GATE PASS GATE PASS

(Gate Pass approval will only be from Mondays- (Gate Pass approval will only be from Mondays-Saturdays,
Saturdays, 8:00AM-5:00PM) 8:00AM-5:00PM)

Please allow the following items for: DELIVERY PULLOUT Please allow the following items for: DELIVERY PULLOUT
Please check (ü) and fill in the blanks Please check (ü) and fill in the blanks

Date Filled up: Date of Delivery or Pullout: Date Filled up: Date of Delivery or Pullout:
Name and Signature of Authorized Delivery/Pullout Name and Signature of Authorized Delivery/Pullout Person:
Unit Owner's Property Person: Unit Owner's Property
Tenant's Property Tenant's Property
Others:________________________ Others:________________________
QUANTITY DESCRIPTION OF ITEM QUANTITY DESCRIPTION OF ITEM
(Pls. Indicate No. & if Sets or Pcs.) (Pls. Indicate No. & if Sets or Pcs.)

1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
BLDG./ UNIT BLDG./ UNIT
UNIT OWNER AUTHORIZED REP. UNIT OWNER AUTHORIZED REP.
NO. NO.
Authorized by: Authorized by:
(Printed name & (Printed name &
Signature) Signature)

Purpose: PROPERTY MANAGER / AUTHORIZED SIGNATORY

Approved by: Checked and Recorded by: Approved by: Checked and Recorded by:

PROPERTY MANAGER / AUTHORIZED SIGNATORY Gate SG-on-Duty PROPERTY MANAGER / AUTHORIZED SIGNATORY Gate SG-on-Duty
Date & Time: Date & Time: Date & Time: Date & Time:
**Please accomplish in two (2) copies **Please accomplish in two (2) copies

DPMC Form 016- Rev 01

DPMC Form 016- Rev 01