rd

3 TELECOMMUNITY
DEED OF CONFIRMATION

I Ms./Mr./Mrs. _______________________________________ of legal age, and resident of

_________________________________________________________ after having known that
Ms./Mr./Mrs._________________________________________ is an agent who came to me to
introduce the benefits of MAHARLIKAN 3RD TELECOMMUNITY TOWER PROJECTS called Transmission
Cell Site to be built on my parcel of land measuring 300-500 sqm only, and to be rented for a period of
thirty (30) years by the said company.

I recognize well the efforts exerted by him/her, hence, I hereby state to voluntarily give an amount of
One Million Pesos (amount in words) P1,000,000 (amount in figures) as consolation, and for his/her
satisfaction too, once this endeavor is approved and realized.

Therefore, for the truthfulness of this note, I, hereby affix my signature below, dated this______ of
________________________2023.

________________________________

Name & Signature of Land Owner

I Ms./Mr./Mrs. _______________________________________ of legal age, and resident of

_________________________________________________________ hereby confirm the amount to be
given by the landowner, and agree to equally share the amount of One Million Pesos (amount in words)
P1,000,000 (amount in figures) with the following whose names and signature appear below

________________________________ 1. ___________________________________
Name and Signature of Agent Name and Signature of Co- Agent

2._______________________________ 3. __________________________________
Name and Signature of Co- Agent Name and Signature of Co- Agent

____________________________________
Name and Signature of Group Team Leader

____________________________________ __________________________________
Name and Signature of VIP/Company Personnel Name and Signature of Company
Nationwide Coordinator
 Sept. 18, 2023
DATE:________________

TEAM VISAYAS
rd
3 TELECOMMUNITY
Land Owner Checklist
1. REGION:________________________________________________________________
VIII
2. EASTERN SAMAR
PROVINCE:______________________________________________________________
3. SAN JULIAN
CITY/MUNICIPALITY:______________________________________________________
4. SAN MIGUEL
BARANGAY:_____________________________________________________________.
5. 3,264 sq.m.
TOTAL AREA 500 SQM:_____________________________________________________
6. N/A
LAND TITLE:______________________________________________________________
7. ARP#11-200016-
TAX DECLARATION:________________________________________________________
8. 11.7192318
00142
LATITUDE:_______________________________________________________________
9. 125.452739
LONGITUDE:_____________________________________________________________
10. BRGY. SAN MEGIGUEL
LANDMARK:_____________________________________________________________
11. COVERED COURT/ BRGY EDGARDO T. LAND OWNER’S
SAN MIGUEL PAGBABANGNAN,
TOBIA/ JOSEFINA
NAME/CLAIMANT:____________________________________________
12. ELEM.SCHOOL SAN J.JULIAN,
TOBIA (WIFE) LAND OWNER’S
JOSEFINA J. TOBIA
EASTERN SAMAR
ADDRESS:__________________________________________________
13. CELL SITE
NELLY C. BOOC
LOCATOR:________________________________________________________
14. GROUP TEAM LEADER:
_____________________________________________________

PREPARED BY: CHECKED BY:

_____________________________
_____________________________ GROUP TEAM LEADER SECRETARY
GROUP TEAM LEADER

CERTIFIED CORRECT BY: SUBMITTED BY:

_______________________________
______________________________
VIP/COMPANY PERSONNEL COMPANY NATIONWIDE
COORDINATOR