Republic of the Philippines

DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS

National Capital Region
2nd Street, Port Area, Manila
Road Project/Flood Control: _______________________________ Lot No.:
Name of Project:
Location: Total Floor Area:
Name of Claimant:
Total Amount: _________________________________________ Area Affected: _________________________
Payments Made: ________________________________________
Unpaid Balance: ________________________________________ Acquired width of ROW: _________________

CHECKLIST OF DOCUMENTS
(Per D.O. 185, Series of 2002)

A. FOR LOTS PARTICULARS REMARKS

______1. Deed of Absolute Sale signed by the owner and the duly authorized
personnel of the DPWH; ATTACHED___________________________
______2. Original or Transfer Certificate of Title certified as true copy by the
Registrar of Deeds. OCT/TCT No.; ATTACHED _______________________
______3. Tax Declaration certified as true copy by the Assessor’s Office
Tax Declaration No.; ATTACHED ___________
______4. Really tax clearance issued by the local treasurer; ATTACHED ___________
______5. Certification by the Regional Director that the said lot is within the
boundaries of the right-of-way limits as shown in the Parcellary survey
plan and/or structure mapping plan; ATTACHED ________________________
______6. Certification by the Planning Service that the claim is not within the
ROW of a converted provincial road. ATTACHED __________________________
______7. Basis of valuation of affected lots (Zonal Valuation/Appraisal Committee/
Independent Land Appraiser/ Court Order/etc.); ATTACHED /
______8. Original Parcellary survey plan and/or verification survey plan with sketches
certified correct by Regional Director or Project Director; ATTACHED_______________________
______9. DENR approved subdivision plan for partially affected property; N/A___________________________ ____
______10. Certification by the IO that there is no previous pending claim or
no payment received (for properties without partial payment; ATTACHED__________________________
______11. Project Profile of the project certified correct by the Regional Director
or Project Director; ATTACHED___________________________
B. FOR IMPROVEMENTS/STRUCTURES
______1. Agreement to Demolish and Remove Improvements signed by owner __________ _____________
______2. Tax Declaration certified as true copy by the Assessor’s Office,
Tax Declaration No.; ATTACHED (PHOTOCOPY) _
______3. Realty Tax Clearance issued by the Local Treasurer; ATTACHED (PHOTOCOPY) ___
______4. Certification by the Regional Director of Project Director that the said
improvements/structure is within the boundaries of the right-of-way
limits as shown in the Parcellary survey plan and/or structure mapping plan; _____

______5. Bill of materials, cost estimates for improvements/structure, certified by the

head of Implementing Office or validated by Ad Hoc Committee; _____________________ __
______6. Clear photographs (before, during and after improvements/demolition) Separate Claim
of the structures certified by Head of Implementing Office; ___________________ ____
______7. Structural mapping plan certified correct by the Regional Director or
Project Director; _____________ __________
______8. Certification by the IO that there is no previous pending claim or no payment
received (for properties with our partial payment); ____________ ___________
______9. Certification by Assessor’s Office, Barangay Captain and land owner that the
claimant for improvements/structure resided in the property before the
cut-off date; _____________ __________
______10. Project Profile of the project certified correct by the Regional Director or
Project Director; ______________ _________
______11. Appraised value of trees and crops, certified by Provincial/City/MMDA Assessor. _________________________ ___

Prepared by: Reviewed by: