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08-5 Application for Guano Permit

MGB quarry application form for guano permit

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Republic of the Philippines
PROVINCIAL/CITY MINING REGULATORY BOARD (P/CMRB)
Province/City of ________________

APPLICATION FOR GUANO PERMIT
Kind of Guano Permit Applied for:___________________________________________
(state whether Gratuitous or Commercial)
Applicant ______________________________________________________________
Date Filed ______________________________________________________________
Address _______________________________________________________________
Citizenship ____________________________________________________________
Civil Status ____________________________________________________________
Location/Area of Interest __________________________________________________
Size of Area Applied _____________________________________________________
In accordance with the provisions of the Philippine Mining Act of 1995 and the
Revised Implementing Rules and Regulations (IRR) promulgated thereunder, the
undersigned citizen of ______________________, for and in behalf of
_______________________, has the honor to apply for a _______________________
(state whether Gratuitous or Commercial Guano permit) to extract and dispose
________________ cubic meters of guano from the areas/caves, which have been duly
identified/located.
1.

The applicant agrees that the statements made in the application or made later in
support thereof, shall be considered as conditions and essential parts of the Guano
Permit that may be granted by virtue thereof, and any falsehood in these
statements or omission of facts which may later change, or affect substantially the
facts set forth in said statements shall be sufficient cause for the nullification of
the Permit granted.

2.

The applicant further agrees to submit additional requirements should the
Provincial/City Mining Regulatory Board deem it necessary.

3.

This application is for the exclusive use and benefit of the applicant, and not
either directly or indirectly for the benefit of any other person.

4.

The application fee of P ____________ has been paid under the Official Receipt
No. _________________ dated __________________.

5.

The foregoing statements are hereby verified to be true to the best of the
applicant’s knowledge and belief.
_______________________, Philippines ______________, 19____.

___________________________
Applicant
TIN _______________________

ACKNOWLEDGEMENT

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MGB Form No. 08-5

Republic of the Philippines
)
Province of _______________ )s.s.
City/Municipality of ________ )

SUBSCRIBED AND SWORN to before me, at the place aforesaid, on this
____________ day of _________________, 19 ________. The affiant exhibited to me
his/her Community Tax Certificate No. ____________ issued at __________________
on the ___________________ day of ___________________, 19 _______________.

____________________________
NOTARY PUBLIC
Until Dec. 31, 19 ____
PTR No. ___________

Doc. No.
Page No.
Book No.
Series of

___________
___________
___________
___________

INSTRUCTION

1.

This application shall be accomplished in quintuplicate, two copies to be retained
by the applicant, the original and one copy to be forwarded to the Provincial/City
Mining Regulatory Board and the remaining copy for the files of the MGB
Regional Office.

2.

All pertinent information required shall be given, inapplicable word canceled, and
all blanks shall be filled up.

3.

Application not accompanied with all the required documents shall not be
accepted.

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