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Residential Free Patent Application
DENR application form for residential free patent
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Republic of the Philippines
Department of Environment and Natural Resources
NATIONAL CAPITAL REGION
L & S Building, 1515 Roxas Boulevard, Manila
APPLICATION FOR RESIDENTIAL FREE PATENT
Application No.: ___________________________________
Entry No. _____________
Name of Applicant: ___________________________________________________________
Mailing Address of Applicant: ___________________________________________________
Citizenship: _____________________ Civil Status: ________________ Sex : ____________
Age: _____________ If MINOR, name of legal guardian ______________________________
Date of Birth: _______________ Place of Birth: _____________________________________
Name of Spouse: ____________________________________________________________
Contact Nos. : _______________________________________________________________
Location of residential land applied for:
No./Street
Barangay
Municipality/City
___________________
__________________________
_______________________
Description of residential land applied for:
Lot #
Block #
Survey #
Area (Sq.M.)
_____________
________________________
__________
___________________
Applicant’s predecessor-in-interest (if Any) : ________________________________________
Date of entry by applicant or predecessor-in-interest upon the residential land applied for: (on
or about) _________________________ .
I declare, under the penalties of perjury, that my total land holdings are not more than
12 hectares and that this application has been made in good faith and to the best of my
knowledge all information contained herein are true and correct.
______________________________
Applicant’s Name and Signature
CTC/I.D. No. : ___________________
Issued On : ___________________
Issued At
: ___________________
SUBSCRIBED
AND
SWORN
TO
before
me
_____________________ at _____________________________.
this
_______day
of
______________________________
Office Authorized to
Administer Oath
This form is not for sale.
This form must be accomplished in five (5) copies.
