KP Forms No.

1: NOTICE TO CONSTITUTE THE LUPON

Republic of the Philippines

Province of ________________________
CITY/MUNICIPALITY OF ____________________________
Barangay ______________________________

OFFICE OF THE PUNONG BARANGAY

_____________ , 20___
(Date)

NOTICE TO CONSTITUTE THE LUPON

To All Baangay Members and All Other Persons Concerned:

In compliance with Section 1 (a), Chapter 7, Title One, Book III, Local Government
Code of 2091 (Republic Act No. 7160), of the Katarungang Pambarangay Law, notice is
hereby given to constitute the Lupong Tagapamayapa of this Barangay. The persons I am
considering for appointment are the following:
1. __________________________________ 13. ____________________________________
2. __________________________________ 14. ____________________________________
3. __________________________________ 15. ____________________________________
4. __________________________________ 16. ____________________________________
5. __________________________________ 17. ____________________________________
6. __________________________________ 18. ____________________________________
7. __________________________________ 20. ____________________________________
8. __________________________________ 20. ____________________________________
9. __________________________________ 21. ____________________________________
10. __________________________________ 22. ____________________________________
11. __________________________________ 23. ____________________________________
12. __________________________________ 24. ____________________________________
25. ____________________________________

They have been chosen on the basis of their suitability for the task of conciliation
considering their integrity, impartiality, independence of mind, sense of fairness and
reputation for probity in view of their age, social standing in the community, tact,
patience, resourcefulness, flexibility, open mindedness and other relevant factors. The
law provides that only those actually residing or working in the barangay who are not
expressly disqualified by law are qualified to be appointed as Lupon members. All
persons are hereby enjoined to immediately inform me and of their opposition to or
endorsement of any or all the proposed members or recommend to me other persons not
included in the list but not later than the _____________ day of _________, 20 _____
(the last day for posting this notice).

___________________________
Punong Barangay

IMPORTANT: This notice is required to be posted in three (3) conspicuous places

in the barangay for at least three (3) weeks.

WARNING: Tearing or defacing this notice shall be subject to punishment according to

law.
KP Forms No. 2 APPOINTMENT LETTER

Republic of the Philippines

Province of ___________________
City/Municipality of ____________
Barangay _____________________

OFFICE OF THE PUNONG BARANGAY

____________, 20___
(Date)

TO: __________________________

Pursuant to Chapter 7, Title One, Book III, Local Government Code of 1991 (Republic
Act No. 7160), you are hereby appointed MEMBER of the Lupong Tagapamayapa of this
Barangay effective upon taking your oath of office and until a new Lupon is constituted
on the third year following your appointment.

______________________________
Punong Barangay

ATTESTED:

___________________________
Barangay Secretary
KP Forms No. 3 NOTICE OF APPOINTMENT

Republic of the Philippines

Province of ___________________
City/Municipality of ____________
Barangay _____________________

OFFICE OF THE PUNONG BARANGAY

_______________, 20___
(Date)

____________________________
____________________________
____________________________

Sir/Madam:

Please be informed that you have been appointed by the Punong Barangay as a
MEMBER OF THE LUPONG TAGAPAMAYAPA, effective upon tking your oath of
office, and until a new Lupon is constituted on the third year following your appointment.
You may take your oath of office before the Punong Barangay on
____________________________.

Very truly yours,

___________________________
Barangay Secretary
KP Forms No. 4

Republic of the Philippines

Province of ___________________
City/Municipality of ____________
Barangay _____________________

OFFICE OF THE PUNONG BARANGAY

__________________, 20___
(Date)

LIST OF APPOINTED LUPON MEMBERS

Listed hereunder are duly appointed members of the Lupong Tagapamayapa in

this Barangay who shall as such upon taking oath of office and until a new lupon is
constituted on the third year following their appointment.

