Republic of the Philippines

Province of South Cotabato

Municipality of
Barangay

BARANGAY AGRARIAN REFORM COMMITTEE [BARC]

N O T I C E
FOR MEDIATION/CONSULTATION

Reference No.
DATE: Mediation Conference
£ 1st £ 2nd £ 3rd

TO:

The Barangay Agrarian Reform Committee received a complaint/concerns over a parcel of land
with basic facts as follows:

Title #
Lot #, Survey Plan #
Area Size
Location of the Property:

By virtue of Executive Order #229 under RA 6657 as mandated by laws to the CARP barangay-
level implementing unit, this office is inviting your presence for a conference/mediation:

Date:
Time:
Venue:

We highly appreciate your personal appearance during the conference/mediation. Please don’t
fail to come.

Very Truly Yours,

_______________________________
BARC Chairman
(Signature over Printed Name
SUBSCRIBE and SWORN to b
SWORN to before me,this______day of ____,20____in _____________________,the certifying BARC Chairperson/Member having pre
having presented to his/her competent proof of identification _____________________.
 Republic of the Philippines
Province of South Cotabato
Municipality of
Barangay

BARANGAY AGRARIAN REFORM COMMITTEE [BARC]

Name of Activity MEDIATION / CONFERENCE

Date of Activity

Gender
NAME Address Signature
Male Female
 Republic of the Philippines
Province of South Cotabato
Municipality of
Barangay

BARANGAY AGRARIAN REFORM COMMITTEE [BARC]

MINUTES OF THE MEETING/CONFERENCE

Time Started:

Name of Attendees:

Name Position/Designation

ex. Rolando Josol BARC Chairman

Juan Dela Cruz Complainant
Pedro Raño Respondent

Basic Facts
Title # Lot # Area Size:
Location of the Property:

Discussion

Remarks

Recommendation

Certified Correct: Attested by:

BARC Secretary BARC Chairman

 SETTLEMENT / AGREEMENT FORM

A G R E E M E N T

By my signature below, I attest, understand and agree to the following:

The compromise was executed voluntarily and out of our own volition. We have read and
understood the contents thereof.

The parties agree that this constitutes full and final settlement of any complaint each may have
against the other in relation to this case.

PARTY A PARTY B

Signature over printed name Date

PARTY A PARTY B

Signature over printed name Date

Assisted By:

BARC Chairman/ Mediator

 KASUGTANAN / PANAGSABOT

KASUGTANAN/ KASABUTAN

Pinaagi sa akong pirma sa ubos, Ako, magpamatuod sa nakasabutan ug nakasugtan sa mga

musunod:

Kini nga kasugtanan o kasabutan gihimu nga boluntaryo ug gikan sa amung personal nga kabubut-on.
Amung nabasa ug nasabtan ang unod nining kasulatan.

Ang tanan nga partidos nagkasinabot nga ang kilangkuban niining kasulatan mao ang tibuok ug
pinal/katapusan nga kasugtanan sa tanang reklamo nga gipadangat sa usag-usa bahin ani nga kaso.

PARTIDO A PARTIDO B

Signature over printed name Date

PARTIDO C PARTIDO D

Signature over printed name Date

Assisted By:

BARC Chairman/ Mediator

gtan sa mga

nga kabubut-on.

tibuok ug
ni nga kaso.

Date

Date
 Republic of the Philippines
Province of South Cotabato
Municipality of
Barangay

BARANGAY AGRARIAN REFORM COMMITTEE [BARC]

INDORSEMENT
Date: __________________

Respectfully indorsing to the Municipal Agrarian Reform Program Officer, Tampakan South Cotabato,
the herein Request for Mediation resulted in a NON-SETTLEMENT at the level of the Office of the BARC-
Chairman due to:

[ ] Failure to reach an agreement

[ ] Non-appearance of Parties
[ ] Refusal to undergo Mediation/Consultation/Conference
[ ] Others:

Name of Complainant/s:

Respondents

Nature of Case :

Landholding Information: Title No./s

Lot No/s.
Survey #:
Location:
Registered Owner:

Brief summary of proceedings/Action Taken / Recommendations:

All efforts have been exhausted by the Mediator/BARC Chairman in assisting the disputing parties. It is
recommended that the parties shall proceed to the DAR Municipal Office for further mediation/conference with the
presence of MARPOs/Legal Officers.

BARC Chairman
Attachments:
Notice of Meeting, Attendance Sheets and Minutes of Meeting (3 meetings)