HLURB Form

APPLICATION FOR CLEARANCE TO MORTGAGE

_____________________
Date

The Regional Director

________________________________
HOUSING AND LAND USE REGULATORY BOARD
HLURB Bldg., Kalayaan Ave., cor Mayaman St.
Diliman, Quezon City

Sir:

Pursuant to Section 18 of PD No. 957 as amended and LRC Circular No. 48, the undersigned respectfully
applies for a clearance to mortgage _________________________________________________ lots/units
(No. of Lots/Units)
in ____________________________________________________________________________located at
(Subdivision / Condominium)
______________________________________________ square meters covered by Transfer/Condominium
(excluding road lots & open spaces) Certificate of Titles Nos. __________________

(use additional sheet if necessary)

Attached herewith are the following:

1. Two (2) copies of Affidavit of owner/mortgagor.
2. Two (2) copies of Affidavit of mortgage Bank.
3. One (1) Certified True Copy of Titles and list of titles to be mortgage.

____________________________________
Name & Signature of Applicant

Address : ________________________________
Telephone No. : ________________________________

SUBSCRIBE AND SWORN to before me this ______ day of ______________________ 20____,

Affiant exhibiting his/her Residence Certificate No. _____________________________________ issued at
__________________________ on ___________________________.

Doc No. _________ ______________________________

Page No. _________ NOTARY PUBLIC
Book No. _________
Series of 20_______
HLURB Form

REPUBLIC OF THE PHILIPPINES )

) S.S

AFFIDAVIT
(Mortgagee Bank)

I, _________________________________ of legal age, single/married, with residence and postal

address at __________________________________________________________ after being sworn to in
accordance with law hereby depose and say.

1) That I am the ___________________________ of the _________________________________

(State Position) (State name of Bank/Financing Institute)
property/ies of ___________________________________________________________________ located
at ___________________________________________________________________________________.
2) That the loan value of each lot/unit covered by the mortgage is
_____________________________________________________________________________________.
3) That this Bank/Financing institution shall accept direct payments made by the lot/unit buyers to
be applied to the mortgage indebtedness of the corresponding lot/unit and full payment thereof. To
release the individual titles thereat;

4) That this Bank/Financing institution shall notify, the Housing and Land Use Regulatory Board
in case of the mortgagors default of 3 months for monthly amortization and once for quarterly and
semiannualy amortization;

5) That in case of an additional loan on the same project or a restructuring of loan, this bank will
cause the mortgagor to have his previous loan in current form;

6) That as an authorized officer of the above-mentioned mortgagee bank, I hereby undertake to

partially release/cancel the mortgagee of fully paid lot(s) and/or units (s) in said
Subdivision/condominium/townhouses project notwithstanding the non-payment yet of the total mortgage
loan incurred by the mortgagor;

7) That I am executing this affidavit for and behalf of the Bank/Financing institution attesting to
the facts stated therein to comply with the requirements of the HLRB and for all legal instents and
purpose.

AFFIANT FURTHER SAYS NOTHING.

_____________________________
Affiant

SUBSCRIBE AND SWORN to before me this _______ day of ____________________________ 20___.

Affiant exhibiting before me his/her Residence Certificate No. ____________________________ issued at
___________________________________ on ________________________________.

_____________________________
NOTARY PUBLIC
Doc. No. ________
Page No. ________
Book No. ________
Series of ________
HLRB Form
HLURB Form

REPUBLIC OF THE PHILIPPINES )

______________________________ ) s.s

AFFIDAVIT
(Owner)

I, ______________________________________ of legal age, single/married, with residence and

postal address at __________________________________________________________ after being sworn
to in accordance with law hereby depose and say.

1) That I am the __________________________, of the _________________________________,

(State Position) (State name of Bank/Financing Institute)
owner/developer of ______________________________________________________________ located at
(State Subdivision)
_____________________________________________________________________________________.

2) That the said property/ies is/are to be mortgaged with _________________________________.

(State Name of Bank/Financial Institution)

3) That I shall notify the lot/unit buyers of the mortgage loan and that they shall be allowed to
make direct payments to the mortgagee bank in the even that I default in my amortization to enable
the said buyers to obtain title on the lot/unit promptly after full payment thereof;

4) That the proceed of the loan shall be used exclusively for the development of
the __________________________________________________________;
(Name of Subdivison/Condominium)

5) That I am executing this affidavit for and in behalf of abovestates corporation/partnership

attesting to the facts states therein to comply with the requirements of the HLRB and for all legal
intents and purposes.

AFFIANT FURTHER SAYS NOTHING.

_____________________________
Affiant

SUBSCRIBE AND SWORN to before me this _______ day of ____________________________ 20___.

affiant exhibiting before me his/her Residence Certificate No. ____________________________________
issued at ______________________ on ___________________________.

_____________________________
NOTARY PUBLIC
Doc. No. ________
Page No. ________
Book No. ________
Series of ________