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KATARUNGANG PAMBARANGAY

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KP FORM # 21: CERTIFICATION TO FILE ACTION (FROM PANGKAT<br />

SECRETARY)<br />

Republic of the Philippines<br />

Province of __________<br />

CITY/MUNICIPALITY OF ______________<br />

Barangay _________________<br />

OFFICE OF THE LUPONG TAGAPAMAYAPA<br />

___________________ Barangay Case No. __________<br />

___________________ For: ______________________<br />

Complainant/s _________________________<br />

__________________________<br />

— against —<br />

__________________<br />

__________________<br />

Respondent/s<br />

CERTIFICATION TO FILE ACTION<br />

This is to certify that:<br />

1. There has been a personal confrontation between the parties before<br />

the Punong Barangay but mediation failed;<br />

2. The Pangkat ng Tagapagkasundo was constituted but the personal<br />

confrontation before the Pangkat likewise did not result into a<br />

settlement; and<br />

3. Therefore, the corresponding complaint for the dispute may now be<br />

filed in court/government office.<br />

This _________ day of _________, 19_____.<br />

_________________<br />

Pangkat Secretary<br />

Attested by:<br />

_________________<br />

Pangkat Chairman<br />

106 A HANDBOOK

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