RURAL BANK OF LANUZA (Surigao del Sur), INC.

Brgy. Puyat, Carmen, Surigao del Sur

REGISTER OF DEEDS / ASSESSOR'S CONFIRMATION
Date:_____________
REGISTER OF DEEDS / MUNICIPAL ASSESSOR
TANDAG SDS / Municipality of _______________
SUBJECT: OCT / TCT / TD/s #_________________________________________
DECLARED OWNER: __________________________________________
Dear Sir / Madam:
We would like to appreciate very much if you could provided us the following
information about the above stated subject/s by accomplishing and filling up the form
below.
It is understood that any information you will furnish us will be kept strictly
confidential.
Thank you very much.
Very truly yours,
Wilberto C. Tupas
Manager
(Please Detach)
----------------------------------------------------------------------------------------------------------SUBJECT: OCT / TCT / TD/s # : ______________________________________
DECLARED OWNER: ______________________________________________
Is this property free from any encumbrance? (Yes _____) (No _____)
If NO, what bank or financial institution is it encumbered? ________________________
Is this property free from any litigation? (Yes _____) ( No _____)
If NO, who filed for the annotation of Lis Pendens? ____________________________
Is the attached Tax Declaration the latest revised edition? (Yes _____) (No _____)
If NO, what year is its latest revision and how much is its FMV? _______ P__________
Other related information, if any:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
___

REGISTER OF DEEDS / MUNICIPAL ASSESSOR

Municipality of ____________