PETITION

Petitioner through counsel respectfully alleges:

1. That he, _______________, is a qualified voter and was one of the registered
candidates voted for in the barangay election held on _____________ in the city of
_______________, Philippines, within the jurisdiction of the court;

2. That according to the certificate of canvass of the electoral board of canvassers for
the barangay of ________, the total votes for the office of the Barangay
Captain/Kagawad for the said Barangay was ___________ the respondent appearing to
have received ______ votes, the petitioner ____________votes and the other registered
candidate voted for, as follows:_______________

3. That on _______, the said electoral board of canvassers proclaimed the respondent
________ elected to the office of the Barangay Captain/Kagawad of the Barangay of
_______;

4. That the petitioner contests the election of the said respondent on the following
grounds:

A.
B.
C.

5. That the petitioner is willing to give a bond, as this Honorable Court may determine
to cover all reasonable expenses and costs and damages, incidental to these
proceedings;

WHEREFORE, it is respectfully prayed:

1. That upon service of summons in accordance with law, a day be set for the hearing of
the protest;

2. That an order be issued to the City treasurers of the City of ______ to bring and
present before the Honorable Court on or before the day of the hearing of this protest
the ballot boxes, copies of the registry list, the election statements, the voter’s
affidavits, and other documents used in the said election in said municipalities, in order
that this Honorable Court may re-examine and revise the same;

3. That after due proceedings, the election of the respondent, and ________________
for the office of Barangay Captain/Kagawad ____________ be annulled and that the
petitioner be declared duly elected instead;

4. That the expenses and costs incurred in these proceedings be assessed against the
respondent.

________ City, Philippines, this _____ day of _______2018.

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 COUNSEL:
_____________________________________
Appointment No. _____________________
Roll of Attorney No. ___________________
PTR No.____, ____ (__________________)
IBP No. ____, ____ (__________) (______)
Office Address________________________
Email Address ________________________
Contact No. __________________________
MCLE Compliance (or Exemption) No._____

Copy Furnished:

_________________________________
Name and address of adverse counsel
(Personal Service)

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, _______________________, of legal age, after having been duly sworn in

accordance with law, depose and state that:
1. I am a plaintiff in the above-stated case;
2. I caused the preparation of the foregoing complaint;
3. I have read the contents thereof and the facts stated therein are true and
correct of my personal knowledge and/or on the basis of copies of documents
and records in my possession;
4. I have not commenced any other action or proceeding involving the same
issues in the Supreme Court, the Court of Appeals, or any other tribunal or
agency;
5. To the best of my knowledge and belief, no such action or proceeding is
pending in the Supreme Court, the Court of Appeals, or any other tribunal or
agency;
6. If I should thereafter learn that a similar action or proceeding has been filed
or is pending before the Supreme Court, the Court of Appeals, or any other
tribunal or agency, I undertake to report that fact within five (5) days therefrom
to this Honorable Court.

___________________________

Affiant

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 SUBSCRIBED AND SWORN to before me this ___ day of __________ 2018
at _________________ affiant exhibiting to me his Community Tax Certificate
No.____________________ issued on ________________ 2018 at ______________
City.

Doc. No. ;
Page No. ;
Book No. ;
Series of 2018