Form LS
Form LS
Form LS
RE: ____________________________________
_____________________________________
(Name of Project and its Location
as indicated in the submitted Sworn Registration Statement)
_________________
(Date)
Pursuant to pertinent laws and the implementing rules and regulations of this Board, I am hereby
applying for a CERTIFICATE OF REGISTRATION (CR) and LICENSE TO SELL (LS) for the
above mentioned project.
Please consider the attached documents listed below with check or cross (“/” or “x”) and numbered
consecutively to support the application for CR/LS:
In this connection, I attest to the fact that: (1) The number identifying the documents listed above
under perspective applications corresponds to each of the attached documents; (2) Duplicate copies are
the authentic and faithful reproduction of the original documents; and, (3) Documents conforms strictly
to the official checklist of requirements and the detailed description thereof.
I understand that additional requisites, including but not limited to subdivision approval and other
pertinent documents of the compliance project per R.A. 7279 (20% socialized housing under Section
18), if covered, the performance bond, and the balance of the processing fee or LS, may be required
only through a written notice signed by an authorized official and that, further action on subject
applications may be withheld if there is an unfavorable decision (final and executor) in case before this
Board or an order in connection with a violation against the undersigned applicant which has not been
complied with.
Address :
Telephone No. /CP No. :
Or through my representative:
Address :
Telephone No. /CP No. :
SUBSCRIBED AND SWORN to before to me in this ______ day of ________ 2022, affiant
exhibiting to me his/her Residence Certificate No. ______ issued at _______________________ on
__________________________.
NOTARY PUBLIC
REGISTRATION STATEMENT
(SINGLE PROPRIETORSHIP)
5. Attached hereto is the Declaration of UDHA Compliance, pursuant to the Implementing Rules and
Regulations and Circulars issued under Section 18 of Republic Act No. 7279.
7. In my capacity as owner of the project, I bind myself to comply with all the rules and regulations pertaining
to this project and shall be held responsible for all the facilities, improvements, infrastructures and similar
forms of development hereon.
____________________________________ __________________________________
Date Place
__________________________________
Affiant
SUBSCRIBED AND SWORN to before to me in this ______ day of ________ 2022, affiant exhibiting to
me _________________issued in _____________________________on __________________________.
NOTARY PUBLIC
B. COMPLIANCE PROJECT :
a. Nature _______________________________________________
b. Name of Project _______________________________________________
c. Location _______________________________________________
d. Owner/Developer _______________________________________________
e. CR or CRLS No. _______________________________________________
f. Total Project Area or
Total Project Cost _______________________________________________
g. Allotted Block _______________________________________________
and lot or unit nos. _______________________________________________
h. Equivalent Area or Cost _______________________________________________
(and/or)
_____________________________ ____________________
(Signature Over Printed Name) Date
Owner/Developer
Republic of the Philippines
DEPARTMENT OF HUMAN SETTLEMENTS AND URBAN DEVELOPMENT
Kagawaran ng Pananahanang Pantao at Pagpapaunlad ng Kalunsuran
Regional Office 02
3rd Flr. PuR Seinte Bldg., Maharlika Highway, Tanza, Tuguegarao City, Cagayan
Email Address: region2@dhsud.gov.ph
I. COMPLIANCE PROJECT:
_____________________________ ____________________
(Signature Over Printed Name) Date
Owner/Developer
Republic of the Philippines
DEPARTMENT OF HUMAN SETTLEMENTS AND URBAN DEVELOPMENT
Kagawaran ng Pananahanang Pantao at Pagpapaunlad ng Kalunsuran
Regional Office 02
3rd Flr. PuR Seinte Bldg., Maharlika Highway, Tanza, Tuguegarao City, Cagayan
Email Address: region2@dhsud.gov.ph
REGISTRATION STATEMENT
(CORPORATION)
________________________________ ______________________________
________________________________ ______________________________
________________________________ ______________________________
________________________________ ______________________________
4. a) That said Corporation is both the owner and developer of certain parcels of land hereinafter
called __________________________________________________________________________ situated
at ____________________________________________________________________ and covered by
TCT’s No. (s) _______________________________________ comprising an aggregate area
of _________________________ sq.m.;
or
5. Attached hereto is the Declaration of UDHA Compliance, pursuant to the implementing rules and
regulations and circulars issued under Section 18 of Republic Act No. 7279.
(Fill-out the attached Declaration of UDHA Compliance Form
for main subdivision project or compliance project)
7. In our capacity as owner and/or developer, we bind ourselves to comply with all the rules and regulations
pertaining to this project and shall be held responsible for all the facilities, improvements, infrastructures
and similar forms of development thereon.
Republic of the Philippines
DEPARTMENT OF HUMAN SETTLEMENTS AND URBAN DEVELOPMENT
Kagawaran ng Pananahanang Pantao at Pagpapaunlad ng Kalunsuran
Regional Office 02
3rd Flr. PuR Seinte Bldg., Maharlika Highway, Tanza, Tuguegarao City, Cagayan
Email Address: region2@dhsud.gov.ph
____________________________________ __________________________________
Date Place
__________________________________
Affiant
CONFORMITY:
________________________
OWNER
(If # 4b above applies)
SUBSCRIBED AND SWORN to before to me in this ______ day of __________ 2022, affiant exhibiting to
me _________________issued in _____________________________on __________________________.
