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Foi Request Form

This document is an FOI request form from the Department of Environment and Natural Resources Environmental Management Bureau Regional Office No. IV – A CALABARZON. The form requests information such as the title of the requested document, date, purpose, requester's details and required identification. It also specifies the types of requests that can be made including for certifications, appeals/motions for reconsideration and availability of documents. The form must be signed, include contact information and payment before a decision maker can approve or disapprove the request.

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Leo De ocampo
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505 views2 pages

Foi Request Form

This document is an FOI request form from the Department of Environment and Natural Resources Environmental Management Bureau Regional Office No. IV – A CALABARZON. The form requests information such as the title of the requested document, date, purpose, requester's details and required identification. It also specifies the types of requests that can be made including for certifications, appeals/motions for reconsideration and availability of documents. The form must be signed, include contact information and payment before a decision maker can approve or disapprove the request.

Uploaded by

Leo De ocampo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

FOI REQUEST FORM

Department of Environment and Natural Resources


Environmental Management Bureau
Regional Office No. IV – A CALABARZON
6th Floor DENR by the Bay Bldg., Roxas Blvd., Ermita, Manila
Telefax (02) 8536-3095
E-mail address: calabarzon@emb.gov.ph/recordscalabarzon@emb.gov.ph
Website: www.calabarzon.emb.gov.ph

FOI REQUEST FORM


EDATS NUMBER:
RELEASING TIME/DATE:
ACTION OFFICER:
TITLE OF DOCUMENT:_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
DATE (mm/dd/yyyy): _____________________________________________________________________________________
PURPOSE: _____________________________________________________________________________________
_____________________________________________________________________________________

REQUESTING PARTY:

a DENR Official/Employee, assigned at: _____________________________________________________

not a DENR Official/Employee with permanent personal address at:__________________________


_____________________________________________________________________________________________

Requirements:
REQUEST FOR:
___This request
___SPA for Representative
a certification of (pls check appropriate boxes)
___Valid ID (any of the following)

APPEAL/MOTION FOR RECONSIDERATION FILED A. DENR ID


APPEAL MEMORANDUM FILED B. Any Government ID
AVAILABILITY OF DOCUMENTS
C. Company ID
OTHERS (pls specify)_______________________________________
D. GSIS E-card
E. SSS ID
Authorized copies of documents
F. IBP ID
Photocopy/ies G. PRC ID
H. Passport
____________________________ ____________________________ I. Driver’s License
Signature over printed name Date J. Voter’s ID
K. Postal ID
____________________________ ____________________________ L. School ID
Contact No./s Email address M. Brgy. Captain Certificate
N. Senior Citizen’s ID
DECISION Reason/s for disapproval:
MAKER PAYMENT

APPROVED PHP _____________________


EDATS NUMBER:

DISAPPROVED
OR No. __________________
SIGNATURE/
DATE Date _____________________

………………………………………………………………………………………………………………………………………………
Department of Environment and Natural Resources
Environmental Management Bureau
Regional Office No. IV – A CALABARZON
6th Floor DENR by the Bay Bldg., Roxas Blvd., Ermita, Manila
Telefax (02) 8536-3095
E-mail address: calabarzon@emb.gov.ph/recordscalabarzon@emb.gov.ph
Website: www.calabarzon.emb.gov.ph
RELEASING DATE: ______________________ ACTION OFFICER: _______________________

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