a he. Cane MENTOR y, Ae ne Se as % 8 weotved By: ie ©. Ding Fo — Hala et MEMORANDUM . he 4, : “a ya ono To 5 LL REGIONAL DIRECTORS: FROM ‘THE UNDERSECRETARY TTourlem Regulation. Coordination & Resource Generation suBECT Application for DOT Endorsement oAte August 14, 2012 ‘ir, reference to all applications for endorsement for Specisi Patent, Foreshore Lease, Miscellaneous Lease and other types of applications for DOT endorsement, plasse find attached the officiel application form to be filed up by the Supicants/oropenents together with the list of required supporting: documents that company their applications, . ‘cation and supporting documents shai subject for your evaluation prcr suance of the endorsement latter. For 1 st reference, a ff Waclib 44 Vv. JASMIN, “ \ 4 os PLO Box $489, Manga, Ps woe igunes.com. 0hwe OTSR Form-005 DEPARTMENT OF TOURISM APPLICATION FOR ENDORSEMENT OF SPECIAL PATENT, FLAG-T, MISCELLANEOUS LEASE AND. PRESIDENTIAL PROCLAMATION AS-TOURIST ZONE INSTRUCTIONS: 1. Read through the differeot items before accomplishing it 2. Submit one 1) set ofthe duly notarized completed form together with copy of other pertinent documents and Feguirements, APPLICANT Name ba i eae ae Address es eee TIN Telephone No/s. : Fax No,/E-Mall Address Nationality ; B. APPLICANT'S REPRESENTATIVE Name & Designation Address a ee SE Ne ee Telephone No/s. ——____Fantioe-mail address © PURPOSE OF APPLICATION —— Special Patent * ___ Foreshore Lease —Fuac- —— Others (ple, specify) D.AGENCY APPLICANT SEEKS TO BE ENDORSED TO —~ bepartment of Agrarian Reform (DAR) _—— Lahg Registration Authority (LRA) —— Departmentof Environment & Natural Resources (DENR) —— Others (pis. spectiy) E DEVELOPMENT PLAN FOR THE AREA Accommodation Establishments/Facilties (Hotel, Tourist Inn, Apartelle, Condotel) Resort (AAA, AA, A, Special Interest) . ‘Tourism Enterprise Zone Healthcare and Wellness Facility Retirement Vilage Others (pls. specify) © PROJECT oBTAMS Project Name 1, Seep reso eee At oa ocetion ofthe Project : Sas Sis SPE Se Size of Land (in sqm.) 2OTSR Form-005 1. DOCUMENTARY REQUIREMENTS 2 Dar | * , Notarized Board Resolution of the corporation Dor | “authorising the fellowings * Use |. a1 Authority to sign the application; Saly |, 32 Authority to transact business with the Department: and 2.3 Authority to fle the applicatton ‘association oF other entice ee cingle/sole proprietorship, novarized authortzation letter from the owner Authorizing the following: a Authority to transact business with the Department; and, a5 Authority to file the application '“Municipal/City Government endorsement oF approval of ie den lopment project ‘through a resolution/ordinance in favor of the proponent/owner Seutcation/endorsemen/non-objection oF the development FrOISe Barangay Counell through a resolution/ordinance in favort che proponent/é @ Vicinity Location Map ‘e._‘Site Development Plan 1. “Brief Project Description from the ‘owner tl CERTIFICATION 1 hereby cercify that the data and information containdd 'n his application Form and In the attached supporting docusneots soe ena correct. Done inthecity/provincs of “APPLICANT, REPUBLIC OF THE PHILIPPINES CITY/PROVINCE OF ss MUNICIPALITY OF Subserbed and sworn to before me this day of in the city/province of ‘ affant exhibltng to “me his/ber Residence Cerificare No EEE h Hes on age NOTARY PuBLIC Document No, ?