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    HLURB Case Form No 01 Complaint

    Uploaded by

    Earl Kristoffer Pirante
    This document is a complaint form filed with the Housing and Land Use Regulatory Board (HLURB) by a complainant against a respondent. It includes sections for providing personal details of the complainant and respondent, a chronological listing of events underlying the complaint, documents supporting the complaint, and the reliefs sought including damages and provisional remedies. The complainant signs to verify the complaint and certify that the issues have not been filed in any other tribunal or court.

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

    HLURB Case Form No 01 Complaint

    Uploaded by

    Earl Kristoffer Pirante
    320 views2 pages
    This document is a complaint form filed with the Housing and Land Use Regulatory Board (HLURB) by a complainant against a respondent. It includes sections for providing personal details of the complainant and respondent, a chronological listing of events underlying the complaint, documents supporting the complaint, and the reliefs sought including damages and provisional remedies. The complainant signs to verify the complaint and certify that the issues have not been filed in any other tribunal or court.

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    Complaint Form

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    This document is a complaint form filed with the Housing and Land Use Regulatory Board (HLURB) by a complainant against a respondent. It includes sections for providing personal details of the complainant and respondent, a chronological listing of events underlying the complaint, documents supporting the complaint, and the reliefs sought including damages and provisional remedies. The complainant signs to verify the complaint and certify that the issues have not been filed in any other tribunal or court.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    320 views2 pages

    HLURB Case Form No 01 Complaint

    Uploaded by

    Earl Kristoffer Pirante
    This document is a complaint form filed with the Housing and Land Use Regulatory Board (HLURB) by a complainant against a respondent. It includes sections for providing personal details of the complainant and respondent, a chronological listing of events underlying the complaint, documents supporting the complaint, and the reliefs sought including damages and provisional remedies. The complainant signs to verify the complaint and certify that the issues have not been filed in any other tribunal or court.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    HLURB Case Form No.

    01

    Republic of the Philippines


    Office of the President
    HOUSING AND LAND USE REGULATORY BOARD
    - - - - - - - - - R e g i o n a l Field Office

    Complainant/s,

    - versus - HLURB Case No.


    --
    Respondent/s.
    x---------------------------------------x
    COMPLAINT

    1. The personal circumstances of the complainant/s:

    Name Sex/Age/CS/HOA CR No. Address Contact No.

    (Note: If more space needed, write at the back of this page)

    2. The personal circumstances of the respondent/s:

    Name Sex/Age/CS/HOA CR No. Address Contact No.

    (Note: If more space needed, write at the back of this page and countersign)

    3. The ultimate facts are as follows: (chronological)

    Date Events

    (Note: If more space needed, write at the back of this page and countersign)
    HLURB Case Form No. 01(2)

    4. In support of the foregoing facts and circumstances, the following documents and affidavits are
    herewith attached:

    Annex Letter Description of Document Purpose of Document

    (Note: If more space needed, write at the back of this page and countersign)

    5. Complainant is entitled to the following reliefs:

    (Note: If more space is needed, write at the back of this page and countersign)

    Damages (please check): D Actual/Compensatory: P._____ D Moral: P._ _ _ _ _ __


    D Exemplary: P. D Attorney's Fees: P _ _ _ _ __
    D Others P- - - - -

    Provisional Remedies:
    ---------------------------
    - - - - - - - - · f o r Quezon City. - - - - - - - -

    Complainant

    VERIFICATION AND CERTIFICATION AGAINST FORUM SHOPPING

    I,, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . of legal a g e , - - - - - - - - · and a resident of


    (name) (citizenship)
    - - - - - - - - - - - · o n oath, state:

    1. That I am the complainant in the above-entitled case and have caused this Complaint to be prepared;
    that I read and understood its contents which are true and correct of my own personal knowledge and/or
    based on true records;

    2. That I have not commenced any action or proceeding involving the same issue or subject matter in
    the Supreme Court, the Court of Appeals or any other tribunal or agency; that to the best of my
    knowledge, no such action or proceeding is pending in the Supreme Court, the Court of Appeals or any
    other tribunal or agency, and that, if I should learn thereafter that a similar action or proceeding has been
    filed or is pending before these courts or tribunal or agency, I undertake to report that fact to the Court
    within five (5) days therefrom;

    Complainant

    REPUBLIC OF THE PHILIPPINES)


    _ _ _ _ _ _ _ _ _ _ _ )S.S.

    SUBSCRIBED AND SWORN to before me, this _ day of _ _ _ _ _ _ , affiant exhibiting to me


    his/her issued at _ _ _ _ _ _ _ o n - - - - - - - -

    Doc.No. _ __ Notary Public


    Page No. _ __
    Book No. ---
    Series of ---

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