REPUBLIC OF THE PHILIPPINES

OFFICE OF THE PUNONG BARANGAY

______________________________________________________________________

TO WHOM IT MAY CONCERN:

__________________ of Barangay,
Complainant/s
-against-
__________________ of Barangay,
Respondent/s

THIS IS TO CERTIFY THAT:

1. A dispute arose between the above-named parties;

2. That there has been a personal confrontation between the above-named parties
before the Office of the Punong Barangay but mediation or amicable settlement
has failed; and
3. Therefore, the corresponding complaint for the dispute may now be filed in the
proper court/government office.

This ______ day of ______, 2022.

__________________
PUNONG BARANGAY