Republic of the Philippines

Province of Iloilo
Municipality of Calinog

OFFCIE OF THE SANGGUNIANG BAYAN

________________
Date

APPLICATION FOR MEMORIAL PARK

(Final)

HON. ROY D. CASTOR

Chairman, Committee on Housing and
Land Utilization
Municipality of Calinog

SIR:

In accordance with Sec. 4 of P.D 957 and its implementing Standard, Rules and
Regulations, as amended by Executive Order No. 648 dated 07 February 1981 I am
applying for final approval for Memorial Park Project having an area of
_________________ square meters, containing __________________ number of lots.

Attached hereto are the lists of requirements for final approval and approved
pertinent papers for Preliminary Approval.

Very truly yours,

__________________
Applicant

Reg. No. ____________ Address: __________

PTR No. ____________ Tel. No. __________
T.A.N ______________

Subscribed and sworn to before me this ______________ day of

__________________ 2004 ________ affiant exhibiting his/her Residence Certificate
No. ________________ issued at _________________ on ____________________.

WITNESS MY HAND AND SEAL.

NOTARY PUBL.IC
Doc. No. ______________
Page. No.______________
Book No. _____________

Application No.______________ HOUSING AND LAND USE REGULATORY

BOARD
Date: of Receipt______________
_____________________________________________
PMO No. / O.R. No.__________
_____________________________________________
Date of issued_______________
Amount Paid________________