APPLICATION FOR LAND REGISTRATION

To: The Regional Trial Court Branch No.___ of the Province of Benguet.

Warm Greetings!

The undersigned, ____________________________

____________________________________________________________________________
_________________________hereby applies (or apply) to have the land hereinafter described
brought under the operation of the Property Registration Decree, and to have the title thereto
registered and confirmed:
AND DECLARE . . . . .

1. That the applicants/s is/are the owners of the land (by virtue of inheritance or deed of sale
or conveyance and/or possession in accordance with Section 14 of said Decree), together with
the building and improvements thereon, with the exception of the following:
____________________________________________________________________________
______________________________________ which is/are the property of
____________________________ residing at _____________________________ The said
land, consisting of ____________________ parcel/s is/are situated, bounded and described as
shown on the plan and technical descriptions attached hereto and made a part hereof, with the
following exception: ____________________________________
____________________________________________________________________________
_________________________________

2. That said land at the last assessment for taxation was assessed at P ____, Philippine
currency, and the buildings and other improvements at P ___________, Philippine currency.

3. That to the best of my/our knowledge and belief, there is no mortgage or encumbrance of
any kind whatsoever affecting said land, nor any other person having any interest therein, legal
or equitable, or in possession, other than as follows:
____________________________________________________________________________
____________________________________________________________

4. That the applicant/s has/have acquired said land in the following manner:
________________________________
(Note: Refer to Sec. 14 of said Decree. State also whether the property is conjugal, paraphernal
or exclusive property of the applicant/s)

5. That said land is occupied by the following person:

____________________________________________________________________________
______________________________

6. That the names in full and addresses, as far as known to the undersigned, of the owners of
all adjoining properties, of the persons mentioned in paragraphs 3 and 5, and of the persons
shown on the plan as claimants, are as follows:
____________________________________________________________________________
____________________________________________________________________________
_______
7. That the applicant/s is/are single or married to _____________________ (Note: if marriage
has been legally dissolved, state when and how the marriage relation
terminated.)__________________________________________________________________
____________________________________________

8. That the applicant's/s' full name, age, citizenship, residence, and postal address/es is/are
as follows:
____________________________________________________________________________
____________________________________

9. That (Note: If the land included in the application is bounded by a public or private way or
road, there should be stated in this paragraph whether or not the applicant claims any and what
land within the limits of the way or road and whether the applicant desires to have the line of the
way or road determined.)
____________________________________________________________________________
____________________________________________

10. That the following documents are attached hereto and made a part hereof:
____________________________________________________________________________
_____________________________________________________________

Schedule of Documents

(a) The original or tracing plan, together with a blue print copy thereof;
(b) The technical description of the land (in duplicate);
(c) The surveyor’s report of survey, or surveyor’s certificate (in duplicate);
(d) Muniments of title relied upon by the applicant to prove his ownership of the land.

Signed at ___________________ this _____________________ day of

____________________, in the year nineteen hundred and ______________________.

_______________________
Applicant
_________________
(Post Office Address)
REPUBLIC OF THE PHILIPPINES
PROVINCE (OR CITY) OF _______________

On this _______________ day of _________________________,19 ________ personally

appeared before me the above- named
__________________________________________________ known to me to be the person/s
who executed the foregoing application and made oath that the statements therein are true of
his/their knowledge, information and belief.

The Residence Certificate/s ______________________ of the applicant/s ______________

was/were exhibited to me being No. _________________ issued at ___________________
dated ____________, 19 __________.
_______________________
(Notary Public, or other Officer
authorized to administer oaths)
 PTR NO. _________________

(Add Verification and Certification)

Copy furnished by registered mail:

The director of lands (Attach proof of service)