Cancellation Form No.
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Province of_________
Region No._____
CANC APPLICATION NO. ______________________
APPLICATION FOR CANCELLATION
We, Elizabeth S. Abalde, Heman Greg Salcedo, Filipino , of legal ages, married/single , a
Resident of __________________________________________________________________, do
Hereby apply for the cancellation of tittle/s in accordance with DAR Administration Order (AO)
No. 2, Series of 2018, as amended, described as follows:
EP/CLOA No./Title REGESTRY OF AREA REGESTERED LOCATION
No. DEEDS (ROD) sqms OWNERS
_______________ ___________ _____ __________ _________
_______________ ___________ _____ __________ _________
_______________ ___________ _____ __________ _________
The aforesaid application for cancellation of tittles is based upon any of the following: (Please check
appropriate box).
1. Existence of a final and executory (FINEX) judgement with following information:
Docket No. : ______________________________________________
Case tittle : ______________________________________________
Name of parties : ______________________________________________
Office/Court : ______________________________________________
Date of Decision : ______________________________________________
2. Correction of technical description in the aforesaid tittles which do not affect the identity
Or number of agrarian reform beneficiaries or the size and scope of the landholdings under
The said tittles.
3. Transfer of tittle on the basis of a conveyance approved through a valid DAR transfer
Clearance.
4. Motion of the petitioners or all the parties to withdraw the Cancellation Action.
Hereto attached are the require documents to support the processing of my/our applications:
(Please check appropriate box).
Certified true copies of the subject EP/CLOA/other tittle issued not later than six (6)
Month before the filling of the applications.
Certification true Copy of the Decision of the court/office.
Certification from the court office that the judgement has become final and executory
Motion to Dismiss or Withdraw in case No. ___________ pending at ______________
Docketed as __________
DAR Transfer Clearance issued by the Region Direction (RD)
Correction Technical Description of the subject EPCLOA/other tittle issued under agrarian
Reform program certificate as true and correct by the DENR-LMS/LRA
Proof of service that the registered owners of the EP/CLOA/other titles and the registry
Of deeds (ROD) were served with a copy of the cancellation Form No. 1
I/WE hereby certify under oath that all statement I/WE made in this applications are true and
Correct based on my/our personal knowledge and that all documents attached are authentic.
_____________________________________________
Signature over Printed Name of Application/owner
________________
Date
SUBSCRIBED AND SWORN to before me this ___ day of _____, 2018 at __________________,
His identification No._____ issued at _______ on _____.
Notary Public
DOC No. _______:
Pages No. _______:
Book No. _______:
Series of 20__
Copy furnished:
Proof of service
Registry of Deeds (Date/Received by)
Registered owner of the EP/CLOA
Cancellation Form No.2
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Province of Misamis Oriental & Camiguin
Region No. X
CANC APPLICATION NO. ______________________
ACKNOWLEDGEMENT RECEIPT
I acknowledgement the receipt of the accomplishment Application for Cancellation (Form No.1) or the
verified Petition for cancellation and the attached application documents filed by
___________________ (Name of Applications): (Please check appropriate box)
Certified true copies of the subject EP/CLOA/other tittle issued not later than six (6)
Months before the filing of the applications.
Certified true the filing of the applications
Certified from the court/Office that the Judgement has become final and executory
Motion to Dismiss or Withdraw in case No. ________ pending at ______________
Docketed as ___________
Corrected Technical Description of the subject Ep/CLOA/other tittle issued under
Agrarian reform program certified as true and correct by the DENR-LMS/LRA
Proof of service that the registered owners of the EP/CLOA/other titles and the registry
Of Deeds (ROD) were served with a copy of the Application for cancellation (form No.1)
I have examined the said application or the verified Petition for Cancellation and the
Attached documents and found the same complete and in order pursuant to the requirements
Set forth under administrative order No. 2, Series of 2018, as amended.
Done this ___day of ____20__
___________________________________________
Signature over Printed Name of Chief, Legal Division
_________________
Date
Cancellation Form No. 3
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Province of_________
Region No._____
CANC APPLICATION NO. ______________________
PARPO II RECOMMENDATION
Pursuit to DAR Administrative Order No. 2 Series of 2018, as amended, and Memorandum
Circular No.___, Series of 2018, the undersigned hereby recommends the Grant or Denial of the
Following titles.
EP/CLOA No./title REGISTRY OF AREA REGISTERED LOCATION
NO DEEDS (ROD) (sqms) OWNER
______________ ___________ _____ __________ _________
______________ ___________ _____ __________ _________
______________ ___________ _____ __________ _________
The recommendation is based on any of the following: (Please check appropriate box)
Determination that the aforesaid title must be cancelled in accordance to the decision
Describe as follow:
Docket No. : ______________________________________________
Case tittle : ______________________________________________
Office/Court : ______________________________________________
Date of Decision : ______________________________________________
Date of Finality : ______________________________________________
Withdrawal of the Cancellation case
Motion to Dismiss or Withdrawal in Case No. __________ Pending at _______________
Docketed as _____________
Approved transfer of title on the basis of DAR Transfer Clearance dated __________ with
Issuance No. ______________
Attached documents: (please check appropriate box)
Certified true copies of the subject EP/CLOA/other tittle issued not later than six
(6) Months before the filing of the applications
Certified true copy of the Decision of the _______________________
Certification from the court/office of finality of the Decision has become final and
Executory.
Motion to Dismiss or Withdraw the Case
DAR Transfer Clearance
Proof of service that the registered owners of the EP/CLOA or other tittle issued
Under agrarian reform program and the concerned ROD were served with a copy
Of the Application for cancellation (from No.)
Remarks: __________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Respectfully submitted.
_________________________________________
Signature over Printed Name of PARPO II
______________
DATE
Cancellation Form No. 3-A
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Province of_________
Region No._____
CANC APPLICATION NO. ______________________
PARPO II RECOMMENDATION
Pursuit to DAR Administrative Order No. 2 Series of 2018, as amended, and Memorandum
Circular No.___, Series of 2018, the undersigned hereby recommends the Grant or Denial of the
Following titles.
EP/CLOA No./title REGISTRY OF AREA REGISTERED LOCATION
NO DEEDS (ROD) (sqms) OWNER
______________ ___________ _____ __________ _________
______________ ___________ _____ __________ _________
______________ ___________ _____ __________ ________
The recommendation is made to correct the technical descriptions in the aforesaid
Tittles based on the correct technical description as certified by the DENR-LMS/LRA in the following
Manners:
Title No. Erroneous Technical Description Corrected Technical Description
(EP/CLOA)
_________ __________________________ _________________________
_________ __________________________ _________________________
_________ __________________________ _________________________
Attached herewith a certified copy of the correct technical descriptions as certified by
The DAR-LMS/LRA for the aforesaid Eps/CLOAs/other tittles.
Respectfully submitted.
__________________________________________
Signature over Printed Name of PARPO II
___________
DATE
