KP Form No.

1
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE PUNONG BARANGAY

_________________, 20___

NOTICE TO CONSTITUTE THE LUPON

To All Barangay Members and All Other Persons Concerned:

In compliance with Section 1(a), Chapter 7, Title One, Book III, Local
Government Code of 1991 (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. ____________________ 19. ____________________
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.
KP Form No. 1
Page 2

All persons are hereby enjoined to immediately inform me of their opposition

to or endorsement of any or all of 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 Form No. 2

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________

OFFICE OF THE PUNONG BARANGAY

_________________, 20___

APPOINTMENT

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 Form No. 3

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________

OFFICE OF THE PUNONG BARANGAY

_________________, 20___

NOTICE OF APPOINTMENT

______________________
______________________
______________________

Sir/Madam:

Please be informed that you have been appointed by the Punong Barangay as a
MEMBER of the LUPONG TAGAPAMAYAPA, effective upon taking 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 Form No. 4

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE PUNONG BARANGAY

_________________, 20___

LIST OF APPOINTED LUPON MEMBERS

Listed hereunder are the duly appointed members of the Lupong

Tagapamayapa in this Barangay who shall serve as such upon taking their 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. _______________________ 19. _________________________
10. ______________________ 20. _________________________

_______________________________
Punong Barangay

Attested:
___________________________
Barangay/Lupon Secretary

IMPORTANT: The list 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 Lanao del Sur
City/Municipality of _____________
Barangay _________________

OFFICE OF THE PUNONG BARANGAY

OATH OF OFFICE

Pursuant to Chapter 7, Title One, Book II, Local Government Code of 1991
(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 functions as such
member and as member of the Pangkat ng Tagapagkasundo in which I may be
chosen to serve; That I will bear true faith 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 Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE LUPONG TAGAPAMAYAPA

_________________, 20___

WITHDRAWAL OF APPOINTMENT

TO: ____________________

After due hearing and with the concurrence of a majority of all the 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 or omission/s constituting the
ground/s for withdrawal.)

_________________________________
Punong Barangay/Lupon Chairman

CONFORME (Signatures):
1. ________________________ 7. ___________________________
2. ________________________ 8. ___________________________
3. ________________________ 9. ___________________________
4. ________________________ 10. __________________________
 5. ________________________ 11. _________________________
6. ________________________

Received this ______ day of ________________, 20 _____

_______________________________
(Signature)

NOTE: The members of the Lupon conforming to the withdrawal must personally affix their signatures or
thumb marks on the pertinent spaces above. The withdrawal must be conformed to by more
than ½ (one-half) of the total number of members of the Lupon including the Punong Barangay
and the member concerned.

KP Form No. 7

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE LUPONG TAGAPAMAYAPA

________________________ Barangay Case No. _________

________________________ For: ______________________________
Complainant/s ______________________________
- against - ______________________________
________________________
________________________
Respondent/s

COMPLAINT

I/WE hereby complain against above named respondent/s 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 _____.

_______________
Complainant/s

Received and filed this ______ day of _______, 20 ___.

__________________________________
Punong Barangay/Lupon Chairman

KP Form No.8

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
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 Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE LUPONG TAGAPAMAYAPA

________________________ Barangay Case No. _________

________________________ For: ______________________________
Complainant/s ______________________________
- against - ______________________________
________________________
________________________
Respondent/s

SUMMONS

TO: ________________________ ________________________

________________________ ________________________
Respondent/s

You are hereby summoned to appear before me in person, together with your
witnesses, on the ___ day of _____________, 20 ____, 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 filing 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

KP Form No. 9
Page 2

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 they was/were served.)

Respondent/s

_______________ 1. handing to him/them said summons in person, or

_______________ 2. handing to him/them said summons and he/they refused
to receive it, or
_______________ 3. leaving said summons at his/their dwelling with (name) a
person of suitable age and discretion residing therein, or
_______________ 4. leaving said summons at his/their office/place of business
with ______________
(name)
a competent person in charge thereof.
 ___________________
Officer

Received by Respondent/s/representative/s:

_________________ _______________
(Signature) (Date)

_________________ _______________
(Signature) (Date)

KP Form No. 10

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE PUNONG BARANGAY

NOTICE FOR CONSTITUTION OF PANGKAT

TO: _____________________ _____________________

_____________________ _____________________
Complainant/s Respondent/s

You are hereby required to appear before me on the ____day of

________________, 20 __ at _____ o’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 Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE LUPONG TAGAPAMAYAPA

________________________ Barangay Case No. _________

________________________ For: ______________________________
Complainant/s ______________________________
- against - ______________________________
________________________
________________________
Respondent/s

NOTICE TO CHOSEN PANGKAT MEMBER

_________________, 20 ____
 (Date)

TO: ________________________________

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

______________________________
Punong Barangay/Lupon Secretary

Received this ___ day of _________________, 20 ____.

