RIGHT-OF-WAY OF CANAL

for
_________________________________________

______________________________
Address

______________________________
Date

TO WHOM IT MAY CONCERN:

I, ___________________________________, a resident of the Municipality of ___________, Province of __________ hereby

declared as the registered owner of Lot. No. _____________ situated in the Municipality of ______________ do hereby
agree to waive the right to present any and all claims for compensation of the irrigation canal and/or facilities
to be constructed/improved to be covered under the project “_____________________________” for as long as the
system is in operation. In the event that such structure and/or canals are no longer in use, I reserve the right
to automatically repossess said portions of lands therein occupied.

______________________________
Name of Landowner

Witnesses:

______________________________

______________________________
ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES . . . . . ..)

PROVINCE OF ____________________________) S.S.
MUNICIPALITY OF ___________________________

--------------------------------------------------------X

BEFORE ME, a notary Public for and in the Province ________________________________ this _____________ day
of ___________________________, 20___ at ____________________________ personally appear ____________________________ with
_______________________________ No. _____________________________ issued at ______________________ known to me to be the
same person who executed the foregoing instrument and acknowledged to me the same as his/her free act
and deed.

NOTARY PUBLIC

Until____________
PTR No.__________
Issued at_________
Issued on_________

Doc. No.___________
Page No.____________
Book No.____________
Series of ________