2024 Lupong Tagapamayapa Incentives Awards (LTIA) Performance Assessment - Google Forms

2024 Lupong Tagapamayapa
Incentives Awards (LTIA)

Performance Assessment Form
RATIONALE. The Lupong Tagapamayapa Incentives Awards (LTIA) is an annual
assessment in the barangays which aims to strengthen the Katarungang Pambarangay (KP)
as an indigenous conflict resolution structure at the grassroots level; institutionalize a
system of granting economic benefits and other incentives to Lupong Tagapamayapa or
Lupons, which demonstrate exemplary performance; and generate greater awareness
among, and support from the various sectors of society on KP as a vehicle toward social
ordering and human development.
In accordance with DILG Memorandum Circular No. 2023-22, with the subject “Lupong
Tagapamayapa Incentives Awards Enhanced Criteria and Guidelines,” all Lupons
nationwide are eligible to participate in the annual awards.
All the Lupons are evaluated on the basis of the following Criteria with corresponding point
score and point value.
Efficiency in Operations (42 points)

Effectiveness in Securing the Settlement of Interpersonal Dispute Objective of KP
(20 points)
Creativity and Resourcefulness of the Lupong Tagapamayapa (30 points)
Area or Facility for KP Activities Onsite (5 points)
Financial or Non-Financial Support (3 points)
With this and to properly assess the performance of each Lupon, each document and/or
mode of verification (MOV) per indicator of the Criterion shall be uploaded in the
succeeding section as basis of the LTIA Assessor.
COVERAGE. Performance year to be assessed is CY 2023 (January 1, 2023 to December

31, 2023).
📢 GENERAL INSTRUCTIONS. Please read the instructions carefully.
1. Sign in with Google Account is required in submitting documents/MOVs/forms for

security purposes. Use of official barangay email is highly encouraged.
2. Use the prescribed LTIA forms. Please refer to https://bit.ly/LTIAReferences, for the
prescribed forms (Form 06, Form 07, Form 07-a, and Form 07-b).
3. All required LTIA forms MUST be duly accomplished and signed by an authorized
barangay official.
4. All required forms/documents/MOVs should be scanned clearly and readable. It must
be in PDF file (.pdf) and merged/combined in one document/MOV per file.
5. Please observe complete staff work (CSW) on the submission of documents.
6. Follow the naming format of the documents/images/forms as indicated in each
questionnaire/field.
7. More importantly, all Lupons will be assessed based on the submitted available
documents/MOVs.
8. Finally, for inquiries or concerns, please feel free to contact your respective DILG
District Officers.
* Indicates required question
1. Email *
2. ℹ️DATA PRIVACY CONTENT *
The DILG recognizes their responsibilities under the Republic Act No. 10173, also
known as the Data Privacy Act of 2012. The personal data to be obtained from
this online form will be analyzed, entered, and stored within the Department's
authorized information and communication system and will only be accessed by
the DILG-Baguio City Field Office and authorized personnel. The DILG-BCFO
instituted appropriate organizational, technical, and physical security measures to
ensure the protection of the participant's (barangay official) personal data.
Mark only one oval.
I agree.
Respondent's Information (Report Sender)
3. Last Name *
4. First Name *
5. Middle Name
*Optional
6. Extension Name
E.g. Jr. Sr., I, II, III
7. Position in the Barangay *
Mark only one oval.
Punong Barangay
Sangguniang Barangay Member (Barangay Kagawad)
Barangay Secretary
Barangay Treasurer
Other:
8. Barangay District *
Region: Cordillera Administrative Region
Province: Not Applicable
City: Baguio City (HUC)
Award Category: HUC/1st
Mark only one oval.
District 1 Skip to question 9
Skip to section 22 (I: EFFICIENCY IN OPERATION )
District 1
District Officer: LGOO III Sesvir C. Lopez

