Application For Barangay Protection Order
Application For Barangay Protection Order
Application For Barangay Protection Order
City of Naga
Barangay of Tabuco
____________________________________
Signature of Applicant over Printed Name
Date
1
VERIFICATION OF PUNONG BARANGAY
I certify that the applicant for BPO who personally appeared before me is a bonafide resident of
this barangay and is the same person who supplied all the above information and attest to the
correctness of said information.
MARCELO R. BAGADIONG
Punong Barangay
Date Issued:
ORDER
________________________________________Applied for a BPO on ___________________ under oath stating
that __________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
After having heard the application and the witness and evidence, the undersigned hereby issues
this BPO ordering you to immediately cease and desist from causing or threatening to cause
physical harm to ______________________________________ and/or her child/children namely:
___________________________________ ______________________________
___________________________________ ______________________________
___________________________________ ______________________________
___________________________________ ______________________________
MARCELO R. BAGADIONG
Punong Barangay
Date Issued:
2
Copy received by:
______________________________
Signature over Printed Name
Date received:
Served by:
______________________________
Signature over Printed Name
ATTESTATION:
(In case the Punong Barangay is unavailable)
__________________________
Barangay Kagawad
Signature over Printed Name