NOTARY PUBLIC
2. That the above-mentioned property/ies is/are the subject of application for Registration and License to
Sell for the proposed _______________________________________________________ now pending with the
(Project Name)
Department of Human Settlements and Urban Development (DHSUD);
3. That the best of my knowledge, said property/ies is/are free from liens and encumbrances;
4. That in the event said property/ies shall be mortgaged to any person, natural or judicial, I hereby
undertake to notify and secure the approval of the Department of Human Settlements and Urban Development
(DSHUD) prior to such mortgage;
5. That I am executing this affidavit to attest to the veracity of the above-mentioned facts thereby
satisfying the requirements of the Department of Human Settlements and Urban Development (DHSUD)
relative to my application for Registration and License to Sell for the above-mentioned project.
____________________________________ __________________________________
Date Place
__________________________________
Affiant
SUBSCRIBED AND SWORN to before to me in this ______ day of ________ 2022, affiant exhibiting to me
his/her Residence Certificate No. ______ issued at _______________________ on
__________________________.
NOTARY PUBLIC
after being sworn to in accordance with the law hereby depose and states the following:
2. That we have a pending application for Registration and License to Sell for above-mentioned project:
3. That to the best of my knowledge, there is no other project under such name under Presidential
Decree No. 957 and Executive Order No. 648;
4. That in the event that a project does exist, located in the same province as our project and is registered
with the Department of Human Settlements and Urban Development (DSHUD) or with the National Housing
Authority (NHA) under a name similar to our proposed name, we are willing to recognize its prior right over
and above our application;
5. That I am executing this affidavit to signify our willingness to change the name of our proposed
project to another name so as not to effect the vested rights and/or interests of the previous registered project.
____________________________________ __________________________________
Date Place
__________________________________
Affiant
SUBSCRIBED AND SWORN to before to me in this ______ day of ________ 2022, affiant exhibiting to me
his/her Residence Certificate No. ______ issued at _______________________ on
__________________________.
NOTARY PUBLIC
Form No. RI
Republic of the Philippines )
Municipality of ___________) s. s.
Province of ______________)
AFFIDAVIT
2. That our company has a pending application for Registration and License to sell for the
above- mentioned project.
3. I hereby manifest and guarantee before this Board that in conducting its sales transaction
with the buying public it shall include/incorporate in its Contract to Sell form section
17,18,23, to 26 and 30 of PD 957/BP 220 and section 21,30 and 31 of its implementing
standards, rules and regulations, implementing subdivisions and Art. IV Section c of EO
648, Rules and Regulations for Memorial Parks/Cemeteries:
4. That I am executing this affidavit to attest to the veracity of the above- mentioned facts
thereby, satisfying the requirements of the Department and Human Settlements and Urban
Development (DHSUD) relative to my application for the registration and license to sell for
the above-mentioned project.
____________________________________ __________________________________
Date Place
__________________________________
Affiant
SUBSCRIBED AND SWORN to before to me in this ______ day of ________ 2022, affiant exhibiting to me
his/her Residence Certificate No. ______ issued at _______________________ on
__________________________.
NOTARY PUBLIC
3. That I fully understand the legal obligations of my company and guarantee and ensure the
delivery of individual titles to the lots/units purchased by the buyers as well as the
preservation and maintenance of areas declared as open space common areas for such
purpose.
4. That for reasons not attributable to our negligence or intentional malfeasance, and which are
beyond our control, the issuance of such separate titles and inscription of the required
annotation will take time.
5. That I hereby warrant that there is no legal reason or justifiable cause why said titles could be
issued in the normal course of business.
6. That I undertake to submit to this office within fifteen (15) calendar days from release of the
license to sell for the project proof of filling of proper and complete request or application
with the concerned register of deeds for the issuance of individual TCT’s or OCT for all
saleable lots or units and that if deemed necessary and upon demand by Department of
Human Settlements and Urban Development (DHSUD), copies of said title shall be
submitted.
7. That I undertake to submit certified true copy of titles for all the common area, each of
which shall specify the particular purpose for which the lots shall be used (parks &
playground, community facilities, etc.) no later than ______ days counted from release of
the license to sell.
8. That in the case of non- compliance herewith, HLURB may suspend our license to sell or
consider the same revoked, in addition, it may impose penalties for selling without any
license, and:
9. That I bind myself jointly and severally with the company in ensuring with the foregoing.
Republic of the Philippines
DEPARTMENT OF HUMAN SETTLEMENTS AND URBAN DEVELOPMENT
Kagawaran ng Pananahanang Pantao at Pagpapaunlad ng Kalunsuran
Regional Office 02
3rd Flr. PuR Seinte Bldg., Maharlika Highway, Tanza, Tuguegarao City, Cagayan
Email Address: region2@dhsud.gov.ph
____________________________________ __________________________________
Date Place
__________________________________
Affiant
SUBSCRIBED AND SWORN to before to me in this ______ day of ________ 2022, affiant exhibiting to me
his/her Residence Certificate No. ______ issued at _______________________ on
__________________________.
NOTARY PUBLIC
Docket No.:
Date
LAND DEVELOPMENT
% COST OF
ITEM COST PER ITEM REMAINING COST REMARKS
COMPLETION ACCOMPLISHMENT
I. GENERAL REQUIREMENTS
- Mobilization / Demobilization
- Temporary Facilities
- Permits and Clearances
TOTAL
HOUSING COMPONENT
% COST OF
ITEM COST PER ITEM REMAINING COST REMARKS
COMPLETION ACCOMPLISHMENT
TOTAL
EVALUATION / RECOMMENDATION
PREPARED BY:
VERIFICATION
I, _____________________________________________________, of legal age, after having sworn, depose and say that I have read
and accomplished this form and contents herein are true and correct.
SUBSCRIBED AND SWORN to before me in this ______________ day of _______________________________ affiant exhibiting to me
his/her _______________________ No. _________________, issued at __________________________ on ____________________.
NOTARY PUBLIC
Doc. No.:
Book No.:
Page No.:
Series of