9. [District 1] Choose the name of barangay: *
Mark only one oval.
GIBRALTAR
MINES VIEW PARK
PACDAL
PUCSUSAN
SAINT JOSEPH VILLAGE
District 2
District Officer: LGOO V Maria Consolacion S. Buena
Mark only one oval.
BAL-MARCOVILLE (MARCOVILLE)
CABINET HILL-TEACHERS CAMP
DPS AREA
ENGINEERS HILL
GREENWATER VILLAGE
District 3
District Officer: LGOO III Joe Pablo M. Gernale

Mark only one oval.
DAGSIAN, LOWER
DAGSIAN, UPPER
GABRIELA SILANG
HILLSIDE
SANTA ESCOLASTICA
SCOUT BARRIO
District 4
Mark only one oval.
BALSIGAN
BGH COMPOUND
FERDINAND (HAPPY HOMES-CAMPO SIOCO)
IMELDA R. MARCOS (LA SALLE)
LEGARDA-BURNHAM-KISAD
PHIL-AM
SANTO ROSARIO
District 5
District Officer: LGOO VI Carol G. Gano

Mark only one oval.
CITY CAMP CENTRAL
CITY CAMP PROPER
GENERAL EMILIO F. AGUINALDO (QUIRINO-MAGSAYSAY, LOWER)
PALMA-URBANO (CARIÑO-PALMA)
QUIRINO-MAGSAYSAY, UPPER (UPPER QM)
ROCK QUARRY, LOWER
ROCK QUARRY, MIDDLE
ROCK QUARRY, UPPER
District 6
Mark only one oval.
ANDRES BONIFACIO (LOWER BOKAWKAN)
CAMP ALLEN
CAMPO FILIPINO
FAIRVIEW VILLAGE
KAYANG EXTENSION
MARKET SUBDIVISION, UPPER
MRR-QUEEN OF PEACE

District 7
Mark only one oval.
CRESENCIA VILLAGE
GUISAD CENTRAL
GUISAD SORONG
MAGSAYSAY, LOWER
PADRE BURGOS
PADRE ZAMORA
PINSAO PILOT PROJECT
SLAUGHTER HOUSE AREA (SANTO NIÑO SLAUGHTER)
District 8
District Officer: LGOO III Allan F. Ocal

Mark only one oval.
CAMDAS SUBDIVISION
DIZON SUBDIVISION
HAPPY HOMES (HAPPY HOMES-LUCBAN)
PINGET
QUIRINO HILL, EAST
QUIRINO HILL, LOWER
QUIRINO HILL, MIDDLE
QUIRINO HILL, WEST
District 9
Mark only one oval.
AMBIONG
AURORA HILL, NORTH CENTRAL
AURORA HILL, SOUTH CENTRAL
BAYAN PARK EAST
BAYAN PARK VILLAGE
BAYAN PARK WEST (BAYAN PARK)
SAN ANTONIO VILLAGE

District 10
Mark only one oval.
GENERAL LUNA, LOWER
GENERAL LUNA, UPPER
HARRISON-CLAUDIO CARANTES
MALCOLM SQUARE-PERFECTO (JOSE ABAD SANTOS)
SALUD MITRA
SESSION ROAD AREA
District 11
Mark only one oval.
COUNTRY CLUB VILLAGE
HAPPY HOLLOW
LUALHATI
LUCNAB
OUTLOOK DRIVE
SOUTH DRIVE

District 12
Mark only one oval.
APUGAN-LOAKAN
ATOK TRAIL
FORT DEL PILAR
KIAS
LIWANAG-LOAKAN
LOAKAN PROPER
District 13
Mark only one oval.
CAMP 7
CAMP 8
MILITARY CUT-OFF
POLIWES
SAN VICENTE

District 14
Mark only one oval.
BAKAKENG CENTRAL
BAKAKENG NORTH
DONTOGAN
SANTO TOMAS PROPER
SANTO TOMAS SCHOOL AREA
SLU-SVP HOUSING VILLAGE
District 15
Mark only one oval.
ASIN ROAD
DOMINICAN HILL-MIRADOR
LOURDES SUBDIVISION EXTENSION
LOURDES SUBDIVISION, LOWER
LOURDES SUBDIVISION, PROPER
SAN LUIS VILLAGE
SAN ROQUE VILLAGE

