Republic of the Philippines

Bangsamoro Autonomous Region in Muslim Mindanao

Province of Maguindanao
Municipality of Upi
Barangay Kibucay

OFFICE OF THE LUPONG TAGAPAMAYAPA

Brgy. Case no.2022-

DisputesFor:__________
Joh Tenorio Badoy
Complainant

Tow Ambang and Dennis Ambang

Against

S U M MO N S

To: Tow Ambang and Dennis Ambang

You are hereby summoned to appear before me in person, together with your witnesses, on August 08,
2022 at 1:00 O’clock in Afternoon then and there to answer to a complaint made before me, copy of
which is attached hereto, for mediation /conciliation of your dispute with complainant/s.

You are hereby warned that if you refuse or willfully fail to appear in observance to this summons, you
may be barred from filing any counterclaim arising from said complaint.

FAIL NOT or else faces punishment as for contempt of court.

This 08th day of August 2022.

Mario P. Linto Sr.

Acting Punong Barangay/Lupon Chairman
 OFFICER RETURN’S

I serve this summons upon respondent on the ______________________by:

(write name/s of respondent before made by which he/they was/were served)

Respondent/s:

_____________ 1. Handling to him/them said summons in person, or

_____________ 2.Handling to him/them said summons ad he/they refused to receive it or
_____________3. Leaving said summons at his/their dwelling with __________________
(name) of person of suitable age and discretion residing therein, or
_____________4. Leaving said summons at his/their office/place of business with
__________________ (name) a competent person in charge thereof.

MR._______________
-* OFFICER
Received by respondent/s representative/s:

_____________________________ ______. 2022

Signature Date

_____________________________ _______. 2022

Signature Date

_____________________________ ________. 2022

Signature Date

_____________________________ ________ 2022

Signature Date

_____________________________ ________ 2022

Signature Date