REQUEST FOR SURVEY AUTHORITY
Date : ________________
The PENR Officer
Sta. Cruz, Guiguinto, Bulacam
Madam:
This is to request/apply for a survey authority to ____________________________Lot(s)
_____________________ Survey _____________ located in Brgy._______________,
Municipality _______________, Cavite and consisting of _______________ square
meters/hectares, more or less.
My name is __________________________ with residence and postal address at
_________________________________________________________.
I am the ( ) owner/claimant ( ) representative of said lot as evidenced by the following:
a) _______________________________________
b) _______________________________________
c) _______________________________________
d) _______________________________________
I shall abide by all the legal conditions: imposed by your agency pertaining to the survey. I
shall hire the services of Geodetic Engineer Narciso A. Vergara Jr. to execute the survey.
Hoping that this request merits your kind consideration.
Very truly yours,
__________________________ NARCISO A. VERGARA JR.
Requestee/Owner/Claimant Geodetic Engineer
______________________________ 09274855963/navjr@y7mail.com
Contact Number/ e-mail address Contact Number/e-mail address
RECORDS VERIFICATION
Lot Number: _________________________________
Survey Claimant: ______________________________
Public land Application:
__________________________
Date: ______________________ __________
Patent No : __________________________
Date: __________________________
Date of Cancellation (if any):____________________
Verification: _______________________
Date: _____________________
Referred to:
Land Investigator: ______________________________
Date: ________________________________________
REMARKS:
_____________________________________________________________________________
_____________________________________________________________________________
__________________________________________________________________
Republic of the Philippines
Department of Environment and Natural Resources
Provincial Environment and Natural Resources Office
Trece Martires City
_______________________
Date
SUBJECT:
Request for Survey Authority
For a tract of PublicLand located in
__________________________________
__________________________________
Engr. NARCISO A. VERGARA JR.
132 Aguinialdo Highway, Maitim 2nd East
Tagaytay City, Cavite, 4120
Sir/Madam:
Pursuant to DENR Administrative Order No. 38 and upon investigation and
favorable recommendation of _________________________________________, on the request of
_______________________________, who intends to avail your services for the survey of
parcel of land described above, AUTHORITY is hereby granted to you to execute survey
thereof subject to relevant provisions of the Manual for Land Surveys in the Philippines
and to the conditions stated at the back hereof.
Violation of any aforesaid conditions shall invalidate this Authority and the
damages that may result there from shall be your sole liability and professional
responsibility.
Very truly yours,
Conditions accepted: ______________2022
NARCISO A. VERGARA JR. JANUEL R. PERAS
Signature/Name of G.E. OIC, PENR Officer
Reg. No. 11273 Date: 02-03-2022
Lic. No.4753916 Date:02-03-2022
Issuance of Survey Authority
Above stated request confirmed: Recommended:
_____________________________________ _________________________________
(Claimant/Name) (Signature/Name)
_________________________________________ _______________________________
(Address) (Position/Designation)
_________________________________________
Cost of______________________________paid
Under O.R. No.__________________________
Dated:__________________________________
NOTE:
For this Survey Authority to be valid the four (4) required signatures must be present
CONDITIONS
The Survey Authority granted at the face thereof shall be valid only under the following
conditions:
1. That the land sought to be surveyed is an undecreed portion of an alienable
and disposable area entitled by the Bureau of Forest Development of the
DENR;
2. That the land has not been reserved for public quasi-public purposes;
3. That the land does not embrace any holding of a bonafide occupant public
land applicant or claim of a private person; and if it does, the area of
landholding or claim shall be excluded from the survey or if the survey is
conducted for settlement of claims and conflict, the same shall be indicated
on the survey plan;
4. That the land is not within a cadastral or public land subdivision survey
project still in programs;
5. That the land is not the subject of a pending ordinary land registration case
or litigation in the court.
That above conditions shall be deemed to have been automatically modified by
administrative issuances that may be issued by the DENR Secretary, the Director LMB,
of the Regional Executive director of this Technical Director of Lands Management.
