FORM 0

CATEGOR

FINALIST LUPONG TAGAPAMAYAPA:

CITY / MUNICIPALITY:
PROVINCE:
REGION:
BARANGAY CHAIRMAN:
MAYOR:

NATURE OF CASES
SETTLED
(Specify nature and frequency)
(2)
(1)

CRIMINAL CIVIL OTHERS MEDIATION CONCILIATION ARBITRATION

TOTAL
(1a) (1b) (1c) (2a) (2b) (2c)

***Total Number of Lupons excluding Lupon Chairman and Lupon Secretary

***Please see attached summary of cases

 FORM 01 - LTIA BASIC ASSESSMENT FORM

CATEGORY: _________________________________

POPULATION:
LAND AREA:
TOTAL NO. OF CASES:
NUMBER OF LUPONS:
MALE:
FEMALE:

NOT SETTLED
(3)

DROPPED/
WITHDRAWN
CERTIFIED TO FILE (4)
TOTAL PENDING DISMISSED REPUDIATED TOTAL
ACTION IN COURT
(2a+2b+2c) (3a) (3b) (3c) (3a+3b+3c+3d)
(3d)

0 0
 ON:

O. OF CASES:
OF LUPONS:

OUTSIDE THE
TOTAL
JURISDICTION BUDGET
[Total Number of Settled
OF THE ALLOCATED
+ Total Number of
BARANGAY (6)
Unsettled + (4) +(5)]
(5)

0
 FORM 01 - LTIA BASIC ASSESSMENT FORM

CATEGORY: _________________________________

FINALIST LUPONG TAGAPAMAYAPA:

CITY / MUNICIPALITY:
PROVINCE:
REGION:
BARANGAY CHAIRMAN:
MAYOR:

NATURE OF CASES
(Specify nature and SETTLED NOT SETTLED
frequency) (2) (3)
(1)

CERTIFIED
MEDI- CONCI- ARBI- DIS- REPU- TO FILE
CRIMINAL CIVIL OTHERS TOTAL PENDING
TOTAL ATION LIATION TRATION MISSED DIATED ACTION IN
(1a) (1b) (1c) (2a+2b+2c) (3a)
(2a) (2b) (2c) (3b) (3c) COURT
(3d)

0 0

***Total Number of Lupons excluding Lupon Chairman and Lupon Secretary

***Please see attached summary of cases

RM

____

POPULATION:
LAND AREA:
TOTAL NO. OF CASES:
NUMBER OF LUPONS:
MALE:
FEMALE:

TOTAL
OUTSIDE
[Total
THE
Number of
DROPPED/ JURISDIC- BUDGET
Settled +
WITHDRAWN TION OF ALLOCATED
Total
TOTAL (4) THE (6)
Number of
(3a+3b+ BARANGAY
Unsettled +
3c+3d) (5)
(4) +(5)]

0 0
 LUPONG TAGAPAMAYAPA INCENTIVES AWARDS (LTIA)
ASSESSMENT FORM

A. IDENTIFYING INFORMATION
Lupong Tagapamayapa : ____________________________________ Region : __________________
City or Municipality: ________________________________________ Award Category : ___________
Province or Provincial Location: ______________________________

B. EVALUATION CRITERIA
General Instruction: Please read the Technical Notes at the back before accomplishing this form.

ASSIGNED SCORE

TABLE REMARKS/ TECHNICAL NOTES:

CRITERIA POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT
I. EFFICIENCY IN OPERATION

A). Observance of Settlement Procedure and 5

Settlement Deadlines

1. a) Proper Recording of every dispute
2.5 Proper Recording means to keep and maintain a record book of all complaints filed
with the Punong Barangay/Lupon Chairman numbered consecutively in the order
in which they were received and enter therein the names of the parties, date and
time filed, nature of the case, and disposition. (Rule III, Section 2 (a) of
Katarungang Pambarangay Implementing Rules and Regulations)

Means of Verification/s (MOV/s): The Record Book must contain the following:
names of the parties, date and time filed, nature of the case, and disposition.

