EO 34 Inventory of Lands (LGUs)

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DHSUD Form B

Inventory of Idle Government-owned Lands based on LGU data

LGU: _____________________________________________________________

TCT No./ Total Land Area Idle/Vacant Land Zoning Idle Land
City / Municipality Province Region Owner Location Actual Land use1 Remarks
Issuance No. (in sqm.) Area (in sqm.) Classification2 Category3

Note:
Actual Land Use: residential, commercial, institutional, industrial, agricultural, others
1

Zoning Classification: residential, commercial, institutional, industrial, agricultural, others


2

Idle Land Category:


3

(a) Government-owned idle lands or lands that have not been used for the purpose for which they have been originally reserved or set aside for at least ten (10) years, and on which no improvements have been made by the owner.
(b) Idle/vacant portion of partially utilized government lands;
(c) Government lands occupied by informal settlers, whether for residential, commercial, or industrial use;
(d) Government properties where derelict/abandoned/blighted structures that require replacement or redevelopment are situated;

We hereby declare under oath that the information reported in this form is true, correct and complete to the best of our knowledge as of date herein submitted. Should there be any additional information or updates, we commit to provide such information to DHSUD pursuant to EO
34, s. 2023. We further authorize the DHSUD to verify/validate the contents stated in herein report. We understand that the deliberate witholding or concealing of information shall be subject to corresponding penalties or liabilities based on pertinent provisions of laws, rules and
regulations of the Republic of the Philippines.

Prepared by: Approved by:

(Name and Signature)___ (Name and Signature)___


(Designation/Office) Head of Office/Authorized Designated

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Agency Representative

Date: : ___________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)


____________________________ ) S.S.

BEFORE ME, a NOTARY Public, for and in __________________, Philippines, this ______ day of ___________________, 2023 personally appeared and exhibited to me their government-issued IDs, as
follows:

Name Government ID Date/Place of Issue

NOTARY PUBLIC

Doc. No. ____;


Page No.____;
Book No. ___;
Series of 2023.

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