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Republika ng Pilipinas

LALAWIGAN NG RIZAL

Road A Phase IV COGEO Village, Barangay Bagong Nayon, Antipolo City 1870 Rizal, Philippines
 barangay_bagongnayon@yahoo.com   647-0942   942-0358   bagongnayon.antipolo@gmail.com
www.facebook.com/BagongNayonOfficialPage   www.antipolo.ph

KP PORMULARYO BLG. 18

BARANGAY CASE NO. _______________

____________________________
COMPLAINANT/S
____________________________
____________________________
(Address)

AGAINST: FOR:

____________________________ ____________________________________
RESPONDENT/S
____________________________ ____________________________________
Barangay Bagong Nayon,Antipolo City
(Address)

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 on 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:
____________________________
____________________________
Barangay Bagong Nayon : Kabalikat sa Kaunlaran at Pagbabago ng Lungsod ng Antipolo.

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