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KP Form No. 16
KP Form No. 16
16
Republic of the Philippines
Province of Camarines Sur
Municipality of Lupi
Barangay _____________________
-o0oOFFICE OF THE LUPONG TAGAPAMAYAPA
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________________________
________________________
______________________________
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___.
Complaint/s
Respondent
____________________________
____________________________________
____________________________
____________________________________
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 consequence of such settlement.
________________________________
Punong Barangay/Pangkat Chairman