Point Score of 0.5 for each of the 5 needed data; 0 if no Record Book.
b) Sending of Summons to Parties within the 2.5 Point Score of 0 if summon is sent on the 4th day
prescribed period 1 to 3 days only

2. Settlement and Award Period 10

a). Mediation (within 15 days after initial
confrontation with the Lupon Chairman)
10 Mediation means upon receipt of the complaint, the Lupon Chairman shall within
the next working day summon the respondent(s), with notice to the complainant(s)
for them and their witnesses to appear before him for a mediation of their
conflicting interests. If he fails in his mediation effort within fifteen (15) days from
the first meeting of the parties before him, he shall forthwith set a date for the
constitution of the Pangkat in accordance with the provisions of this Chapter.
(Section 410 (b) Chapter 7 Katarungang Pambarangay, RA 7160 or the Local
Government Code of 1991)
 ASSIGNED SCORE

TABLE REMARKS/ TECHNICAL NOTES:

CRITERIA POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT
Mediation should be conducted by the Punong Barangay, not by the Officer-of-the-
Day. The Punong Barangay is prohibited to inhibit during mediation.

b). Conciliation (15 days after initial confrontation
with the Pangkat) with column of the date of
initial confrontation
8 Conciliation stipulates that no complaint, petition, action, or proceeding involving
any matter within the authority of the lupon shall be filed or instituted directly in
court or any other government office for adjudication, unless there has been a
confrontation between the parties before the lupon chairman or the pangkat, and
that no conciliation or settlement has been reached as certified by the lupon
secretary or pangkat secretary as attested to by the lupon or pangkat chairman or
unless the settlement has been repudiated by the parties thereto. (Section 412 (a),
Chapter 7 Katarungang Pambarangay, RA 7160 or the Local Government Code of
1991)

The Pangkat shall arrive at a settlement or resolution of the dispute within fifteen
(15) days from the day it convenes in accordance with this Section. (Section 410
(e), Chapter 7 Katarungang Pambarangay, RA 7160 or the Local Government Code
of 1991). Exhaust the 15-day period if the Pangkat will be constituted.

c). Conciliation with extendible period of another 6 Conciliation with extendible period - This period shall, at the discretion of the
15 days pangkat, be extendible for another period which shall not exceed fifteen (15) days,
except in clearly meritorious cases. (Section 410 (e), Chapter 7 Katarungang
Pambarangay, RA 7160 or the Local Government Code of 1991)

d). Arbitration (within 10 days from the date of the
agreement to arbitrate)
4 Arbitration means the parties may, at any stage of the proceedings, agree in writing
that they shall abide by the arbitration award of the lupon chairman or the pangkat.
Such agreement to arbitrate may be repudiated within five (5) days from the date
thereof for the same grounds and in accordance with the procedure hereinafter
prescribed. The arbitration award shall be made after the lapse of the period for
repudiation and within ten (10) days thereafter. (Section 413 par. (a), Chapter 7
Katarungang Pambarangay, RA 7160 or the Local Government Code of 1991)

e). Conciliation beyond 46 days but not more than 2

60 days
To compute:
Cases Settled x Assigned Point Score
= Score
Total No. of Cases Filed
 ASSIGNED SCORE

TABLE REMARKS/ TECHNICAL NOTES:

CRITERIA POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT

Actual Illustration:
Total No. of Cases: 25
Mediated Cases: 18
Conciliated Cases: 3
Arbitrated Cases: 2

Mediated Cases: 18 x 10
= 7.2
25
Conciliated Cases: 3x8
= 0.96
25
Arbitrated Cases: 2x4
= 0.32
25
Total Score: 7.2 + 0.96 + 0.32 = 8
B. Systematic Maintenance of Records 5 Systematic Maintenance of Records means systematic records keeping of all
complaints brought and filed, settled or resolved by the Lupon including minutes of
meetings and transmittal of reports to the court and the DILG. (DILG
Memorandum Circular No. 2004-43, Efficiency of Operations no. 4, page 2)

MOVs: Photo/s of Record Books in reference to the assessment year, computerized

records of cases and the filing cabinet.
● Records of Cases by docket number
⧫ Manually 1 The Lupong Tagapamayapa must explain briefly how KP records are maintained.

⧫ Computerized 1 At least computer-aided: computerized transmittal letters of reports to the Court

and DILG at the minimum; monthly summary of cases.

