CARPER LAD Form No.

70-C

Republic of the Philippines

DEPARTMENT OF AGRARIAN REFORM
Region No. ________
Province of ____________________

REQUEST FOR ANNOTATION OF THE NAMES OF ARBs IN THE EXISTING

COLLECTIVE CLOAs (CCLOAs)

______________________
Date

FOR : ____________________________________
Register of Deeds

FROM : ____________________________________
Provincial agrarian Reform Program Officer

SUBJECT : Request for Annotation of the Names of Agrarian Reform Beneficiaries

(ARBs) in the Existing CCLOAs on File at ROD

This refers to the parcelization of CCLOA determined by DAR for subsequent issuance of individual
computerized titles (c-Titles) to ARBs concerned in accordance with Administrative Order (AO) No.
01, Series of 2021, titled “Revised Guidelines and Procedures on the Parcelization of Landholdings
with Collective Certificates of Land Ownership Award”, described as follows:

CCLOA Serial No. : ______________________________

OCT/TCT No. : ______________________________
Lot No. and Survey No. : ______________________________
Sequence No. : ______________________________
Total Area (sq.m.) : ______________________________
Total ARBs : ______________________________
Total Male : ______________________________
Total Female : ______________________________
Location of Property : ______________________________

In view thereof and in accordance with pertinent rules and regulations, we are requesting the
annotation of all names of ARBs concerned in the DAR approved and certified List of
ARBs/Masterlist of ARBs/Amended Masterlist of ARBs in the CCLOA on file at ROD in order to
process the parcelization of the said CCLOA. (see attached copy List of ARBs/ Masterlist of
ARBs/Amended Masterlist of ARBs)

Very truly yours,

__________________________________________
Provincial Agrarian Reform Program Officer II
(Signature over Printed Name)

Copy Distribution:
Original – ROD
Duplicate - DARPO