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Province of Laguna
____Derek Ramsay_______________
— against —
Respondent/s
1. There has been a personal confrontation between the parties before the Punong
Barangay but mediation failed;
2. The Pangkat ng Tagapagkasundo was constituted but the personal confrontation before
the Pangkat likewise did not result into a settlement; and
3. Therefore, the corresponding complaint for the dispute may now be filed in
court/government office.
________________________
Pangkat Secretary
Attested by:
___________________________
Pangkat Chairman
REPUBLIC OF THE PHILIPPINES )
Province of Laguna )
Municipality of Santa Cruz ) S.S.
COMPLAINT-AFFIDAVIT
DEREK RAMSAY
Affiant
Piolo Pascual
Prosecutor II
Roll No. 51379-2006
IBP No. 808787-1/3/11
PTR No. 4128464- 1/3/11; Laguna
MCLE Compliance III No. 001360
Republic of the Philippines }
Province of Laguna }
Municipality of Santa Cruz }
AFFIDAVIT OF WITNESS
1.
I executed this affidavit to attest the truthfulness of the foregoing facts and to
support the filing of Criminal Cases against _______________for violations of
________________.
_________________
Affiant
SUBSCRIBED AND SWORN to before me this 14th day of April, 2019 at Santa
Cruz, Laguna. I HEREBY CERTIFY that I have personally examined the herein affiant
and I am satisfied that they voluntarily executed and understood their given affidavit.
Notary Public