1. _________________________ 11. ________________________

2. _________________________ 12. ________________________

3. _________________________ 13. ________________________

4. _________________________ 14. ________________________

5. _________________________ 15. ________________________

6. _________________________ 16. ________________________

7. _________________________ 17. ________________________

8. _________________________ 18. ________________________

9. _________________________ 20. ________________________

10. ________________________ 20. ________________________

_________________________
Punong Barangay
ATTESTED:

_______________________
Barangay/Lupon Secretary

________________________________________________________________________
IMPORTANT: This is shall be posted in three (3) conspicuous places in the barangay for the duration of the terms
of office of those named above.
WARNING: Tearing or defacing this notice shall be subject to punishment according to law.
KP Form No. 5

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE PUNONG BARANGAY

OATH OF OFFICE

Pursuant to Chapter 7, Title One, Book 11, Local Government Code of 2091
(Republic Act No. 7160), I, ______________________, being duly qualified and having
been duly appointed member of the Lupong Tagapamayapa of this Barangay, do hereby
solemnly swear (or affirm) that I will faithfully and conscientiously discharge to the best
of my ability my duties and my functions as such member and as member of the Pangkat
ng Tagapagkasundo in I which may be chosen to serve; that I will bear true and
allegiance to the Republic of the Philippines; that I will support and defend its
Constitution and obey the laws, legal orders, and decrees promulgated by its duly
constituted authorities; and that I voluntarily impose upon myself this obligation without
any mental reservation or purpose of evasion.

SO HELP ME GOD. (In case of affirmation the last sentence will be omitted.)

___________________
(Member)

SUBSCRIBED AND SWORN to (or AFFIRMED) before me this _______ day of

__________________, 20______.

_________________________
Punong Barangay
KP Form No. 6

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

_____________, 20____
(Date)

WITHDRAWAL OF APPOINMENT

TO:_______________

After due hearing and with the concurrence of a majority of all Lupong
Tagapamayapa members of this Barangay, your appointment as member thereof is hereby
withdrawn effective upon receipt hereof, on the following ground/s:

- Incapacity to discharge the duties of your office as shown by __________________

____________________________________________________________________

- Unsuitability by reason of _______________________________________________

_____________________________________________________________________
(check whichever is applicable and detail or specify the act/s omission/s constituting the ground/s
of withdrawal):

____________________________
Punong Barangay/Lupon Chairman

CONFORME (Signatures):
1. ______________________ 7. ______________________
2. ______________________ 8. ______________________
3. ______________________ 9. ______________________
4. ______________________ 10. _____________________
6. ______________________ 11. _____________________

Received this _____ day of ______________, 20____.

_____________________
(Signature)

____________________________________________________________________
NOTE: The members of the lupon conforming to the withdrawal must personally affix their signature or thumb marks on the pertinent
spaces above. The withdrawal must be conformed to by more than one-half of the total number of the members of the lupon including
the punong barangay and the member concerned.
KP Form No. 7

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ________

____________________ For: ____________________
____________________
- against - ____________________
____________________
____________________
Respondent/s

COMPLAINT

I/WE hereby complain against the above named respondents for violating my/our
rights and interests in the following manner:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

THEREFORE, I/WE pray that the following relief/s be granted to me/us in

accordance with law and/or equity:

Made this ______ day of _________________, 20____.

_______________
Complianant/s

Received and filed this ______ day of ______________ 20____.

________________________
Punong Barangay/Lupon Chairman
KP Form No. 8

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

NOTICE OF HEARING
(MEDIATION PROCEEDINGS)

TO: ___________________

___________________
Complainant/s

You are hereby required to appear before me on the ____ day of ____________,
20____ at __________ o’clock in the morning/afternoon for the hearing of your
complaint.

This _____ day of ________________, 20____.

_____________________________
Punong Barangay/Lupon Chairman

Notified this _____ day of ________________, 20____.

Complainant/s:

___________________

___________________
KP Form No. 9

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

_______________________ Barangay Case No. _____________

_______________________ For: _________________________

Complainant/s _________________________

_________________________
- against -
_____________________

_____________________
Respondent/s

SUMMONS
TO: _________________________ __________________________

_________________________ __________________________
Respondents

You are hereby summoned to appear before me in person, together with your witnesses, on the
_____ day of _____________, 20___ at _______________ at _____o’clock in the morning/afternoon, then
and there to answer to a complaint made before me, copy of which is attached hereto, for mediation,
conciliation of your dispute with complainant/s.
You are hereby warned that if you refuse or willfully fail to appear in obedience to this summons,
you may be barred from filling any counterclaim arising from said complaint.
FAIL NOT or else face punishment as for contempt of court.
This _____ day of _______________, 20____.
______________________________
Punong Barangay/Pangkat Chairman
_______________________________________________________

