HLURB MC No.

Series of 200___
Form No. 001
Annex _____

REGISTRATION STATEMENT
(For Corporation)
I, _______________________________, Filipino of legal are, single/married,
with postal address and residence at _______________________________________,
after being sworn to in accordance with the Law do hereby depose and state the
following:
1. That I am the _________________________ of __________________________
with postal address at ______________________________________________.
2. That
the
name
and
address
of
the
Directors,
Officer
of
__________________________________________________ are as follows:
(Corporation)

________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
3. That the general character of the business being conducted by
______________________________ is _____________ with a capitalization of
________________________________ (P ______________ ) broken down as
follows:
Authorized _____________________ (P _________________ )
Subscribed ____________________
(P _________________ )
Paid up ________________________ (P _________________ )
4. a. That the corporation is both the owner and developer of certain parcels of land
hereinafter called _________________________________________ situated at
_______________________________________ and covered by TCT Nos.
______________________________________ comprising an aggregate area of
________________ sq.m.; or
b. That the said corporation is the developer of certain parcel(s) of land
hereinafter called ____________________________________ situated at
______________________________
and
covered
by
TCT
No.(s)
_________________________________ comprising an aggregate area of
_________________________________;
(Delete which is not applicable)

5. That our authorized broker(s) shall be __________________________________

________________________________________________________________
________________________________________________________________
________________________________________________________________

6. That is our capacity as owner and/or developer, we bind ourselves to comply with
all the rules and regulations pertaining to this project and shall be held
responsible for all the facilities, improvement infrastructures and similar form of
development hereon.
_________________________________
(Date)

________________________________
(Place)

________________________________
AFFIANT
Conforme:

________________________________
Owner
(If No. 4b applies)
ACKNOWLEDGEMENT
SUBSCRIBED AND SWORN to before me this _______ day of __________, Affiant
exhibiting before me his/her Community Tax Certificate No. __________________
issued at ______________________ on _______________.

Doc No. ______

Page No. _____
Book No. _____
Series of ______

Notary Public