District 16
Mark only one oval.
IRISAN
MIDDLE QUEZON HILL SUBDIVISION(QUEZON HILL MIDDLE)
PINSAO PROPER
QUEZON HILL PROPER
QUEZON HILL, UPPER
VICTORIA VILLAGE
District 17
Mark only one oval.
ALFONSO TABORA
MAGSAYSAY PRIVATE ROAD
NEW LUCBAN
SANITARY CAMP, NORTH
SANITARY CAMP, SOUTH
TRANCOVILLE

District 18
Mark only one oval.
A. BONIFACIO-CAGUIOA-RIMANDO (ABCR)
ABANAO-ZANDUETA-KAYONG-CHUGUM-OTEK (AZKCO)
KABAYANIHAN
KAGITINGAN
KAYANG-HILLTOP
MAGSAYSAY, UPPER
RIZAL MONUMENT AREA
TEODORA ALONZO
District 19
Mark only one oval.
AURORA HILL PROPER (MALVAR-SGT. FLORESCA)
BROOKSIDE
BROOKSPOINT
LOPEZ JAENA
MODERN SITE, EAST
MODERN SITE, WEST

District 20
Mark only one oval.
HOLY GHOST EXTENSION
HOLY GHOST PROPER
HONEYMOON (HONEYMOON-HOLY GHOST)
IMELDA VILLAGE
MANUEL A. ROXAS
I: EFFICIENCY IN OPERATION
Indicators:
A. Observance of Settlement Procedure and Settlement Deadlines
B. Systematic Maintenance of Records
C. Timely Submission of Reports to Concerned Agencies
D. Conduct of Monthly Meetings Exclusively on KP Matters
Summary of Disputes
29. Total Number of Disputes Filed *

If none, put '0' (zero).
Note: withdrawn cases, dismissed cases due to non-appearance of the complainant or

both parties, referred to other agencies and cases outside the jurisdiction of KP should be
deducted to the total number of cases filed.
A. Observance of Settlement Procedure and Settlement Deadlines
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]
30. A.1.a. Proper Recording of every dispute/complaint *

Means of Verifications (MOVs): Two (2) photos with caption of the Record Book and
sample entries in the record book
Note: Record must contains docket number, names of the parties, date and time filed,
nature of the case and disposition
FILE NAME FORMAT (.pdf):

Camp 7_MOV_A1a.pdf
Files submitted:
31. Describe the actual experience of the Lupon Secretary on how to assess if the case
is under KP and record the same in the case record book.
32. A.1.b. Sending of Notices and Summons *
Sending of Notices and Summons with complete and accurate information to the parties
within the prescribed period (within the next working day upon receipt of complaint)
and prescribed forms such as KP Form No. 7 – Complaint’s Form, KP Form No. 8 – Notice
of Hearing, and KP Form No. 9 – Summon with Officer’s Return)
(NOTE: MOVs shall be uploaded on separate link.)
TOTAL NUMBER OF DISPUTES WITH COMPLAINT'S FORM, ISSUED NOTICES, AND

SUMMONS.
33. Describe the actual experience on how the serving officer delivered the summons
to the respondent and provide copy of the notice to the complainant.
A.2. Settlement and Award Period
a.) Mediation (within 15 days from initial confrontation with the Lupon Chairman)
b.) Conciliation (15 days from initial confrontation with the Pangkat)
c.) Conciliation (with extended period not to exceed another 15 days)
d.) Arbitration (within 10 days from the date of the agreement to arbitrate)
e.) Conciliation beyond 46 days but not more than 60 days (clearly meritorious cases)
Note: Settlement and Award must be supported with minutes of the settlement
proceedings.
34. A.2.a. Total Number of Disputes Settled by Mediation *

35. A.2.b. Total Number of Disputes Settled by Conciliation *
36. A.2.c. Total Number of Disputes Settled by Conciliation with Extensible *

Period not exceeding 15 days
37. A.2.d. Total Number of Disputes Settled by Conciliation beyond 46 days but *
not more than 60 days
38. A.2.e. Total Number of Disputes Settled by Arbitration *