OFFICER’S RETURN
I served this summons upon respondent _____________________ on the ____ day of
__________________, 20___, and upon respondent on the day of ______________________, 20___, by:
(Write name/s of respondent/s before mode by which he/she was/were served.)
Respondent/s
___________________ 1. Handing to him/them said summons in person
___________________ 2. Handing to him/them said summons and he/they refused to receive it
___________________ 3. Leaving said summons at his/their dwelling with _________________,
(Name)
a person or suitable age and discretion residing therein
___________________ 4. Leaving said summons at his/their office/place of business with
___________, a competent person in charge thereof.
(Name)

Officer

_____________________________
(Name and signature)

Received by Respondent/s Representative/s:

________________________ __________________________
(Name and Signature) (Date)
KP Form No.10
Republic of the Philippines
Province of La Union
MUNICIPALITY OF _________________

BARANGAY ___________________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

NOTICE FOR CONSTITUTION OF PANGKAT

TO: ________________________________ ___________________________________

________________________________ ___________________________________
Complainant/s Respondent/s

You are hereby required to appear me on the ________ day of

_________________________________, 20_____, at ________________0’clock in the
morning/afternoon for the constitution of the Pangkat ng Tagapagkasundo which shall conciliate
your dispute. Should you fail to agree on the Pangkat membership or to appear on the aforesaid date
for the constitution of the Pangkat, I shall determine the membership thereof by drawing lots.

This ___________ day of ____________________________________,20_____.

___________________________
Punong
Barangay

Notified this _____ day of ______________________________,20____.

________________________________ ___________________________________

________________________________ ___________________________________
Complainant/s Respondent/s
KP Form No.11
Republic of the Philippines
Province of _____________________
MUNICIPALITY OF _____________________
BARANGAY ___________________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

_______________________________ Barangay Case No._________________________

_______________________________ For: _____________________________________
Complainant/s ________________________________________

-against-

______________________________
______________________________
______________________________
Respondent/s

NOTICE TO CHOSEN PANGKAT MEMBER

_________________________
(Date)

TO: _________________________________

Notice is hereby given that you have been chosen member of the Pangkat ng
Tagapagkasundo to amicably conciliate the dispute between the parties in the above-entitled case.

______________________________
Punong Barangay/Lupon Chairman

Received this ______ day of _______________________________,20_____.

_____________________________________
Pangkat Member
KP Form No. 12

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

TO: ____________________ _____________________

____________________ _____________________
Complainant/s Respondent/s

NOTICE OF HEARING
(CONCILIATION PROCEEDINGS)

You are hereby required to appear before the pangkat on the ____ day of
__________________, 20___, at _____________ o’clock in the morning/afternoon for a hearing
of the above-entitled case.

This ____ day of ______________, 20___.

___________________
Pangkat Chairman

Notified this ____ day of ______________ 20, ____.

Complainant/s: Respondent/s:

_____________________ ___________________

_____________________ ___________________
KP Form No. 13

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ________

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

SUBPOENA

TO:

____________________ Witness _____________________

____________________ _____________________

You are hereby commanded to appear before me on the ____ day of __________,
20 ___, at __________ o’clock in the morning/afternoon, then and there to testify in the
hearing of the above-captioned case.

This ____ day of _____________, 20 ___.

_____________________________
Punong Barangay/Pangkat Chairman
(Cross out whichever one is not applicable)
KP Form No. 14

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

AGREEMENT FOR ARBITRATION

We hereby agree to submit our dispute for arbitration to the Punong

Barangay/Pangkat ng Tagapagkasundo (please cross out whichever is not applicable) and
bind ourselves to comply with the award that may be rendered thereon. We have made
this agreement freely with a full understanding of its nature and consequences.

Entered into this ____ day of ______________, 20 ___.

Complainant/s: Respondent/s:
_____________________ _____________________
_____________________ _____________________

ATTESTATION:

I hereby certify that the foregoing Agreement for Arbitration was entered into by
parties freely and voluntarily, after I had explained to them the nature and consequences
of such agreement.

_____________________________
Punong Barangay/Pangkat Chairman
(Cross out whichever is not applicable)
KP Form No. 15

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ___

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s

ARBITRATION AWARD

After hearing the testimonies given and careful examination of the evidences
presented in this case, award is hereby made as follows:

_______________________________________________
_______________________________________________
_______________________________________________

Made this ___ day of ____________, 20 ___ at _______________.

___________________________
Punong Barangay/PangakatChairman*

__________________
Member

__________________
Member
ATTESTED:

____________________________
Punong Barangay/Lupon Secretary**

_______________________________________________________________________

* To be signed by either, whoever made the arbitration award.

