LTC Form No.

1
Republic of the Philippines)
City of Butuan )S.S.

APPLICATION FOR ISSUANCE OF LAND TRANSFER CERTIFICATE

WE, the heirs of EUSTIQUIO B. ORBOC and CANDIDA C. ORBOC namely:

CHARLITA ORBOC BELDERA, of legal age, Filipino, married to Dominador

Beldera, and with residence and Purok 2, Ong Yiu, Butuan City City;

FERNANDO C. ORBOC, of legal age, Filipino, married to Ramonita N. Orboc, and

with residence and postal address at Purok 5, Bading, Butuan City;

NORMA ORBOC VILLANUEVA, of legal age, Filipino, married to Paul Eldepous

M. Villanueva, and with residence and postal address at Purok 1, Bading, Butuan
City;

MARLITA ORBOC EVALLAR, of legal age, Filipino, married to Nelson C. Evallar,

and with residence and postal address at Brgy. Bancasi, Butuan City;

GENITA ORBOC ORAJAY, of legal age, Filipino, married to Rosemeller Orajay,

and with residence and postal address at Brgy. Bancasi, Butuan City;

Heirs of LEONARDO C. ORBOC, represented by LEAMAE P. ORBOC, of legal

age, Filipino, single, and with residence and postal address at Purok Silangan,
Agusan Pequeńo, Butuan City;

Heirs of JULIETO C. ORBOR, represented by ELIZABETH O. OCLIASA, of legal

age, Filipino, married, and with residence and postal address at Ireland; and

Heirs of EMMANUEL C. ORBOC, represented by MICHAEL R. ORBOC, of legal

age, Filipino, married, and with residence and postal address at Purok 6, Bancasi,
Butuan City.

1. We are the parties in a Extra Judicial Settlement of the Estate of Spouses

EUSTIQUIO B. ORBOC and CANDIDA C. ORBOC involving:

a. A parcel of Agricultural Land with an area of 1.2227 has situated in Brgy.

Cabcabon, Butuan City under Tax Declaration No. 20-11-0005-00037;
b. A parcel of Agricultural Land, a portion of Lot No. 218, CAD 84, with an area
of 1 ha situated in Brgy. Cabcabon, Butuan City under Tax Declaration No. 20-
11-0005-00039; and
c. A parcel of land, Lot No. 759-A, Psd-10-008875, with an area of 20,000 square
meters situated in Brgy. Baobaoan, Butuan City under TCT No. T-4217;

2. This application for the issuance of Land Transfer Clearance (LTC) is not
contrary to law because all of us are qualified to dispose and acquire the land
described above. In addition, the said land is neither covered under the agrarian
reform program nor within the CARPER LAD Balance, and that the
deed/contract will not violate the retention limit provided under the law;

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3. In support thereto and in compliance with DAR A.O. No. 04, Series of 2021, the
mandatory documents are hereto attached and made integral parts hereof as
(please check appropriate box);

1. GENERAL REQUIREMENT

a. OR of filing fee (upon release) : Annex _____

b. Deed of conveyance, original and notarized : Annex _____
c. E-copy of title issued within 6 months from the : Annex _____
date of filing of application or Certified true
copy of the current Tax Declaration, if land-
holding is untitled
Municipal Agrarian Reform Program Officer
Certification (LTC Form No. 2)

2. FOR THE TRANSFEROR

a. Affidavit of Retention, Non-Tenancy/ : Annex ____

Tenancy with compliance of tenant’s right of
Pre-emption and/or redemption and no
pending case before the regular courts or any
other tribunal involving the land subject of
the transaction, if there is a case before the
regular courts or any other tribunal, the same
had been decided with finality (To be
executed by all the transferor individually)
b. Municipal Assessor’s Certificate of Aggregate : Annex ____
Landholding
c. City Assessor’s Certificate of Aggregate : Annex ____
Landholding
d. Provincial Assessor’s Certificate of Aggregate : Annex ____
Landholding

3. FOR THE TRANSFEREE

a. Affidavit of Aggregate Landholding (to be : Annex ____

executed by each of the transferee
individually)
b. Municipal Assessor’s Certificate of Aggregate : Annex ____
Landholding
c. City Assessor’s Certificate of Aggregate : Annex ____
Landholding
d. Provincial Assessor’s Certificate of Aggregate : Annex ____
Landholding

4. Having submitted/attached hereof the mandatory documents as required

under DAR A.O. No. 04, Series of 2021, we hereby file this instant
application/request to facilitate the issuance of the corresponding Certificate
on LTC.

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 IN WITNESSS WHEREOF, we have hereunto set our hands, this _____ day of
August 2023 at Butuan City, Philippines.

The Heirs of EUSTIQUIO B. ORBOC and CANDIDA C. ORBOC:

CHARLITA ORBOC BELDERA DOMINADOR BELDERA

Applicant Spouse

FERNANDO C. ORBOC RAMONITA N. ORBOC

Applicant Spouse

NORMA ORBOC VILLANUEVA PAUL ELDEPOUS M. VILLANUEVA

Applicant Spouse

MARLITA ORBOC EVALLAR NELSON C. EVALLAR

Applicant Spouse

GENITA ORBOC ORAJAY ROSEMELLER ORAJAY

Applicant Spouse

Heirs of LEONARDO C. ORBOC Heirs of JULIETO C. ORBOR

Rep. by LEAMAE P. ORBOC Rep. ELIZABETH O. OCLIASA
Applicant Applicant

Heirs of EMMANUEL C. ORBOC

Rep. by MICHAEL R. ORBOC
Applicant

SUBSCRIBED AND SWORN TO BEFORE ME, this _____ day of August 2023 at Butuan
City, Philippines. Affiants exhibited to me their duly issued government IDs with
details stated above.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2023.

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