BJ Form No.

10

REPUBLIC OF THE PHILIPPINES

CITY OF MANILA
BARANGAY _________, ZONE _____, DISTRICT_____

OFFICE OF THE PUNONG BARANGAY

NOTICE FOR CONSTITUTION OF PANGKAT

_____________________________ __________________________
_____________________________ __________________________
Complainant/s Respondent/s

You are hereby required to appear before me on __________________________

Day of _______________________, 201____, at _________ o’clock in the
morning/afternoon for the constitution on 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 _________________, 201_____.

____________________________
Punong Barangay/Lupon Chairman

We hereby acknowledged receipt of the foregoing notice this ____ day of

_______________, 201_____.

____________________________ _____________________________

____________________________ _____________________________
Complainant/s Respondent/s