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Sample Forms For LGU

This document is a request from an applicant to the Housing and Land Use Regulatory Board (HLURB) for certification on whether a property located in [location] is within or outside the Urban Land Reform Zone, specifically any Areas for Priority Development, as outlined in Proclamations 1967 and 2284. The applicant needs this certification for a proposed project, sale/mortgage, or registration of rights and has included various required documents like a vicinity map, proof of ownership, and tax declaration. The applicant affirms that the information provided is true and correct.

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Arnold Onia
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385 views

Sample Forms For LGU

This document is a request from an applicant to the Housing and Land Use Regulatory Board (HLURB) for certification on whether a property located in [location] is within or outside the Urban Land Reform Zone, specifically any Areas for Priority Development, as outlined in Proclamations 1967 and 2284. The applicant needs this certification for a proposed project, sale/mortgage, or registration of rights and has included various required documents like a vicinity map, proof of ownership, and tax declaration. The applicant affirms that the information provided is true and correct.

Uploaded by

Arnold Onia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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_________________

Date
Housing and Land Use Regulatory Board
___________________________________

________________________________
Attention:

The Director
Region ___________________

Sir/Madam:
May I request for certification as to whether or not the property/ies located in ________________
________________________________________ or covered by transfer Certificate of Title No./s
________________ is/are within or outside the Urban Land Reform Zone, specifically, any of the
Areas for Priority Development (APD), as per Prool. No. 1967 as amended by Prool. No.
2284,Said request is necessary for my:
[ ] 1.

Proposed
___________________________________________________
specifically whether it is residential, commercial, industrial, etc;

project

[ ] 2.

Proposed sale/mortgage;

[ ] 3.

Proposed registration of new right and/or interest;

[ ] 4.

Proposed registration of existing rights end/or interest;

[ ] 5.

Pending case in Court;

[ ] 6.

Other (please specify) -____________________________________________________

Attached herewith are the following documents necessary therewith;


[ ] 1.

Vicinity map drawn to any scale or sketch map and affidavit as to actual location site;

[ ] 2.

Site Development plan drawn to scale;

[ ] 3.

Proof of ownership or right over the property certified true copy;

[ ] 4.

Tax Declaration;

[ ] 5.

Verification Form;

[ ] 6.

Deed of Sale;

[ ] 7.

Affidavit of non-tenancy or waiver by tenant or rights of refusal, if tenanted;

Finally, I do hereby certify that the documents submitted herewith (or any other document that
will be required of me) are to the beet of my knowledge, true and correct the same having been
prepared personally by me or under my supervision and instruction.

______________________________
Applicants Signature

HLURB Form No. 1120


Republic of the Philippines) S.S.
---------------------------------)
AFFIDAVIT
I, ________________________________________________________ of legal age,
____________________________________, and a resident of and with postal address at
_____________________________________________________ after having been sworn to in
accordance with law, hereby depose and say:
That I am a tenant/owner/authorized representative to the owner of a house/apartment/
parcel of land located at _________________________________________________________.
That I have filed with Housing and Land Use Regulatory Board (HLURB) a request for
certification as to whether or not the abovementioned property is within or outside the Urban
Land Reform Zone (ULRZ) specifically any of the Areas for Priority Development (APD).
That I have sketched or caused to be sketched a location map of said property for purpose
of verification With ULRZ of the HLURB.
That the said sketch is a faithful representation of the present arid actual location of the
property per original/transfer certificate of title/tax declaration;
That this affidavit is executed to attest to the veracity of the abovementioned facts,
thereby satisfying the requirement of HLURB on my request for APD certification.
Further, I sayeth naught.
_____________________________, 200____, ______________________, Philippines
_________________________
Affiant
Republic of the Philippines )
----------------------------------)
SUBSCRIBED AND SWORN to before me this day of _____________________
200________, in the City/Province of __________________________, affiant exhibited to me
his/her Residence Certificate No. ___________________ issued at ________________________
on ____________________ 200________.

Doc. No. ________;


Page No. ________;
Book No. ________;
Series 200________;

NOTARY PUBLIC

Republic of the Philippines


Office of the President
Housing and Urban Development Coordinating Council
HOUSING AND LAND USE REGULATORY BOARD
Region: __________________
Address: ____________________________________________
Form No. 1302-A

VERIFICATION FORM
FOR PROCLAMATION NO. 1957, PROCLAIMING 244 AREAS FOR PRIORITY DEVELOPMENT AND
PROCLAMATION NO. 2284, PROCLAIMING DAGAT-DAGATAN AS AN AREA FOR PRIORITY DEVELOPMENT

LAND DESCRIPTION:
Land Survey No. _________________________
Lot No. ____________ Block No. ____________
Portion of _______________________________
[ ] Owner [ ] Tenant [ ] Others ____________
_______________________________________
ADDRESS OF APPLICANT:
_______________________________________
_______________________________________
Tel. No.
_______________________________________
NAME OF OWNER
Land Area_______________________________
Title No. ________________________________
Tel. No.
Tax Declaration No. _______________________
ADDRESS OF OWNER:
Tax Declaration Description: ________________
_______________________________________
Tel. No.
_______________________________________
NATURE OF TRANSACTION:
_______________________________________
[ ] Certification
[ ] Sale
_______________________________________
[ ] Existing Rights
[ ] Mortgage
LOCATION OF LAND:
[ ] New Rights
[ ] Lease Agreement
No. or Street ____________________________
SIGNATURE OF APPLICANT:
Barangay _______________________________
Town/City ______________________________
Province _______________________________
(DO NOT FILL BELOW)
RECORD FINDINGS
VERIFICATION FINDINGS
[ ] Inside APD
Code
[ ] No Previous Record [ ] Has Previous Record
[ ] Outside APD
[ ] Inside [ ] Outside [ ] Others ___________
[ ] Others (see remarks)
NATURE OF PREVIOUS TRANSACTION
NAME OF APPLICANT:

NAME OF PREVIOUS APPLICANT


ADDRESS OF PREVIOUS APPLICANT
Verified by:

Date

No. and Location of APD _____________________


__________________________________________
Remarks: _________________________________
__________________________________________
__________________________________________
__________________________________________
Verified by:

Date

Noted by:
__________________________________
Head, RIU
FOR INTERNAL USE ONLY, NOT VALID FOR OUTSIDE TRANSACTION

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