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AFFIDAVIT OF LOT OWNER’S CONSENT

KNOWN ALL MEN BY THESE PRESENTS:

I, _______________________________, single/married, Filipino, a legal age, and a resident


of ___________________________________, hereby depose and state, that:

This is to CONFIRM that I have allowed the erection of pole/s on my


property located in Sitio/Zone ______________________Brgy.
, City/Municipality of ,Philippines.

I am completely aware that the said poles will be utilized for FOC Laying under PLDT
FIBERGEN Expansion Project.

Confirmed by: Noted by:

__________________________________ ________________________________
Lot Owner / Authorized Representative ROW Engineer/ZTE Phils Inc.
(Signature over Printer Name)
Contact No: ________________________ .
Date: _____________________________

SITE NO: ________________

POLE NO. COORDINATES (LAT/LON)

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