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28 Preliminary List of Potential Agrarian Reform Beneficiaries

DAR form for list of preliminary potential agrarian reform beneficiaries

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CARPER LAD Form No. 27
(RSS Form
No. 2-A)
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Region No. _________
Province of __________________
Municipality of __________________
REQUISITION FOR SURVEY SERVICES INVOLVING LANDS FOR ACQUISITION AND DISTRIBUTION

MUNICIPALITY OF
_________________

Date:
(MM/DD/YYYY)
BOUNDARY/PERIMETER

OCT/TCT NO.

CARPER LAD FORM No. 27/ Page 1 of 2

OTHER TYPE OF SURVEY: Specify
below:

AMENDMENT/CORRECTION

SUBDIVISION

REQUISITION FOR
SURVEY SERVICES
NAME OF LANDOWNER/s
(Last Name, First Name, Middle
Initial)

TYPE OF SURVEY (PLS. CHECK APPROPRIATE BOX)

SUBDIVISION WITH PLUM

TAX DEC No.

LOCATION
(Municipality, Barangay)

PROG LAND
CATEGORY1

MODE OF ACQ2

AREA
(Has.)

ESTIMA-TED
NO. OF LOTS

REMARKS/ACTION TAKEN

Downloadable Forms at: www.dar.gov.ph free of charge
CERTIFICATIONS:

I hereby certify that the abovementioned landholdings are fully documented per attached
checklist of required documents for landholding for acquisition and distribution (RSS Form
No. 1-A) and have not been subjected to same type of survey as requested to date.

Date

Copy Distribution:
Original
Duplicate Triplicate Quadruplicate -

I hereby certify that the abovementioned landholdings have been properly
evaluated.

CARPO – Operations Division
(Signature over Printed Name)

BLD
DARPO
DARMO
DARRO

CARPER LAD FORM No. 27/ Page 2 of 2

Date

Provincial Agrarian Reform Officer II
(Signature over Printed Name)

VALID CODES
2
PROGRAM LAND CATEGORY
MODE OF ACQUISITION
1. Private Agricultural Land
1. CA
7. Settlements
2. Operation Land Transfer
2. VOS
8. KKK/GOL
3. Government Owned Lands
3. OLT/PD 27
4. E.O. 407/448
4. E.O. 407/448
5. VLT/DPS
6. Landed Estates
1
 
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