Document text
Republic of the Philippines
Province of [PROVINCE]
City / Municipality of [CITY OR MUNICIPALITY]
Barangay [BARANGAY NAME]
OFFICE OF THE LUPONG TAGAPAMAYAPA
[FULL NAME OF COMPLAINANT] Barangay Case No. [TO BE FILLED IN BY THE LUPON SECRETARY]
[ADDRESS] For: [NATURE OF THE DISPUTE — e.g., COLLECTION OF SUM OF MONEY / UNPAID RENT / DAMAGE TO PROPERTY / NUISANCE / SLANDER / BOUNDARY DISPUTE]
Complainant / Nagrereklamo
— against —
[FULL NAME OF RESPONDENT]
[ADDRESS]
Respondent / Inirereklamo
COMPLAINT
To the Punong Barangay and Lupon Chairman of Barangay [BARANGAY NAME]:
I, [FULL NAME OF COMPLAINANT], of legal age, [CIVIL STATUS], residing at [COMPLETE ADDRESS], respectfully file this complaint against [FULL NAME OF RESPONDENT], of legal age, residing at [COMPLETE ADDRESS], and state:
1. The respondent and I both actually reside in [THIS BARANGAY / THE SAME CITY OR MUNICIPALITY — BARANGAY ___ AND BARANGAY ___]. [IF THE DISPUTE IS ABOUT REAL PROPERTY: The property involved is located at ___, within this barangay.]
2. On [DATE], [STATE WHAT HAPPENED — e.g., "the respondent borrowed from me the amount of ₱25,000.00 and promised to pay it in full on or before 30 June 2026, as shown by the acknowledgment receipt he signed"].
3. [CONTINUE THE FACTS IN ORDER OF DATES — e.g., "Despite my repeated requests on [DATES], the respondent has not paid any amount."]
4. On [DATE], I sent the respondent a written demand [by personal delivery / registered mail / text message], but [HE / SHE] [REFUSED / IGNORED IT / ASKED FOR MORE TIME BUT DID NOT PAY]. [DELETE IF NO DEMAND WAS MADE.]
5. Because of the respondent's acts, I have suffered [THE LOSS OF ₱___ / DAMAGE TO MY PROPERTY / DISTURBANCE / OTHER HARM].
RELIEF REQUESTED (Hinihiling)
I respectfully ask that the respondent be summoned for mediation, and that through amicable settlement the respondent:
1. [PAY ME THE AMOUNT OF ₱___ / IN INSTALLMENTS OF ₱___ EVERY ___ ];
2. [REPAIR OR PAY FOR THE DAMAGE TO ___ / STOP THE ACTS COMPLAINED OF / VACATE ___ ];
3. [OTHER RELIEF THAT IS JUST AND FAIR].
Supporting documents (copies attached)
1. [PROMISSORY NOTE / ACKNOWLEDGMENT RECEIPT / LEASE CONTRACT]
2. [DEMAND LETTER AND PROOF OF DELIVERY]
3. [PHOTOS / SCREENSHOTS OF MESSAGES]
4. [NAMES OF WITNESSES: ___ ]
I certify that the facts above are true and correct to the best of my knowledge, and that I have not filed any other complaint on the same matter before any court or office.
Made this [DAY] day of [MONTH], [YEAR] at Barangay [BARANGAY NAME], [CITY OR MUNICIPALITY].
______________________________
[FULL NAME OF COMPLAINANT]
Complainant
[MOBILE NUMBER]
Received and filed:
Date and time: [DATE, TIME] · Filing fee paid: ₱[AMOUNT] · O.R. No. [NUMBER]
______________________________
[NAME]
Punong Barangay / Lupon Secretary
NOTES BEFORE FILING — delete this part
Where to file: if you both live in the same barangay — there. If you live in different barangays of the same city or municipality — in the barangay of the respondent (your choice if there are several). Real property disputes — where the property is. Disputes at the workplace or school — where it is located (R.A. 7160, s.409).
What happens next: the Punong Barangay summons the respondent within the next working day. Mediation runs up to 15 days from your first meeting. If it fails, a three-member Pangkat ng Tagapagkasundo is formed; it meets within 3 days and has 15 days (extendable by 15) to settle (s.410).
Appear in person. Lawyers and representatives are not allowed; minors and incompetents may be assisted by a non-lawyer relative (s.415).
If you settle: the settlement is in writing. Either side may repudiate it within 10 days for fraud, violence or intimidation (s.418). Otherwise it becomes final like a court judgment after 10 days (s.416) and can be enforced by the Lupon within 6 months (s.417).
If you do not settle: ask for the Certification to File Action. Without it, a court generally will not accept a case that falls under the Lupon (s.412).
Prescription: filing here interrupts the period to sue, but for no more than 60 days from filing (s.410(c)). If your deadline is close, the law lets you go straight to court (s.412(b)(4)).
Not for the barangay: cases against the government or a public officer about official duties, offenses punishable by more than one year or a fine over ₱5,000, offenses with no private offended party, and parties in different cities unless barangays adjoin and both agree (s.408).
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