** To be signed by the Punong Barangay if the award is made by the Pangkat Chairman, and by the
Lupon Secretary if the award is made by the Punong Barangay.
KP Form No. 16

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

AMICABLE SETTLEMENT

We, complainant/s and respondent/s in the above-captioned case, do hereby agree

to settle our dispute as follows:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

and bind ourselves to comply honestly and faithfully with the above terms of settlement.

Entered into this ____ day of _______________, 20 ___.

Complainant/s: Respondent/s:
______________________ ______________________
______________________ ______________________

ATTESTATION:

I hereby certify that the foregoing amicable settlement was entered into by the parties freely and
voluntarily, after I had explained to them the nature and consequence of such settlement.

_____________________________
 Punong Barangay/Pangkat Chairman

KP Form No. 17

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _______

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -
____________________
____________________
Respondent/s

REPUDIATION

I/WE hereby repudiate the settlement/agreement for arbitration on the ground that my/our consent
was vitiated by:

(Check out whichever is applicable)

- Fraud. (State details) __________________________________________________
___________________________________________________________________

- Violence. (State details) ________________________________________________

___________________________________________________________________

- Intimidation. (State details) _____________________________________________

____________________________________________________________________

This ____ day of ________________, 20 ___.

Complainant/s Respondent/s
___________________________ __________________________
___________________________ __________________________

SUBSCRIBED AND SWORN TO before me this ____ day of ______________,

20 ___ at _________________
________________________
Punong Barangay/
Pangkat Chairman/Member

Received and filed * this _____ day of _______________, 20 ____.

_____________________
Punong Barangay

______________________________________________________________________________________
* Failure to repudiate the settlement or the arbitration agreement within the time limits respectively set [ten
(10) days from date of settlement and (5) days from the date of arbitration agreement] shall be deemed a
waiver of the right to challenge on said grounds.
KP Form No. 18

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

NOTICE OF HEARING
(RE: FAILURE TO APPEAR)

TO: __________________
__________________
Complainant/s

You are hereby required to appear before me/the Pangkat on the ____ day of
____________, 20 ___, at ____________ o’clock in the morning/afternoon to explain
why you failed to appear for mediation/conciliation scheduled on ______________, 20
___ and why your complaint should not be dismissed, a certificate to bar the filling of
your action in court/government office should not be issued, and contempt proceedings
should not be initiated in court for willful failure or refusal to appear before the Punong
Barangay/Pangkat ng Tagapagkasundo.

This ___ day of _______________, 20 ____.

Notified this ___ day of ________________, 20 ___.

Complainant/s: Respondent/s:
______________________ ______________________
 ______________________________ _____________________________

KP Form No. 19

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

NOTICE OF HEARING
(RE: FAILURE TO APPEAR)

TO: ___________________
___________________
Respondent/s

You are hereby required to appear before me/the Pangkat on the ____ day of
________________, 20 ___, at ___________ o’clock in the morning/afternoon to explain why
you failed to appear for mediation/conciliation scheduled on ________________, 20 ____ and
why your counterclaim (if any) arising from the complaint should not be dismissed, a certificate
to bar the filling of said counterclaim in court/government office should not be issued, and
contempt proceedings should not be initiated in court for willful failure or refusal to appear
before the Punong Barangay/Pangkat ng Tagapagkasundo.

This ____ day of _____________, 20 ___.

______________________________
Punong Barangay/Pangkat Chairman
(Cross out whichever is not applicable)

Notified this ____ day of ________________, 20 ___.

Complainant/s: Respondent/s:
___________________ ____________________
___________________ ____________________
KP Form No. 20

Republic of the Philippines

Province of ____________________
City/Municipality _______________
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 ______________________.

4. Therefore, the corresponding complaint for the dispute may now be filed in
court/government office.

This ____ day of _______________, 20 ___.

__________________
Lupon Secretary
ATTESTED:

____________________
Lupon Chairman
KP Form No. 21

Republic of the Philippines

Province of ____________________
City/Municipality _______________
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 but mediation failed.

2. The Pangkat ng Tagapagkasundo was constituted but the personal confrontation

before the Pangkat likewise did not result into a settlement.

3. Therefore, the corresponding complaint for the dispute may now be filed in
court/government office.

This ____ day of _______________, 20 ___.

