Republic of the Philippines
Province of La Union
Municipality of Agoo
Baraangay SAN AGUSTIN EAST
OFFICE F THE KATARUNGANG PAMBARANGAY
__________________________________________ Brgy. Case No._____________________
__________________________________________ For (Para) _________________________
Complainant/s(Ti Nagdarum)
Against
__________________________________________
___________________________________________
Respondent/s(Ti Naidarum)
PANAGAYAB
Maidawat ti panakapaayab mo nga agparang kaniak a mismo agraman dagiti
testigom, inton_____________nga aldaw ti _______________________________oras ti _________________
bigat/malem tapno lawlawagam ti reklamo a naidanun kaniak, para ti panagkainnawatan/
pakalawlawagan ti susik (riri) yo ken ti nagdarum.
Maiballaag ti saan mo panagparang wenno panangigagaram ti saan a panagtungpal
daytoy a paayab ti mangted karbengan ti nagdarum a mangiyuli ti kaso ti korte o maseknan
nga ahensiya ti gobyerno no sadino a mabalin a malapedan ka nga agipila ti aniaman a
panagkontra ti nasao nga reklamo.
AGPARANG KA NGA AGPARANG ta no saan, madusa ka iti Contempt of Court, wenno
saan mo a pangipangag ti ayab ti pangokoman.
Naaramid ita a petsa___________________________________________________.
ISAGANI A. BULATAO
Lupon Chairman/Punong Barangay
Received by:_________________________________
Date:____________________
Time:___________________
Served by:___________________________________
Name/position
Republic of the Philippines
Province of La Union
Municipality of Agoo
Barangay San Agustin East
OFFICE OF THE KATARUNGANG PAMBARANGAY
_____________________ ______________ Barangay Case No.___________________
________________________________________ For ___CONFRONTATION___________
Complainant/s
against
_________________________________________
Respondent/s
SUMMONS
To: ______________________________________
You are hereby summoned to appear before me in person together with your
witnesses, on the __________ day of ________________________________at __________________________o’clock, in
the morning/afternoon, then and there to answer to a complaint filed before me for
conciliation or mediation of your dispute with complainant/s.
You are hereby warned that your wilful failure to appear in obedience to this
summons, will entitle the complainant/s to proceed directly against you in court or
government office where you may be barred from filing any counterclaim arising from said
complaint.
FAIL NOT, or else face the punishment as for contempt of court.
ISAGANI A. BULATAO
Punong Barangay
Received by:__________________________________________
Date:____________________________________________
Time___________________________________________
Served by:______________________________________
Name/Position