Republic of the Philippines

City of Las Piñas

ZONING ADMINISTRATION UNIT

APPLICATION FOR LOCATIONAL CLEARANCE

(PLEASE FILL-UP COMPLETELY)
Application No. _________________
Date Received: _________________
Received by: ___________________
A. TITLE/DESCRIPTION OF PROJECT: _______________________________________________________________

B. PROJECT OWNER/APPLICANT:

Name: ______________________________________________________________________

Address: ____________________________________________________________________

Name of Authorized Representative: _____________________________________________

Address: ____________________________________________________________________

C. NATURE OF APPLICATION

___New Application ___Renewal of TUP ___Reconsideration Others: _______________________

D. PROJECT TYPE

___New Development/Construction ___Additional/extension/expansion

___Improvement/Renovation Others: _____________________________
E. LOCATION

____________ ___________________________ __________________ ______________

No./Lot & Blk. Street/Subd./Vill. Barangay District
F. PROJECT DESCRIPTION

Lot Area: _________ sq. m. Total Floor Area: __________ No. of Storey/s:__________

G. RIGHT OVER LAND:

_____ Owned _____Leased Others: ____________________________

H. Is there a pending criminal/administrative case and/or complaint relative to the project/activity? _________
If yes, state of nature of case and/or complaint: ___________________________________________
I. ATTACHMENTS:
- Location Plan (Lot Plan), Site Development Plan/Sketch/Architectural Plans
- Certified True Copy of TCT, Current year tax receipt, tax declaration, lease contract when applicable
- Barangay Clearance, Homeowner’s Clearance, Neighbor’s Consent
- Authority to Sign (Corporate Secretary’s Certificate)

I HEREBY DECLARE UNDER THE PENALTIES OF PERJURY THAT THE ABOVE INFORMATION HAS BEEN FURNISHED IN
GOOD FAITH, VERIFIED BY ME, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, ARE TRUE AND CORRECT.

__________________________________________
Signature of Owner/Applicant over Printed Name
ACKNOWLEDGEMENT

Republic of the Philippines)

City of Las Piñas ) S.S.

SUBSCRIBE AND SWORN TO before me this _____ day of ________________, 20___ in the City/Municipality of
_________________ province of ________________________ affiant, exhibit to me his/her Community Tax
Certificate No. _____________________ issued at ____________________ on _____________________, 20___.

Doc.No. _______
Page No. _______ NOTARY PUBLIC
Book No. _______
Series of ________