KATARUNGANG PAMBARANGAY
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KP FORM # 23: CERTIFICATION TO BAR ACTION<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 BAR ACTION<br />
This is to certify that the above-captioned case was dismissed pursuant<br />
to the Order dated ______________, for complainant/s<br />
_______________ (name) and ______________ (name) willful failure<br />
or refusal to appear for hearing before the Punong Barangay/Pangkat<br />
ng Tagapagkasundo and therefore complainant/s is/are barred from<br />
filing an action in court/government office.<br />
This ________ day of ______________, 19____.<br />
_____________________________<br />
Lupon Secretary/Pangkat Secretary<br />
Attested:<br />
________________________________<br />
Lupon Chairman/Pangkat Chairman<br />
IMPORTANT: If Lupon Secretary makes the certification, the Lupon<br />
Chairman attests. If the Pangkat Secretary makes the certification, the<br />
Pangkat Chairman attests.<br />
108 A HANDBOOK