REPUBLIC OF THE PHILIPPINES

PROVINCE OF PANGASINAN
CITY OF SAN CARLOS
BARANGAY OF _______________

CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that a certain parcel of land identified as Lot No.

_______________________________________, Cad./PLS No. _______________ covered with OCT/TCT
No. ____________ in the name of ___________________situated at Barangay
_______________________, Municipality/ City of SAN CARLOS , Province of Pangasinan with a total area
of _______________ is NOT COVERED UNDER TENANCY AGREEMENT in any form (registered or
unregistered).

This is to certify further that said parcel of land DID NOT UNDERGO PREMATURE CONVERSION
OR DEVELOPMENT OF LAND.

That said parcel of land described above has no pending Civil Case or Claim and Conflicts as per
our records as of this date and no boundary encroachment on the adjoining lots.

Issued for legal and reference purpose this 26th day of January 2024 at Barangay
______________________, City of San Carlos, Province of Pangasinan.

___________________________
Punong Barangay