KP FORM
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4: TALAAN NG NAHIRANG NA MGA KASAPI NG LUPON
Republic of the Philippines Province of __________ CITY/MUNICIPALITY OF ______________ Barangay _________________ OFFICE OF THE PUNONG BARANGAY _________, 20 ____ (Date) LIST OF APPOINTED LUPON MEMBERS Listed hereunder are the duly appointed members of the Lupong Tagapamayapa in this Barangay who shall serve as such upon taking their oath of office and until a new Lupon is constituted on the third year following their appointment. 1. _________________ 11. _________________ 2. _________________ 12. _________________ 3. _________________ 13. _________________ 4. _________________ 14. _________________ 5. _________________ 15. _________________ 6. _________________ 16. _________________ 7. _________________ 17. _________________ 8. _________________ 18. _________________ 9. _________________ 19. _________________ 10. _________________ 20. _________________ _______________ Punong Barangay ATTESTED: ______________________ Barangay/Lupon Secretary IMPORTANT: The list shall be posted in three (3) conspicuous places in the barangay for the duration of the terms of office of those named above. WARNING: Tearing or defacing this notice shall be subject to punishment according to law.
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ISANG HANDBOOK