__________________
Pangkat Secretary

ATTESTED BY:

____________________
Pangkat Chairman
KP Form No. 22

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

CERTIFICATE TO FILE ACTION

This is to certify that:

1. There has been a persona confrontation between the parties before the Punong
Barangay but mediation failed.

2. The Punong Barangay set the meeting of the parties for the constitution of the
Pangkat.

3. The respondent willfully failed or refused to appear without justifiable reason at

the conciliation proceedings before the Pangkat.

4. Therefore, the corresponding compliant for the dispute may now be filed in
court/government office.

__________________
Pangkat Secretary

ATTESTED:

___________________
Pangkat Chairman
KP Form No. 23

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

CERTIFICATION TO BAR ACTION

This is to certify that the above-captioned case was dismissed pursuant to the
Order dated _________________, for complainant/s __________________ and
(Name)

_____________________willful failure or refusal to appear for hearing before the

(Name)

Punong Barangay/Pangkat ng Tagapagkasundo and therefore complainant/s is/are barred

form filing an action in court/government office.

This _____ day of ________________, 20 ___.

____________________________
Lupon Secretary/Pangkat Secretary

ATTESTED:

_____________________________
Lupon Chairman/Pangkat Chairman

____________________________________________________________________
IMPORTANT: If the Lupon Secretary makes the certification, the Lupon Chairman attests. If the Pangkat
Secretary makes the certification, the Pangkat Chairman attests.
KP Form No. 24

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

CERTIFICATION TO BAR COUNTERCLAIM

This is to certify that after prior notice and hearing, the respondent/s
_____________________ and ______________________ have been found
(Name) (Name)
to have willfully failed or refused t appear without justifiable reason before the Punong
Barangay/Pangkat ng Tagapagkasundo and therefore respondent/s is/are barred from
filing his/their counterclaim (if any) from the complaint in court/government office.

This ___ day of ________________, 20 ___.

____________________________
Lupon Secretary/Pangkat Secretary

ATTESTED:

_____________________________
Lupon Chairman/Pangkat Chairman

_____________________________________________________________________
IMPORTANT: If the Lupon Secretary makes the certification, the Lupon Chairman attests. If the
Pangkat Secretary makes the certification, the Pangkat Chairman attests.
KP Form No. 25

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. _____

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

MOTION FOR EXECUTION

Complainant/s Respondent/s state as follows:

1. On ___________________, 20 ___, the parties in this case signed an amicable

settlement/received the arbitration award rendered by the
Lupon/Chairman/Pangkat ng Tagapagkasundo.

2. The period of ten (10) days from the above-stated date has expired without any of
the parties filings a sworn statement of repudiation of the settlement before the
Lupon Chairman a petition for nullification of the arbitration award in court.

3. The amicable settlement/arbitration award is now final and executory.

WHEREFORE, Complainant/s/Respondent/s request/s that the corresponding writ

of execution be issued by the Lupon Chairman in this case.

_____________________
(Date)

________________________
Complainant/s/Respondent/s
KP Form No. 26

Republic of the Philippines

Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ________

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

NOTICE OF HEARING
(RE: MOTION FOR EXECUTION)

TO: _____________________ _____________________

_____________________ _____________________
Complainant/s Respondent/s

You are hereby required to appear me on ___ day of _____________________,

20 ____ at _________________ o’clock in the morning/afternoon/evening for the
hearing of the motion for execution, copy of which is attached hereto, filed by
____________________________.
(Name of complainant/s/respondent/s)

____________________
(Date)

_____________________________
Punong Barangay/Lupon Chairman

Notified this ___ day of _________________, 20 ___.

_________________ _________________
_________________ _________________
(Signature) (Signature)
Complainant/s Respondent/s
KP Form No. 27
Republic of the Philippines
Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

____________________ Barangay Case No. ________

____________________ For: ____________________
Complainant/s ____________________
____________________
- against -

____________________
____________________
Respondent/s

NOTICE OF EXECUTION

WHEREAS, on _________________, 20 ___, an amicable settlement was signed by the

parties in the above-entitled case [or an arbitration award was rendered by the Punong
Barangay/Pangkat ng Tagapagkasundo;

WHEREAS, the terms and conditions of the settlement, the dispositive portion of the
award, read: __________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
The said settlement/award is now final and executory;

WHEREAS, the party obliged ____________________ has not complied

(Name)
voluntarily with the aforestated amicable settlement/arbitration award, within the period of five
(5) days from the date of hearing on the motion for execution;

NOW, THEREFORE, on be half of the Lupong Tagapamayapa and by virtue of the

powers vested upon me and the Lupon by the Katarungang Pambarangay Law and Rules, I shall
cause to be realized from the goods and personal property of _____________________the sum of
__________________________ agreed upon in the ____________________________________
(Name of party obliged) (State amount of settlement or award)
said amicable settlement [or adjudged in the said arbitration award], unless voluntary compliance
of said settlement or award shall have been made upon receipt hereof.

