R E PUBLIC O F THE PHI L IPPINES
Department of Human Settlements and Urban Development
Kagawaran ng Pananahanang Pantaa at Pagpapaunlad ng Kalunsuran
NATIONAL CAPITAL REGION
APPLICATION FORM FOR ZONING CERTIFICATION
1. Name of Applicant
2. Address of Applicant
3. Name of Owner
4. Location of Lot (Street, Barangay, Municipality, Province)
5. Total Area of Lot (in square meter)
6. Right over Land
[ ] Owner [ ] Lessee [ ] Others (specify)
7. Preferred mode of release of certification
[ ] pick-up [ ] by mail, addressed [] by E-mail, addressed
to --------------------------------------------------------------
[ ] owner [ ] Authorized Representative
8. Signature of Applicant
9. Signature of Owner
10. Requirements
[ ] Vicinity Map drawn to an appropriate scale showing the property in question
and indicating appropriate landmarks
[] TeT (or any proof of ownership or right over the property) / Tax Declaration
O.R . Number
Date Issued
Amount Paid
Republic of the Philippines )
) S.S.
SUBSCRIBED AND SWORN TO before me this ___ day of _ _ _ _ _ _ _ _ _ _ 20
In the municipality of , province of _ _ _ _ _ _ _ _ _ _ _ __
affiant of exhibited to me hislher Residence Certificate No. _ _ _ _ _ _ _ _ _ _ issued at
_ _ _ _ __ _ _ _ _OD _ __ __ _ __
Doc. No. _ _ __
Page No. _ _ __
Book No. _ _ __ NOTARY PUBLIC