 19____.
___________________
Lupon Secretary
Attested:
__________________
Lupon Chairman
KATARUNGANG PAMBARANGAY
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