Republic of the Philippines

Province of _________
MUNICIPALITY OF _________
Barangay _______

OFFICE OF THE LUPONG TAGAPAMAYAPA

JUAN DELA CRUZ and Barangay Case No. ________________

JUANA DELACRUZ For: Trespassing to Property and
Complainants, Usurpation of Rights
— against —

JOSE BONIFACIO and

ANDRES RIZAL
Respondents.

COMPLAINT

WE hereby complain against above named respondents for violating our rights and
interests in the following manner:

1. That we are the registered owner of parcels of land located at Brgy. ______, Municipality
of _________, _______________with a total combined area of TWO AND ONE-HALF
HECTARES (2.50) evidenced by the herein attached TCT Nos. ____________________;

2. That on _________________, respondents JOSE BONIFACIO and ANDRES RIZAL, by

way of threat and intimidation, forcefully occupied our land and immediately thereafter
took possession of the said land by cultivating and sowing palay seeds;

3. That respondents employed persons who prevented us from entering our property and up
to this time, we cannot freely enter and fully cultivate our land;

4. That respondents are the siblings of my deceased father JULIAN DELA CRUZ who was
my predecessor-in-interest over the said properties;

5. That respondents are residents of this barangay, Barangay ________, and the subject
property is likewise located in the same barangay, making the instant complaint
cognizable and under the jurisdiction of Brgy. ______________, Municipaltiy of
________, as provided for under R.A. No. 7610.

THEREFORE, WE pray that the following reliefs be granted to us in accordance with

law and/or equity:

1. That respondents JOSE BONIFACIO and ANDRES RIZAL be made to appear before
the Lupong Tagapamayapa of Brgy. ________, __________, ________;

2. That after notice and hearing, respondents be directed to vacate our properties;

3. Other reliefs just and equitable are likewise prayed for.

Made this _______ day of June, 2018.

JUAN DELA CRUZ JUANA DELA CRUZ

Complainant Complainant

Received and filed this ________ day of June, 2018.

____________________________
Punong Barangay/Lupon Chairman