Certificate to File Action format

REPUBLIC OF THE PHILIPPINES Barangay Salapan City of San Juan OFFICE OF THE LUPONG TAGAPAMAYAPA

 ___________  _________________ _____________ ____________ _____  ___________  _________________ _____________ ____________ _____ Complainant/s

Barangay Barangay Case No. _______ ___________  ____  For:________ For:_______________ ______________ _________  __ 

-against __________________________   __________________________  Respondent/s

C E R T IF IC A TI ON

T O F IL E ACTI ON

This is to certify that:

1. There There has been been no personal personal confro confront ntati ation on between between the partie partiess before before the Punong Punong Barang Barangay ay  because the respondent respondent was absent and that mediation mediation failed. 2. The Pangkat Pangkat Tagapagk Tagapagkasu asund ndo o was constit constitute uted d but there there has been no person personal al confro confront ntati ation on  before the Pangkat likewise likewise did not result into a settlement settlement because the respondent respondent was absent. 3. Therefore Therefore,, the correspondi corresponding ng complaint complaint for the the dispute dispute may now be filed in court/g court/govern overnment ment office. This ________day of __________________ __________________ 2010.

 __________________________  Pangkat Secretary Attested by:

 ___________  _________________ _____________ ____________ _____ Pangkat Chairperson

___________ __________________ ______________ ___________  ____  Pangkat Member  

 ___________  __________________ ______________ ___________  ____  Pangkat Member 

Noted by:

PATROCINIO DS. DELA CRUZ Punong Barangay / Lupon Chairperson

REPUBLIC OF THE PHILIPPINES Barangay Salapan City of San Juan OFFICE OF THE LUPONG TAGAPAMAYAPA

 ___________  _________________ _____________ ____________ _____  ___________  _________________ _____________ ____________ _____ Complainant/s

Barangay Barangay Case No. _______ ___________  ____  For:________ For:_______________ ______________ _________  __ 

-against __________________________   __________________________  Respondent/s

C E R T IF IC A TI ON

T O F IL E ACTI ON

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 Tagapagkasundo was constituted but the personal confrontation before the Pangkat likewise did not result into a settlement; and 3. Therefore Therefore,, the correspondi corresponding ng complaint complaint for the the dispute dispute may now be filed in court/g court/govern overnment ment office. This ________day of __________________ __________________ 2010.

 __________________________  Pangkat Secretary Attested by:

 ___________  _________________ _____________ ____________ _____ Pangkat Chairperson

___________ __________________ ______________ ___________  ____  Pangkat Member  

 ___________  __________________ ______________ ___________  ____  Pangkat Member 

Noted by:

PATROCINIO DS. DELA CRUZ Punong Barangay / Lupon Chairperson

REPUBLIC OF THE PHILIPPINES Barangay Salapan City of San Juan OFFICE OF THE LUPONG TAGAPAMAYAPA

 ___________  _________________ _____________ ____________ _____  ___________  _________________ _____________ ____________ _____ Complainant/s

Barangay Barangay Case No. _______ ___________  ____  For:________ For:_______________ ______________ _________  __ 

-against __________________________   __________________________  Respondent/s

C E R T IF IC A TI ON

T O F IL E ACTI ON

This is to certify that:

1. There There has been been no personal personal confro confront ntati ation on between between the partie partiess before before the Punong Punong Barang Barangay ay  because the respondent respondent was absent and that mediation mediation failed.

2. The Pangkat Tagapagkasundo was constituted but the personal confrontation before the Pangkat likewise did not result into a settlement; and 3. Therefore Therefore,, the correspondi corresponding ng complaint complaint for the the dispute dispute may now be filed in court/g court/govern overnment ment office. This ________day of __________________ __________________ 2010.

 __________________________  Pangkat Secretary Attested by:

 ___________  _________________ _____________ ____________ _____ Pangkat Chairperson

___________ __________________ ______________ ___________  ____  Pangkat Member  

 ___________  __________________ ______________ ___________  ____  Pangkat Member 

Noted by:

PATROCINIO DS. DELA CRUZ Barangay Chairperson / Lupon Chairperson

REPUBLIC OF THE PHILIPPINES Barangay Salapan City of San Juan OFFICE OF THE LUPONG TAGAPAMAYAPA

 ___________  _________________ _____________ ____________ _____  ___________  _________________ _____________ ____________ _____ Complainant/s

Barangay Barangay Case No. _______ ___________  ____  For:________ For:_______________ ______________ _________  __ 

-against __________________________   __________________________  Respondent/s

C E R T IF IC A TI ON

T O F IL E ACTI ON

This is to certify that:

 __________________________  Pangkat Secretary Attested by:

 ___________  _________________ _____________ ____________ _____ Pangkat Chairperson

___________ __________________ ______________ ___________  ____  Pangkat Member  

 ___________  __________________ ______________ ___________  ____  Pangkat Member 

Noted by:

PATROCINIO DS. DELA CRUZ Barangay Chairperson / Lupon Chairperson