39. A.2.f. Four photos with caption of on-going procedure (mediation, conciliation
or arbitration)
FILE NAME FORMAT (pdf):

Camp 8_MOV_A2f.pdf
Files submitted:
40. Briefly describe the actual experience of the Lupong Tagapamayapa in handling
the cases filed in the Barangay. Please do not state the provision of the KP Law re:
settlement and award period.)
B. Systematic Maintenance of Records
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)
41. B.1. Records of Cases *

MOV: Two (2) photos of the computer database (spreadsheet/excel file) with searchable
engine. Note: eKP can also be considered as one of MOVs for this item.
FILE NAMING FORMAT (.pdf):

Asin Road_MOV_B1.pdf
Files submitted:
42. B.2. Compilation of Minutes of Lupon Meetings

MOVs: Two (2) photos with caption re: Sample compilation of minutes of Lupon meetings
with attached attendance sheets and notices to the lupon members.
FILE NAMING FORMAT (.pdf,):

San Antonio Village_MOV_B2.pdf
Files submitted:
43. B.3 Compilation of reports submitted to the Court and DILG on file
MOVs: Two (2) photos with caption re: Compilation of duly signed reports submitted to
the Court on file with date stamp/received and DILG on file.
FILE NAME FORMAT (.pdf):

Poliwes_MOV_B3.pdf
Files submitted:
44. B.4. Filing Cabinet/s

All records are kept on file in a secured filing cabinet(s). Judicial standard is observed,
where filing cabinets is secured with lock and have key.
MOVs: Two (2) photos with caption of the filing cabinet

San Vicente_MOV_B4.pdf
Files submitted:
C. Timely Submissions to the Court and the DILG
45. C.1 To the Court, i.e., Municipal Trial Court in Cities (MTCC)
Submitted/ presented copies of settlement agreement to the Court from the lapse of the
ten-day period repudiating the mediation/ conciliation settlement agreement, or within
five (5) calendar days from the date of the arbitration award.
Note: Copies of transmittal letters with settlement agreements attached using prescribed
forms (KP Form No. 16 Amicable Settlement or KP Form No. 14 Agreement for
Arbitration) must be stamped as received by the Court.
FILE NAMING FORMAT (.pdf)

Gibraltar_MOV_C1.pdf
Files submitted:
46. C.1.a Total Number of Settled Cases Transmitted/Reported to the Court *

47. C.2 To the DILG Baguio City Field Office (Quarterly)
MOVs: Copy of monitoring logsheet of eKP AND Screenshot of quarterly

submission to the DILG Baguio Field Office through DILG FLEKS.

Gibraltar_MOV_C2.pdf
Files submitted:
D. Conduct of Monthly Meetings Exclusively on KP Matters
Katarungang Pambarangay Matters – The Lupon shall meet regularly once a month on a
date set by the Lupon Chairman, to provide for a forum for the exchange of 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 problems relating to the amicable settlement of
disputes, and device solution thereto by harnessing the resources provided by the
Sangguniang Barangay and other local resources of the Barangay. [Section 7 (b), Rule IV, KP
IRR]
Minutes of Meetings must contain status and agreement/resolution of cases and sharing of
settlement procedure and technique.
MOVs: Notices of Meetings, Minutes of Lupon Meetings, Attendance Sheets
48. D.1 Total Number of Notices of Monthly Meeting Issued *

If NONE, put '0' (zero).
49. D.1.a. MOVs Notices of Monthly Meeting Prepared and Issued

MOVs: Copies of Notices of Meetings with Name and date and time stamped receipt of
each Lupon Members.
FILE NAMING FORMAT:

Dominican-Mirador_MOV_D1a.pdf
Files submitted:
50. D.2. Total Number of Minutes of the Monthly Meeting Prepared *
If NONE, put '0' (zero).
51. D.2.a. MOVs on Minutes of the Monthly Meetings Prepared

MOVs: Copies of Minutes of Meetings with Attendance Sheets
FILE NAMING FORMAT:

Dominican-Mirador_MOV_D2a.pdf
Files submitted:
52. D.3. Photos of on-going meeting