Signed this ____ day of ______________, 20 ___.

__________________________
Punong Barangay
Copy furnished:
 ______________________ ______________________
Complainant/s Respondents/s

KP Form No. 28
Republic of the Philippines
Province of ____________________
City/Municipality _______________
Barangay ______________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

_______________________
Date

MONTHLY TRANSMITTAL OF FINAL REPORTS

To: _________________________
Municipal Judge
__________________________, La Union

Enclosed herewith are the final reports of settlement of disputes and arbitration awards
made by the Punong Barangay/Pangkat Tagapagkasundo in the following cases:

Barangay Case No. TITLE

(Complainant, et al vs. Respondent, et al)

__________________________
Clerk of Court

IMPORTANT: Lupon/Pangkat Secretary shall transmit not later than the first five days of each
month the final reports for preceding month.
 Specific offenses carry a penalty of not more than one year imprisonment:

The Revised Penal Code enumerates specific cases in which penalties are not
more than one year of imprisonment, to wit:

 Article 154 – Unlawful use means of publication and unlawful

utterances
 Article 155 – Alarms and scandals
 Article 175 – Using false certificates
 Article 178 – Using fictitious names and concealing true names
 Article 179 – Illegal use of uniforms or insignias
 Article 252 – Physical injuries inflicted in a tumultuous affray
 Article 253 – Giving assistance to unconsummated suicide
 Article 260 – Responsibility of participants in a duel if only
physical injuries are inflicted or no physical
injuries have been inflicted
 Article 265 – Less serious physical injuries
 Article 266 – Slight physical injuries and maltreatment
 Article 269 – Unlawful arrest
 Article 271 – Inducing a minor to abandon his home
 Article 275 – Abandonment of person in danger and abandonment
of one’s own victim
 Article 276 – Abandoning a minor (a child of under seven years
old)
 Article 277 – Abandonment of minor by person entrusted with his
custody; indifference of parents
 Article 280 – Qualified trespass to dwelling (without the use of
violence or intimidation)
 Article 281 – Other forms of trespass
 Article 283 – Light threats
 Article 285 – Other light threats
 Article 286 – Grave coercion
 Article 287 – Light coercion
 Article 288 – Other similar coercions (compulsory purchase of
merchandise and payment of wages by means
of tokens)
 Article 289 – Formation, maintenance and prohibition of
combination of capital or labor through
violence or threats
 Article 290 – Discovering secrets through seizure of
correspondence
 Article 291 – Revealing secrets with abuse of office
 Article 309 – Theft (if the value of property stolen does not exceed
P50.00)
 Article 310 – Qualified theft (if the amount does not exceed
P50.00)
Specific offenses carry a penalty of not more than one year imprisonment:

The Revised Penal Code enumerates specific cases in which penalties are not
more than one year of imprisonment, to wit:
 Article 312 – Occupation of real property or usurpation of real
rights in property
 Article 313 – Altering boundaries of landmarks
 Article 315 – Swindling or estafa (if the amount does not exceed
P200.00)
 Article 316 – Others forms of swindling

 Article 317 – Swindling a minor

 Article 318 – Other deceits
 Article 320 – Removal, sale or pledge or mortgaged property
 Article 328 – Special cases of malicious mischief (if the value of
the damaged property does not exceed
P200.00)
 Article 329 – Other mischiefs (if the damaged property does not
exceed P1,000.00)
 Article 338 – Simple seduction
 Article 339 – Acts of lasciviousness with the consent of the
offended party
 Article 356 – Threatening to publish and offer to prevent such
publication for a compensation
 Article 357 – Prohibited publication of acts referred to in the
course of official proceedings
 Article 363 – Incriminating innocent persons
 Article 364 – Intriguing against honor
 Sec. 1, B.P. 22 – Issuing checks without sufficient funds
 Pres. Decree No. 772 – Squatting and other similar acts
 Pres. Decree No. 1612 – Fencing of stolen properties of not more
than P50.00