Republic of the Philippines

DEPARTMENT OF AGRARIAN REFORM

DAR CLEARANCE
Under AO 6 Series of 2016
APPLICATION FORM
AF Official Receipt # ________________
Date: _______________
To:

The Provincial Agrarian Reform Program Officer

DARPO-Cavite
Name of the Transferee: ___________________________________________
Address:

___________________________________________

Male _____ Female ______

Nationality: _____________

Name of the Transferor: ___________________________________________

Address:

___________________________________________

Male _____ Female ______

Nationality: _____________

Property Profile:
Area:
Tax Declaration __________________________________________________
Location:

__________________________________________________

Actual Use: Agricultural ___ not: ___ Under Agricultural Leasehold ______ not: ____ (just check)
Status of the Land : (awarded land, TAL, or DAL) _____________________________
Mode of Transfer : (sale, donation, consolidation of ownership, mortgage, extrajudicial settlement, self-adjudication, etc.)

Signature: Transferor/Transferee __________________________