MOVs: Three (3) photos of on-going meeting with caption
FILE NAMING FORMAT:

Dominican-Mirador_MOV_D3.pdf
Files submitted:
II. EFFECTIVENESS IN SECURING THE SETTLEMENT OF INTERPERSONAL

DISPUTE OBJECTIVE OF THE KP
Indicators:
A. Quantity of settled cases against filed
B. Quality of Settlement Cases
C. At least 80% compliance with the terms of settlement or award after the cases have been
settled
A. Quantity of settled cases against filed
Quantity of Settled Cases against Filed is the number of settled cases over the number of
cases filed minus those outside KP jurisdiction, referred to proper agency, dismissed, and
withdrawn or dropped.
53. Total Number of Settled Cases *
For period covering January 1, 2023 to December 31, 2023.
B. Quality of Settlement of Cases
MOV: DILG eKP and LTIA Form 7-A (List of Cases)
54. B.1 With Zero Case Repudiated *

Zero case repudiated means no case has been repudiated from the settled cases/disputes.
[DILG MC No. 2004-43, Effectiveness in Securing KP Objectives par. 3, page 2]
Mark only one oval.
Yes
No
55. B.1.a. If the response was "No" on the previous question, how many case/s
has/have been repudiated?
56. B.2 With Non-Recurrence from the Cases Settled *

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
MC No. 2004-43, Effectiveness in Securing KP Objectives par. 3, page 2]
Mark only one oval.
Yes
No
57. B.2.a. If the response was "No" on the previous question, how many settled
case/s has/have been repeated/recurred with same offense?
C. Compliance with the Terms of Settlement or Award
At least 80% compliance with the terms of settlement or award after the cases have been
settled
58. C.2. Total Number of Compliance with the Terms of Settlement or Award *
For CY 2023, the Barangay achieved a total number compliance with the terms of
settlement or award after the case have been settled.
(NOTE: MOVs shall be uploaded on separate link.)
MOVs: Proof of compliance (e.g. Acknowledgement receipts, ledgers, certifications,

etc.), KP Form No. 16 Amicable Settlement or KP Form No. 14 Agreement for Arbitration
III. CREATIVITY AND RESOURCEFULNESS OF THE LUPONG TAGAPAMAYAPA
Indicators:
A. Settlement Technique
B. Coordination with the Concerned Agencies relating to disputes filed
C. Sustained information drive to promote Katarungang Pambarangay (KP)
A. Settlement Technique
Note: Technique utilized should be within the KP process and procedures.

59. A.1 With settlement technique/s utilized by the Lupon *
Settlement Technique refers to the strategies applied by Lupons to expedite the types of
intervention as stated in the KP Law, without diminishing or altering the concept of KP.
Mark only one oval.
Yes
No
60. A.2. If the answer was "Yes" on the previous question, how many
settlement technique/s do the Lupon utilize?
61. A.3. If Yes, upload two (2) photos with caption of each Settlement Techniques
utilized by the Lupon within the assessment period
FILE NAMING FORMAT:

Dominican-Mirador_MOV_A3.pdf
Files submitted:
62. A.4 If Yes, enumerate and describe the settlement technique used by the Lupong
Tagapamayapa and explain briefly how each settlement technique helps in the
speedy settlement of disputes:
B. Coordination with the Concerned Agencies relating to disputes filed
Coordination with concerned agencies means coordination efforts exerted by the Lupon in
securing participation from other government agencies and non-government organizations
(PNP, DSWD, DILG, DAR, DENR, Office of the Prosecutor, Court, DOJ, CHR, volunteer
groups/organizations, NGOs, CSOs, Barangay Justice Advocates,etc.) for the purpose of
effecting speedy resolution of disputes. [DILG MC No. 2004-43, Creativity and
Resourcefulness of Mediators no. 2, page 2)
63. B.1. MOVs: Any form of communication such as letters, e-mails or any written
or verifiable means of communication.
Note: Copy of any proof of coordination (Certificate of Appearance, letters or other written
documents. For meetings, photos or Visitor`s Log Book which shall indicate the date.)