● Copies of minutes of Lupon meetings with 1

attendance sheets
● Copies of reports submitted to the Court and to the 1 Point Score of 0.5 for the Court and 0.5 for the DILG.
DILG on file
Submission of reports to DILG should be monthly (12 reports in CY 2016), not
quarterly.

● All records are kept on file in a secured filing 1 Any cabinet will do, including "Orocan".
cabinet(s)
 ASSIGNED SCORE

TABLE REMARKS/ TECHNICAL NOTES:

CRITERIA POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT
C. Timely Submission of Reports to Concerned 5 Timely Submission to the Court means the secretary of the lupon shall transmit the
Agencies settlement or the arbitration award to the appropriate city or municipal court within
five (5) days from the date of the award or from the lapse of the ten-day period
repudiating the settlement and shall furnish copies thereof to each of the parties to
the settlemt and the lupon chairman. (Section 419. Transmittale of Settlemtn and
Arbitration, Chapter 7 Katarungang Pambarangay, RA 7160 or Local Government
Code of 1991)

1. To the Court: 4
● Complete and on time = 4
● Complete but not on time = 2
● Incomplete and not on time = 1
● No submission = 0
2. To the DILG 1
● Annual Report submitted to the DILG City or
Municipal Office not later than the 30th of January
of the ensuing year

D. Conduct of Monthly Meetings Exclusively on 10 Katarungang Pambarangay Matters – The Lupon shall meet regularly once a month
KP Matters on a date set by the Lupon Chairman, to provide for a forum for the exchange of
● Notice of Meeting (must contain the Agenda) 2 ideas on matters relevant to the amicable settlement of disputes, and to enable
various conciliation panel members to share with one another their observations
and experiences in effecting speedy resolution of disputes, as well as to discuss
To compute: problems relating to the amicable settlement of disputes, as well as to discuss
problems relating to the amicable settlement of disputes and device solution thereto
No. of Notice of Meeting containing the Agenda x 2 by harnessing the resources provided by the Sangguniang Barangay and other local
12 resources of the Barangay. (Rule IV, Section 7 (b), Katarungang Pambarangay
Implementing Rules and Regulations)

Not counted if no Agenda or not KP related.

● Minutes of the Meeting 8 Minutes of Meetings (must contain status and agreement/resolution of cases and
sharing of settlement procedure and technique)
MOV: Notices of Meetings, Minutes of Lupon Meetings, Attendance Sheets
To compute:

No. of reported KP meetings X 8

12
 ASSIGNED SCORE

TABLE REMARKS/ TECHNICAL NOTES:

CRITERIA POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT
II. EFFECTIVENESS IN SECURING THE
SETTLEMENT OF INTERPERSONAL
DISPUTE OBJECTIVE OF THE
KATARUNGANG PAMBARANGAY

A. Quantity of settled cases against filed 10 Quantity of Settled Cases against Filed is the number of settled cases over the
90 - 100% 10 number of cases filed.

80 - 89% 8 For emphasis: dismissed/pending/withdrawn cases are considered unsettled cases.

70 - 79% 6
60 - 69% 4
59% below 2

To compute:
Total No. of settled cases x 100
Total No. of cases filed - cases outside the jurisdiction of KP

B. Quality of Settlement of Cases 10

● Zero case repudiated 5 Zero case repudiated means no case has been repudiated. (DILG Memorandum
Circular No. 2004-43, Effectiveness in Securing KP Objectives par. 3, page 2)

● Non-recurrence of cases settled 5 Non-Recurrence of cases settled means there is no repetition of the commission of
similar or the same offense by the party or parties to cases already settled by the
Lupon. (DILG Memorandum Circular No. 2004-43, Effectiveness in Securing KP
Objectives par. 3, page 2)

C. At least 80% compliance with the terms of 10 At least 80% compliance with the terms of settlement or award after the cases have
settlement or award after the cases have been been settled pertains to the number of disputes where parties complied with the
settled terms of settlement or award after the cases have been settled.

