Republic of the Philippines

DEPARTMENT OF AGRARIAN REFORM

Provincial Agrarian Reform Office- Bulacan
Castle Chateau Hotel, Bonifacio Drive
Barangay Danao, Bulacan City

June 8, 2022

Ms. HARRIET A. LOOT

OIC-PARPO II
DAR Provincial Office-Bulacan

Dear Ma’am Harriet:

May I request for the re-issuance of a DAR Clearance Certification of r4etention for my
landholdings pursuant to Republic Act (R.A) No. 6657, as amended by R.A No. 9700 with the
total area of ELEVEN THOUSAND SEVEN HUNDRED FORTY FIVE (11,745) SQUARE
METER covered by the following:

TCT No. T-1111

Lot No. 266666
Location Municipality of San Miguel, Bulacan
now Brgy. Poblacion, San Miguel, Bulacan

I certify under oath that the said landholding is the sole agricultural land I own nationwide. I
have no other agricultural land elsewhere,

Very truly yours,

MA. CARTOLINA TULA

SUBSCRIBED AND SWORN to before me this ________________ at Bulacan City. Affiant

exhibited to me her competent evidence of identity as indicated below her name.

Doc. No.________
Page No._______
Book No._______
Series of 2022.