______________________________
Pangkat Member

KP Form No. 12

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

___________________ ___________________
___________________ ___________________
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 for the 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 Lanao del Sur
City/Municipality of _____________
Barangay _________________
OFFICE OF THE LUPONG TAGAPAMAYAPA

________________________ Barangay Case No. _________

________________________ For: __________________________
Complainant/s ______________________________
- against - ______________________________
________________________
________________________
Respondent/s

SUBPOENA
TO: _______________________ _________________________
_______________________ _________________________
Witnesses

You are hereby commanded to appear before me on the _______ day of

___________________, 20 ____, at ____ o’clock, 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 one not applicable.)

KP Form No.14
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
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
__________________ __________________
__________________ __________________

AT T ESTATION

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

____________________________________
Punong Barangay/ Pangkat Chairman
(Cross out whichever one is one not applicable.)

KP Form No.15
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

ARBITRATION AWARD

________________________ Barangay Case No. _____

 ________________________ For: _________________________
Complainant/s _________________________
- against - _________________________
________________________
________________________
Respondent/s

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

Made this___day of _________, 20 ___ at _________.

________________________________
Punong Barangay/Pangkat Chairman*
______________________
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 Lanao del Sur
City/Municipality of _____________
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
consequences of such settlement.

Punong Barangay/ Pangkat Chairman

(Cross out whichever one is one not applicable.)

KP Form No. 17

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
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
__________________ __________________
__________________ __________________

KP Form No. 17
Page 2
 SUBSCRIBED AND SWORN TO before me this ____ day
of____________________, 20___, at ______________________________.

_____________________________________________
Punong Barangay/ Pangkat Chairman /Member
(Cross out whichever one is one not applicable.)

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 FIVE (5) days from 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 Lanao del Sur
City/Municipality of _____________
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 filing 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 ___.

Punong Barangay/ Pangkat Chairman /Member

(Cross out whichever one is one not applicable.)

Notified this ______ day of _____________________, 20 _____.

Complainant/s Respondent/s
__________________ __________________
__________________ __________________
KP Form No. 18
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
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 filing 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 ___.

Punong Barangay/ Pangkat Chairman

(Cross out whichever one is one not applicable.)

Notified this ______ day of _____________________, 20 _____.

Complainant/s
________________________
________________________
Respondent/s
________________________
 ________________________

KP Form No. 19
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
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 filing 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 one is one not applicable.)

Notified this ______ day of _____________________, 20 _____.

Complainant/s
________________________
________________________
 Respondent/s
________________________
________________________

KP Form No. 20
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
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. 20-A

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
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 _____.

________________________
Lupon Secretary
Attested:
 ________________________
Lupon Chairman

KP Form No. 20-B

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
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 was a personal 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 complaint for the dispute may now be filed
in court/government office.

________________________
 Pangkat Secretary
Attested:

________________________
Pangkat Chairman

KP Form No. 21

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
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
______________________________ _______________________________
(name) (name)
willful failure or refusal to appear for hearing before the Punong Barangay/Pangkat
ng Tagapagkasundo and therefore complainant/s is/are barred from filling an
action in court/government office.

This ________ day of _____________________, 20 ___.

 _____________________________
Lupon Secretary/Pangkat Secretary
Attested:
_____________________________
Lupon Chairman/Pangkat Chairman

IMPORTANT: If Lupon Secretary makes the certification, the Lupon Chairman attests. If the Pangkat
Secretary makes the certification, the Pangkat Chairman attests.

KP Form No. 22
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
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 _________________________________
(name) (name)

have been found to have willfully failed or refused to appear without justifiable reason
before the Punong Barangay/Pangkat ng Tagapagkasundo and therefore respondent/s is/are
barred from filling his/their counterclaim (if any) arising from the complaint in
court/government office.

This ___ day of __________________, 20 _______.

 _____________________________
Lupon /Pangkat Secretary
Attested:
_____________________________
Lupon /Pangkat Chairman

IMPORTANT: If Lupon Secretary makes the certification, the Lupon Chairman attests. If the Pangkat
Secretary makes the certification, the Pangkat Chairman attests.

KP Form No. 23

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
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 ______________, the parties in this case signed an

(date)
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 filing 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 requests that the corresponding

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

______________________
(Date) _________________________
Complainant(s)/Respondent(s)

KP Form No. 24
Republic of the Philippines
Province of Lanao del Sur
City/Municipality of _____________
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 before 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 complainants(s)/respondent(s)

_________________
(Date) ________________________________
Punong Barangay/Lupon Chairman

Notified this ______ day of _____________, 20 ____.

_______________________ _________________________
(Signature) (Signature)
Complainant(s) Respondent(s)

KP Form No. 25

Republic of the Philippines

Province of Lanao del Sur
City/Municipality of _____________
Barangay _________________

OFFICE OF THE LUPONG TAGAPAMAYAPA

________________________ Barangay Case No. _____

________________________ For: _________________________
Complainant/s _________________________
- against - _________________________
________________________
________________________
Respondent/s

NOTICE OF EXECUTION

WHEREAS, on ____________________, an amicable settlement was

(date)
Signed by 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;

KP Form No. 25
Page 2

NOW, THEREFORE, in behalf 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 ___________________________
(name of party obliged)
the sum of _____________________________________ agreed upon in
(state amount of settlement or award)

the 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) Respondent(s)