Dontogan_MOV_B1.pdf
Files submitted:
64. B.2. Photos of Coordination Activity

MOVs: ·Two (2) photos each, with caption for each coordination activity with concerned
agencies relating to disputes file

Dontogan_MOV_B2.pdf
Files submitted:
C. Sustained information drive to promote Katarungang Pambarangay (KP)
Sustained information drive to promote Katarungang Pambarangay are the initiatives of the
Lupon to generate greater awareness among the various sectors in the community on KP.
[DILG MC No. 2004-43, Creativity and Resourcefulness of Mediators no. 2, page 2]
65. C.1. Choose what are the IEC initiatives of the Lupon: *
Note: Innovative Campaign Strategy Examples: Use of social media such as FB and other
innovative strategies like distribution of flyers, installation of tarpaulins or information
board about KP.
Choose one or more.
Check all that apply.
a. IEC materials produced

b. IEC activities conducted
c. Innovative Campaign Strategy
d. None
66. C.1.a. IEC materials produced

MOVs: Copies of pamphlets, leaflets, tarpaulins and other IEC materials produced by the
Lupons

New Lucban_MOV_C1a.pdf
Files submitted:
67. C.1.b. IEC activities conducted

MOVs: Two (2) photos with caption of the information drive conducted by the LT in the
promotion of KP in their community

New Lucban_MOV_C1b.pdf
Files submitted:
68. C.1.c. Innovative Campaign Strategy
Note: Innovative Campaign Strategy Examples: Use of social media such as FB and other
innovative strategies like distribution of flyers, installation of tarpaulins or information
board about KP.
MOVs: Two (2) photos of Innovative Campaign Strategy utilized by the Lupon

New Lucban_MOV_C1c.pdf
Files submitted:
69. C.1.d. Briefly explain each information drive strategies practiced by the Lupong
Tagapamayapa to create greater awareness to the community in promoting
Katarungang Pambarangay (KP)
D. KP Training or seminar within the assessment period
KP Training or Seminar within the Assessment Period refers to seminars, exchange visits
and similar fora undertaken in furtherance of KP objectives. [DILG MC No. 2004-43,
Creativity and Resourcefulness of Mediators no. 4, page 3]
70. D.1. KP Training or seminar within the assessment period *
Organized skills training participated by the Lupong Tagapamayapa
Trainings or seminars should cover the following:
General/basic orientation or review of the KP system

Skills training on conduct of KP proceedings e.g. relevant ADR systems, KP case
management
Advanced knowledge on laws, policies, and standards in relation to the KP system
e.g. gender and human rights, criminal/civil justice
None
71. D.1.a. Total Number of Trainings or seminars attended/participated *
72. D.1.b Certified true copies of any proof of trainings such as Certificates of
Completion and/or Participation, Attendance Sheets, among others.
Bakakeng Central_ D1b.pdf
Files submitted:
73. D.1.c Photos on trainings/seminars attended/participated

MOVs:
· Two (2) photos with caption of training on general/basic orientation or review of KP

system
· Two (2) photos with caption of skills training on the conduct of KP proceedings
· Two (2) photos with caption of advance knowledge on laws, policies and standards
in relation to KP system
Bakakeng Central_ D1c.pdf
Files submitted:
IV. AREA OR FACILITY FOR KP ACTIVITIES
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.
74. With Office/Space for KP *
Mark only one oval.
Yes
No
75. A.1 If YES, upload photo of building structure or space

The office or space should be exclusive for KP matters.
MOVs: Three (3) photos with caption of the building or space used exclusively for KP and
LT concerns, furniture, fixtures and equipment used in the operation of the KP Office.

Santo Tomas Proper_A1.pdf
Files submitted:
76. A.2 Please describe briefly the building structure or space provided by the
Barangay exclusively for KP and Lupong Tagapamayapa concerns
V. FINANCIAL OR NON-FINANCIAL SUPPORT
Financial or non-financial support are grants whether it be monetary or in kind, given to the
Lupong Tagapamayapa for the purpose of the implementation of Katarungang
Pambarangay.
77. A. City, Municipal or Provincial Government and NGAs

NOTE:
1. Excluding the regular appropriations for the barangay and incentives from the DILG
programs;
2. Acknowledgement receipt should be signed by both the donor and recipient, and
3. Additional honoraria or support from the Lupon on top of the mandatory allocations.
MOVs: Certified true copies of any proof of support such as Deed of Donation, MOA,
Resolution, Appropriations Ordinance, Acknowledgment Receipts, Vouchers and etc.

