You are on page 1of 1

BPI "Q" Form No.

17
Republic of the Philippines
Department of Agriculture
BUREAU OF PLANT INDUSTRY

NATIONAL PLANT QUARANTINE SERVICES DIVISION


PLANT QUARANTINE SERVICE-LEGAZPI R5

CLEARANCE FOR DOMESTIC TRANSPORT OF No. LGZ-1624-21


PLANTS/PLANTING MATERIALS/PLANT PRODUCTS Date: 17-Sep-21

To the Station Manager:

This is to certify that the plants/planting materials/plant products described below have been inspected by the
undersigned and were found to be substantially free from any plant pests and diseases and are hereby allowed
to be transported from CAMARINES NORTE to LEYTE .

Name, Address and Contact No. of Sender : MARLON R. MALALUAN


OCEAN GROWN PLANT NURSERY, DAET, CAMARINES NORTE
Name, Address and Contact No. of Consignee : ALEXANDER SALVADOR DE PAZ
BRGY. LIBERTY, MAYORGA, LEYTE
Name, Kind and Quantity of
Plants/Planting Materials/Plant Products : 1 RED BEAUTY, 1 GREEN PRINCESS, 1 BLACK CARDINAL
2 LINDENII, 1 CALATHEA CORA
1 BLACK PRINCE, 2 BIRKINS
Source of Plants/Planting Materials/Plant Products : DAET, CAMARINES NORTE
Declared Means of Conveyance : JRS EXPRESS
Additional Information : EXCEPT COCONUT PLANTING MATERIALS AND OTHER PALM SPECIES

Inspected by:

MA. CARMELA C. BANDALES


OFFICIAL Signature over Printed Name of
SEAL OF SERVICE Plant Quarantine Inspector
By the Authority of the Director:

FIVE (5) DAYS VALIDITY AFTER ISSUANCE DANILO L. DOBLON


Signature over Printed Name of
Plant Quarantine Officer

You might also like