Scribd Logo
Upload

Welcome to Scribd!

  • 12K views

    Application For Barangay Protection Order: Vawc Form#3 CONTROL NO.

    Uploaded by

    Jacjac Famador
    This document is an application for a Barangay Protection Order (BPO) from the Republic of the Philippines. It collects information about the applicant, including their name, address, relationship to the victim, and occupation. It also collects information about the victim, including their name, address, civil status, occupation, and any children. Information is also collected about the respondent, including their name, occupation, address, and civil status. The application asks about the relationship between the complainant and respondent, and what acts are being complained of. It records the date of the offense and where it occurred. The barangay captain verifies the applicant is a resident of the barangay and certifies the information provided.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Application For Barangay Protection Order: Vawc Form#3 CONTROL NO.

    Uploaded by

    Jacjac Famador
    12K views1 page
    This document is an application for a Barangay Protection Order (BPO) from the Republic of the Philippines. It collects information about the applicant, including their name, address, relationship to the victim, and occupation. It also collects information about the victim, including their name, address, civil status, occupation, and any children. Information is also collected about the respondent, including their name, occupation, address, and civil status. The application asks about the relationship between the complainant and respondent, and what acts are being complained of. It records the date of the offense and where it occurred. The barangay captain verifies the applicant is a resident of the barangay and certifies the information provided.

    Original Description:

    Vawc application-bpo

    Original Title

    Application-for-bpo-vawc-form-3

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is an application for a Barangay Protection Order (BPO) from the Republic of the Philippines. It collects information about the applicant, including their name, address, relationship to the victim, and occupation. It also collects information about the victim, including their name, address, civil status, occupation, and any children. Information is also collected about the respondent, including their name, occupation, address, and civil status. The application asks about the relationship between the complainant and respondent, and what acts are being complained of. It records the date of the offense and where it occurred. The barangay captain verifies the applicant is a resident of the barangay and certifies the information provided.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    12K views1 page

    Application For Barangay Protection Order: Vawc Form#3 CONTROL NO.

    Uploaded by

    Jacjac Famador
    This document is an application for a Barangay Protection Order (BPO) from the Republic of the Philippines. It collects information about the applicant, including their name, address, relationship to the victim, and occupation. It also collects information about the victim, including their name, address, civil status, occupation, and any children. Information is also collected about the respondent, including their name, occupation, address, and civil status. The application asks about the relationship between the complainant and respondent, and what acts are being complained of. It records the date of the offense and where it occurred. The barangay captain verifies the applicant is a resident of the barangay and certifies the information provided.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 1

    VAWC FORM#3 CONTROL NO.

    ______

    REPUBLIC OF THE PHILIPPINES


    NATIONAL CAPITAL REGION
    CITY OF MANILA
    BARANGAY______ ZONE _____ DISTRICT ____

    APPLICATION FOR BARANGAY PROTECTION ORDER

    1. NAME OF APPLICANT____________________________________ AGE: _______________


    ADDRESS: _____________________________________________ TEL# _______________________
    RELATIONSHIP TO VICTIM: _______________________________ OCCUPATION _______________
    2. NAME OF VICTIMS: _____________________________________ DATE OF BIRTH: _____________
    ADDRESS: _____________________________________________ TEL# _______________________
    CIVIL STATUS Single Married Widow Seperated Legally Seperated
    3. OCCUPATION/SOURCE OF INCOME: ___________________________________________________
    4. NAME/S OF CHILDREN: DATE OF BIRTH: SEX:
    _______________________ _____________ ______
    _______________________ _____________ ______
    _______________________ _____________ ______
    _______________________ _____________ ______
    4.a Other Children under her care
    NAME/S OF CHILDREN: DATE OF BIRTH: SEX:
    _______________________ _____________ ______
    _______________________ _____________ ______
    _______________________ _____________ ______
    _______________________ _____________ ______
    5. NAME OF RESPONDENT: ________________________________ AGE: ___________
    OCCUPATION/SOURCE OF INCOME: ___________________________________________________
    ADDRESS: _____________________________________________TEL#: _______________________
    CIVIL STATUS Single Married Widow Seperated Legally Seperated
    6. Relationship of Compliant to Respondent:
    Wife Former Wifre Common Law/Live-in Relationship
    Dating Relationship Sexual Relation ship
    7. Acts Complained of (Pls. Check)
    Treats Physical Injuries
    8. Date of commission of the offense: ________________________________
    9. Place where the offense was committed: ___________________________
    10. If the applicant is not the victim, state the circumstances of refusal to give consent of the victim/

    ___________________________________
    Signature of Appicant Over Printed Name
    ____________________
    Date

    VERIFICATION OF PUNONG BARANGAY

    I certify that the applicant for BPO who personally appeared before me is a bonafinde resident of
    this barangay and is the same person who supplied all the above information and attest to the correctness
    of said information

    __________________________
    PUNONG BARANGAY

    Date Issued: ___________________

    You might also like