DHSUD HOACD Form No.

2021-004

CERTIFICATION

In connection with the registration of ___________________________________

located at _____________________________________, I hereby certify:

1. That the territorial jurisdiction of ___________________________________

covers:

a. The entire __________________________________________________ as

shown in the attached subdivision plan;
b. Phase(s) ______________ of ____________________________________
as shown in the attached subdivision plan;
c. The unsubdivided parcel of land covered by title no. ___________________
with its boundaries as shown in the attached location or vicinity map;

2. That NO homeowner’s association presently exists within our subdivision, village or

community, and/or duly registered with the Department of Human Settlements and
Urban Development, Housing and Land Use Regulatory Board, Home Financing
Corporation or Home Insurance and Guaranty Corporation, and/or Securities and
Exchange Commission.

3. Since the subdivision is divided by phases and/or the territorial boundaries may be
delineated, there are _____________ homeowner’s associations existing therein,
namely:

a. _________________________________________________________ ;
b. _________________________________________________________ ;
c. _________________________________________________________ .

4. That the nearest registered homeowner’s association existing is

_____________________________________________________ located at
_________________________________________, which is approximately
_______ kilometers away from our association

IN WITNESS WHEREOF, I hereby affix my signature on this _______________ at

__________________.

______________________________
Association President

SUBSCRIBED AND SWORN TO before me this ____________ at ___________, affiant

exhibiting to me his/her ________________ issued on _______________ at
_______________________.

NOTARY PUBLIC

Doc No. ______

Page No. ______
Book No. ______
Series of _______