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Form 1-A-Scc: Other Plaintiffs or Defendants

This document appears to be a form that collects information about other plaintiffs or defendants involved in a small claims case. It requests basic identifying information such as name, address, contact details, as well as information about the type of plaintiff or defendant and whether they are an individual, corporation, partnership, or other type of entity. The form also has sections to provide consent to electronic service and indicates if additional pages are needed to list more than two plaintiffs or defendants.

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Sergie Florague
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2K views

Form 1-A-Scc: Other Plaintiffs or Defendants

This document appears to be a form that collects information about other plaintiffs or defendants involved in a small claims case. It requests basic identifying information such as name, address, contact details, as well as information about the type of plaintiff or defendant and whether they are an individual, corporation, partnership, or other type of entity. The form also has sections to provide consent to electronic service and indicates if additional pages are needed to list more than two plaintiffs or defendants.

Uploaded by

Sergie Florague
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

OTHER PLAINTIFFS OR DEFENDANTS Case Number:

FORM 1-A-SCC Iba pang mga Naghahabla o Hinahabla


 This form is attached to Form 1-SCC (Statement of Claim/s), item 1 or 2.
Ang form na ito ay nakalakip sa Form 1-SCC (Habla ng Pagsingil), item 1 o 2.

1 OTHER PLAINTIFF
Name Pangalan ng Naghahabla Sex Kasarian Age Edad Civil Status Katayuang Sibil

Check those that apply: Pumili sa mga sumusunod at lagyan ng tsek:


Type of Plaintiff Uri ng Naghahabla Type of Business Uri ng Negosyo
 Individual Tao/Indibidwal  Banking Bangko
 Corporation Korporasyon  Lending Pagpapautang
 Partnership Bakasan  Others (pls. indicate): Iba pang uri ng negosyo
 Cooperative Kooperatiba
 Sole Proprietorship Solong Pagmamay-ari

Home Address Pahatirang Sulat sa Bahay ng Naghahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

Place of Work/Business Lugar ng Pinagtatrabahuhan/Negosyo ng Naghahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

Plaintiff’s Representative, if applicable Kinatawan ng Naghahabla, kung meron


Name Pangalan ng Kinatawan ng Naghahabla

Home Address Pahatirang Sulat sa Bahay ng Kinatawan ng Naghahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

Place of Work Lugar ng Pinagtatrabahuhan ng Kinatawan ng Naghahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

 Check here if more than three (3) plaintiffs and fill out as many Form 1-A-SCC as may be necessary.
Lagyan ng tsek kung higit sa tatlo (3) ang naghahabla at punan ang mga karagdagang Form 1-A-SCC.

Other Plaintiffs or Defendants Form 1-A-SCC, Page 1 of 3


Plaintiff’s Statement of Claim/s
(Small Claims)
(Small Claims)
Plaintiff as a juridical entity, if applicable Juridical entity ang naghahabla, kung sakali

 Check here if there is a board resolution or secretary’s certificate attached to the Statement of Claim/s authorizing
the person to file the claim for the juridical entity
Lagyan ng tsek kung may board resolution o secretary’s certificate na nakakabit sa Statement of Claim/s na pinapahintulutan ang
tao na ihain ang paniningil para sa juridical entity

Consent to Electronic Service Pahintulot para sa electronic service

 I give my consent to be served with official court notices, processes, orders, resolutions and decisions, as well
as filings by the defendant, through: Nagbibigay ako ng pahintulot na maihatid sa akin ang mga opisyal na paunawa,
proseso, utos, resolusyon, at desisyon ng hukuman, pati ang mga do
 kumentong ipinasa ng hinahabla, sa pamamagitan ng:
(Check those that apply Pumili sa mga susunod at lagyan ng tsek)

 email address: __________________________________________________________________


 cell phone number: ______________________________________________________________
o phone call
o text message (SMS)
o instant message (ex. Viber, WhatsApp, Facebook Messenger) pls. specify: __________________

Other Plaintiffs or Defendants Form 1-A-SCC, Page 2 of 3


Plaintiff’s Statement of Claim/s
(Small Claims)
(Small Claims)
Case Number:

2 OTHER DEFENDANT
Name Pangalan ng Hinahabla Sex Kasarian Age Edad Civil Status Katayuang Sibil

Check those that apply: Pumili sa mga sumusunod at lagyan ng tsek:


Type of Defendant Uri ng Hinahabla  Cooperative Kooperatiba
 Individual Tao/Indibidwal  Sole Proprietorship Solong Pagmamay-ari
 Corporation Korporasyon
 Partnership Bakasan

Home Address Pahatirang Sulat sa Bahay ng Hinahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

Place of Work/Business Lugar ng Pinagtatrabahuhan/Negosyo ng Hinahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

Defendant’s Representative, if applicable Kinatawan ng Hinahabla, kung meron


Name Pangalan ng Kinatawan ng Hinahabla

Home Address Pahatirang Sulat sa Bahay ng Kinatawan ng Hinahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

Place of Work Lugar ng Pinagtatrabahuhan ng Kinatawan ng Hinahabla


Unit/Floor/House/Building No. Palapag Street Kalsada Barangay Zip Code

City Lungsod/Municipality Munisipalidad Province Lalawigan Region Rehiyon

Contact No. Telepono/Selpon Blg. Email Address

 Check here if more than two (2) defendants and fill out as many Form 1-A-SCC as may be necessary.
Lagyan ng tsek kung higit sa dalawa (2) ang hinahabla at punan ang mga karagdagang Form 1-A-SCC.

Other Plaintiffs or Defendants Form 1-A-SCC, Page 3 of 3


Plaintiff’s Statement of Claim/s
(Small Claims)
(Small Claims)

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