Santo Tomas Proper_A.pdf
Files submitted:
78. Financial/Non-Financial support received from:
National Government
Local/City Government
79. B. People’s Organization, NGOs or Private Sector and others

MOVs: Certified true copies of any proof of support such as Deed of Donation, MOA,
Acknowledgment Receipts, Vouchers and etc.

Santo Tomas Proper_B.pdf
Files submitted:
ADDITIONAL MOVs/Forms/Documents to be Submitted.
Please upload the following accomplished accompished LTIA forms.
80. 1. LTIA Form 06 (Summary of Cases) *

*Format: PDF file (merged/combined multiple pages to one)
*File name: DPS Area_LTIA Form 06.pdf
Files submitted:
81. 2. LTIA Form 07-a (List of Cases) *

*File name: DPS Area_LTIA Form 07a.pdf
Files submitted:
82. 3. LTIA Form 07-b (Lupong Tagapamayapa Profile) *

*File name: DPS Area_LTIA Form 07b.pdf
Files submitted:
83. 6. Date Submitted: *
Example: January 7, 2019
Thank you for your submission.
Please click 'Submit' button.
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2024 Lupong Tagapamayapa

Incentives Awards (LTIA)

Efficiency in Operations (42 points)

COVERAGE. Performance year to be assessed is CY 2023 (January 1, 2023 to December

📢 GENERAL INSTRUCTIONS. Please read the instructions carefully.

1. Sign in with Google Account is required in submitting documents/MOVs/forms for

* Indicates required question

2. ℹ️DATA PRIVACY CONTENT *

Mark only one oval.

Respondent's Information (Report Sender)

7. Position in the Barangay *

Mark only one oval.

Sangguniang Barangay Member (Barangay Kagawad)

Mark only one oval.

District 1 Skip to question 9

District 2 Skip to question 10

District 3 Skip to question 11

District 4 Skip to question 12

District 5 Skip to question 13

District 6 Skip to question 14

District 7 Skip to question 15

District 8 Skip to question 16

District 9 Skip to question 17

District 10 Skip to question 18

District 11 Skip to question 19

District 12 Skip to question 20

District 13 Skip to question 21

District 14 Skip to question 22

District 15 Skip to question 23

District 16 Skip to question 24

District 17 Skip to question 25

District 18 Skip to question 26

District 19 Skip to question 27

District 20 Skip to question 28

Skip to section 22 (I: EFFICIENCY IN OPERATION )

District Officer: LGOO III Sesvir C. Lopez

Mark only one oval.

MINES VIEW PARK

SAINT JOSEPH VILLAGE

Skip to section 22 (I: EFFICIENCY IN OPERATION )

District Officer: LGOO V Maria Consolacion S. Buena

10. [District 2] Choose the name of barangay: *

Mark only one oval.

CABINET HILL-TEACHERS CAMP

Skip to section 22 (I: EFFICIENCY IN OPERATION )

District Officer: LGOO III Joe Pablo M. Gernale

Mark only one oval.

Skip to section 22 (I: EFFICIENCY IN OPERATION )

District Officer: LGOO V Maria Consolacion S. Buena

12. [District 4] Choose the name of barangay: *

Mark only one oval.

FERDINAND (HAPPY HOMES-CAMPO SIOCO)

IMELDA R. MARCOS (LA SALLE)

Skip to section 22 (I: EFFICIENCY IN OPERATION )

District Officer: LGOO VI Carol G. Gano

Mark only one oval.

CITY CAMP CENTRAL

CITY CAMP PROPER

GENERAL EMILIO F. AGUINALDO (QUIRINO-MAGSAYSAY, LOWER)