BLANK - Inclusion

Province of Lanao del Norte
Municipality of Sapad
Barangay Pancilan
CERTIFICATION
TO WHOM IT MAY CONCERN:
It is to certify that ________________________________________ of legal age, single/married,

residing at Pancilan, Sapad, Lanao del Norte, known to me as Potential Farmer
Beneficiary.
This is to certify further that the above-mentioned Agrarian Reform Beneficiary is

the actual tiller occupants of the agricultural land owned by SPS. CLEOPATRA M.
PANINSORO AND NESTOR PANINOSORO, covering the TCT No. CLOA-14,478, CLOA No.
01110095, Lot No. 421, Pls-35 and having the area of 72,621 square meters.
That I am a landless citizen and working as tenant since at the age of ______________.
This certification is being issued to any legal purposes that may serve worth.
Done this _________ day of _________ 2018, at Barangay Pancilan, Sapad, Lanao del
Norte.
ANTONIO HOMAW-AS
BARC CHAIRMAN
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF LANAO DEL NORTE) S.S
MUNICIPALITY OF SAPAD)
x--------------------------------------------------/
AFFIDAVIT OF AGGREGATE LANDHOLDING
That I, _________________________________________ of legal age, married, Filipino and

resident of Sapad, Lanao del Norte, Philippines, after having been duly sworn to an oath in
accordance with law herby depose and say, to wit:
That I am the identical ________________________________________, who is an applicant of

enclosure to a landholding of SPS. CLEOPATRA M. PANINSORO AND NESTOR
PANINSORO, having a CLOA No. 01110095.
That I executed this affidavit to established the foregoing fact and using this affidavit
for any legal purposes that may serve worth.
IN WITNESS WHEREOF, I hereby set my hand this ________ day of ________________ 2018
at Sapad, Lanao del Norte, Philippines.
___________________________________
Affiant
SUBSCRIBED AND SWORN to before me a Notary Public for and in the jurisdiction
above cited Affiant __________________________________________, exhibited to me his/her ID No.
________________ issued at _____________________________ on ____________________.
Doc. No. _____

Page No. _____ Notary Public
Book No. _____
Series of 2018.
Province of Lanao del Norte
Municipality of Sapad
Barangay Pancilan
Application for Inclusion of Farmer Beneficiary

Subject of: Collective CLOA
JALALODIN P. BANGCOLA
Municipal Agrarian Reform Officer
DAR, Sapad, Lanao del Norte
_____________________
Date
S I R:
I would like to apply for an Inclusion of my name as Farmer Beneficiaries in a parcel

of land issued with CLOA No.: 01110095 in the names of SPS. CLEOPATRA M.
PANINSORO AND NESTOR PANINSORO identified as Lot 421, Pls-35 (AR) with an area of
72,621 square meters located at Pancilan, Sapad, Lanao del Norte.
Hoping for your kind approval of my application.
Very truly yours,
________________________________
Farmer Beneficiary
x--------------------------------------------------/
AFFFIDAVIT OF TWO DISINTERESTED PERSONS
That we, _________________________________________, and

____________________________________________ married/single/widow, both farmers and resident
of Barangay Pancilan, Municipality of Sapad, Lana del Norte, having been sworn in
accordance with law, do hereby depose and say:
That we are both fully aware of the personal circumstances of _____________________, a

resident of Barangay Pancilan, Municipality of Sapad, Lana del Norte, who had long
cultivated and developed the farm lot.
That we executed this affidavit to establish the foregoing fact and using this affidavit
for INCLUSION of name of ___________________________________ in a parcel of land owned by the
SPS. CLEOPATRA M. PANINSORO AND NESTOR PANINSORO, located at of Barangay
Pancilan, Municipality of Sapad, Lanao del Norte, covering the TCT No. CLOA-14,478,
CLOA No. 01110095, Lot No. 421, Pls-35 and containing an area of 72,621 square
meters.
IN WITNESS WHEREOF, we hereby set our hands this ______ of ______ 2018 at Sapad,
Lanao del Norte, Philippines.
_________________________ _______________________________
Affiant Affiant
I.D No. __________ I.D No. ___________

Issued on issued on
Issued at issued at
SUBSCRIBED AND SWORN TO BEFORE ME this day of 2018,

___________________, Philippines.
Doc No.
Page No. ______ Notary Public
Book no. ______
Series of 2018
x--------------------------------------------------/
AFFFIDAVIT OF TWO DISINTERESTED PERSONS
That we, _____________________________ and ____________________________,

married/single/widow, both farmers and resident of Barangay Pancilan, Municipality of
Sapad, Lana del Norte, having been sworn in accordance with law, do hereby depose and
say:
That we are both fully aware of the personal circumstances of

_________________________________, a resident of Barangay Pancilan, Municipality of Sapad, Lana
del Norte, who is no longer occupying nor tilling the area awarded to her.
That we executed this affidavit to establish the foregoing fact and using this affidavit
for EXCLUSION of name of __________________________________________ in a parcel of land owned
by the SPS. CLEOPATRA M. PANINSORO AND NESTOR PANINSORO, located at of
Barangay Pancilan, Municipality of Sapad, Lanao del Norte, covering the TCT No. CLOA-
14,478, CLOA No. 01110095, Lot No. 421, Pls-35 and containing an area of 72,621
square meters.
IN WITNESS WHEREOF, we hereby set our hands this ______ of ______ 2018 at Sapad,
Lanao del Norte, Philippines.
_________________________ ____________________________
Affiant Affiant
I.D No. __________ I.D No. ____________

Issued on issued on
Issued at issued at
SUBSCRIBED AND SWORN TO BEFORE ME this day of 2018,

___________________, Philippines.
Doc No. ______

Page No. Notary Public
Book No. _____
Series of 2018

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Province of Lanao del Norte

TO WHOM IT MAY CONCERN:

It is to certify that ________________________________________ of legal age, single/married,

This is to certify further that the above-mentioned Agrarian Reform Beneficiary is

AFFIDAVIT OF AGGREGATE LANDHOLDING

That I, _________________________________________ of legal age, married, Filipino and

That I am the identical ________________________________________, who is an applicant of

Doc. No. _____

Application for Inclusion of Farmer Beneficiary

I would like to apply for an Inclusion of my name as Farmer Beneficiaries in a parcel

Hoping for your kind approval of my application.

Very truly yours,

AFFFIDAVIT OF TWO DISINTERESTED PERSONS

That we, _________________________________________, and

That we are both fully aware of the personal circumstances of _____________________, a

I.D No. __________ I.D No. ___________

SUBSCRIBED AND SWORN TO BEFORE ME this day of 2018,

AFFFIDAVIT OF TWO DISINTERESTED PERSONS

That we, _____________________________ and ____________________________,

That we are both fully aware of the personal circumstances of

I.D No. __________ I.D No. ____________

SUBSCRIBED AND SWORN TO BEFORE ME this day of 2018,

Doc No. ______

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