80 - 100% (with supporting documents) 10

70 - 79% (with supporting documents) 8
60 - 69% (with supporting documents) 6
50 - 51% (with supporting documents) 4
49 and below (with supporting documents) 2

To compute:
Total No. of Complied Settlement or Award x 100
 ASSIGNED SCORE

TABLE REMARKS/ TECHNICAL NOTES:

CRITERIA POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT
Total No. of cases filed - cases outside the jurisdiction of KP

III. CREATIVITY AND RESOURCEFULNESS

OF THE LUPONG TAGAPAMAYAPA

A. Settlement Technique 5 Settlement Technique refers to the strategies applied by Lupons to expedite the
three types of intervention as stated in the KP Law, without diminishing or altering
Settlement technique utilized by Lupon the concept of the KP.
● Reported more than one settlement technique 5

● Reported one settlement technique 3

● No report 0

B. Coordination with Concerned Agencies relating
to disputes filed PNP, DSWD, DILG, DAR, DENR,
Office of the Prosecutor, Court, DOJ, CHR ,
volunteer groups/organizations, NGOs, CSOs,
Barangay Justice Advocates
5 5 Coordination with concerned agencies means coordination efforts exerted by the
Lupon in securing participation from other government agencies and non-
government organizations for the purpose of effecting speedy resolution of
disputes. (DILG Memorandum Circular No. 2004-43, Creativity and
Resourcefulness of Mediators no. 2, page 2)

At least One (1) KP-related coordination.

MOVs: Any forms of communication such as letters, emails or any written or
verifiable means of communication. Meeting (Photos, Visitor's Log Book) date
within the assessment period.

C. Sustained information drive to promote 5 Sustained information drive to promote Katarungang Pambarangay are the
Katarungang Pambarangay initiatives of the Lupons to generate greater awareness among the various sectors in
the community on the KP programs. (DILG MC No. 2004-43, Creativity and
Resourcefulness of Mediators no. 2, page 2)

● IEC materials produced 2 Note:

● IEC activities conducted 2 Innovative Campaign Strategy Example: use of social media such as FB and other
innovative strategies.

● Innovative Campaign Strategy 1 Activities: photos, forum, assemblies

D. KP Training or seminar within the assessment 10 KP Training or Seminar within the Assessment Period refers to the seminars,
period exchange visits and similar fora undertaken in furtherance of KP program
objectives. (DILG MC No. 2004-43, Creativity and Resourcefulness of Mediators
no. 4, page 3)

CRITERIA
1. Conducted by the Barangay
2. Training conducted by government or non-
government organizations participated by Lupon
members
IV. AREA OR FACILITY FOR KP ACTIVITIES
Building structure or space
V. FINANCIAL OR NON-FINANCIAL
SUPPORT
1. City, Municipal or Provincial and NGAs
2. People's Organization, NGOs or Private Sector
and others
TOTAL SCORE
Date: _____________________
ASSIGNED SCORE
TABLE REMARKS/ TECHNICAL NOTES:
POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT
6 Initiated or financed by the barangay (even if the barangay invited a Resource
Person).
Note: KP Trainings or seminars conducted should be supported by the following
documents: Activity Design, Post Activity Report, Photos with date and venue and
Certificate of Participation or Certificate of Completion.
4 Note: KP Trainings or seminars participated should include the following
supporting documents: Certificate of Appearance, Certificate of Participation or
Certificate of Completion, Post Activity Report and photos with date and venue of
training or seminar
5 Area or Facilities for KP activities refers to a separate structure or a space within
the Barangay Hall compound exclusively used for settlement proceedings and other
KP related activities such as filing of complaints, meetings and others. It should
have tables and chairs to accommodate the parties and the Lupons, filing cabinet/s,
record book/s or a computer set and office supplies for documentation purposes.
5 More than a desk
MOVs: photos
5 Financial or non-financial supports are grants whether it be monetary or in kinds,
given to the Lupong Tagapamayapa for the purpose of the implementation of
Katarungang Pambarangay.
MOVs: Deed of Donation, MOA, Resolution, Appropriation Ordinance of higher
Sanggunian, Acknowledgment Receipt, Vouchers
3 Awards given by the Provincial/Municipal Government will be considered only if
received by the Lupon, with MOVs such as Acknowledgment Receipt or Voucher
2
100
Chairman/Member/Board of Judges
 ASSIGNED SCORE

TABLE REMARKS/ TECHNICAL NOTES:

CRITERIA POINT POINT ON-
ASSESS- OBSERVATION
SCORE VALUE SITE
MENT
(Signature Over Printed Name)