Republic of the Philippines

MUNICIPALITY OF NORZAGARAY
Province of Bulacan
KATARUNGANG PAMBARANGAY
COMPLIANCE MONITORING FORM
CY: 20_____
As of ____________________
Regional Report Form - KP (R-III)
Action Taken by the Lupong Tagapamayapa (2)
Nature of Dispute (2a) Settled Cases (2b) Unsettled Cases (2c)
ESTIMATED
Referred to GOVERNMENT
LGU (1) SAVINGS (In
Total (2a.4) Mediation Conciliation Arbitration Total (2b.4) Repudiated Withdrawn Pending Cases Dismissed Certified Cases Concerned
Criminal (2a.1) Civil (2a.2) Others (2a.3) (2b.1) (2b.2) (2b.3) Cases (2c.1) Cases (2c.2) (2c.3) Cases (2c.4) (2c.5) Agencies Total (2c. 7) Php)*3
(2c.6)

JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
I HEREBY CERTIFY THAT I HAVE REVIEWED THE CONTENTS AND HEREBY ATTEST to
the veracity or correctness of the data or information contained in this report.

Prepared by:
BARANGAY SECRETARY/LUPON PUNONG BARANGAY

Date: Date:

Instructions:
1. Write the name of the LGU under column 1.
2. Under column Nature of Dispute, put the total number of cases filed under sub column: Criminal, Civil and Others with the corresponding total.
3. On the Actions Taken by LT, put the total number of Settled Cases by Mediation, Conciliation and Arbitration with the corresponding total.
4. On the Action Taken by LT on the Unsettled Cases, put the total number of Repudiated, Withdrawn, Pending, Dismissed, Certified Cases and Cased Referred to other Agencies with the corresponding total.
5. On the column "Estimated Government Savings" multiply the total number of settled cases by the Estimated Adjudication cost per case of Php9,500.00.
Quarterly Reports to be submitted on the following dates: