Sample Barangay Protection Order PDF Print E-mail

Republic of the Philippines

City of Cebu


Office of the Barangay Captain

Lupong Tagapamayapa




          Vs                                                                                                            Brgy Case No.  _________________

                                                                                           For: __________________________







On (date of petition filed) the petitioner filed a Petition for the Issuance of a  Barangay Order (BPO);

The Petitioner alleged that on __________, __________ the Respondent has violated Resolution No. 02-4177, Ordinance No. 1938 by Committing the following prohibited acts against her person;

A.I. Physical violence consists of any or a combination of the following:

a.1. Slapping, pulling of hair, boxing, kicking, shoving, throwing, banging of the head on the floor, wall or any hard object or surface;

a.2. Hitting with an object or the use of deadly weapons;

a.3. Forcing the use or intake of alcohol, drugs or dangerous substances.

A.II. The emotional/psychological forms of abuse include:

a.1. Threats and intimidation including but not limited to stalkinga.

2. Verbal abuse such as shouting invectives against the victim,

a.3. Name-calling and derogatory remark.

(B) The economic or financial forms of abuse include:

b.1. Withholding of personal property or money due to the victim;

b.2. Not contributing to the family budget;

b.3. Selling common or conjugal properly without the consent of the other party;

B.4. Willful neglect or denial to provide support comprising everything indispensable for sustenance, dwelling, clothing, medical attendance, education and transportation in keeping with the financial capacity of the family.

b.5. Unreasonably preventing the victim from engaging in any profession,  occupation, business or activity, or solely controlling the conjugal money or properties or controlling the victim’s own money or property;

after thoroughly examining and determining the veracity and urgency of the petition and finding that indeed respondent violated the provisions of CityOrdinance No. 1938 more specifically Section 9 thereof, it is hereby ordered that:

( ) a. the respondent is prohibited from committing any act of domestic violence;

( ) b. the respondent immediately leaves the domicile/residence of the petitioner;

( ) c. the respondent is prohibited directly or indirectly communicating or contacting with the petitioner;

( ) d. custody of the minor children is hereby granted to the petitioner/petitioner’s parent or Such person or government agency to the best interest of such minor/s;


__________(date) ________, Cebu City