SUBJECT: Survey Authority for a tract of land,

_____________________________
_______ (Description of Lot)______

_______________________
Date
Survey Authority No. ______________________

(GEODETIC ENGINEER)
(Address of Office)

Pursuant to DENR Administrative Order No. 38 and upon evaluation of the request of the
(Claimants), claimant of the above described tract of land, to avail of your services, authority is
hereby granted to you to execute the survey hereof subject to the relevant provisions of the
Manual for Land Surveys in the Philippines as amended and to the conditions stated at the back
hereof.

Violation of any of the aforesaid conditions shall invalidate this authority ,and damages that
may result there from shall be your sole liability and professional responsibility.

Very truly yours,

For and by the Authority

Conditions accepted _________________2017 of the Secretary of DENR

(4) (GEODETIC ENGINEER) (3) ________________________

Signature/Name of GE OIC-CENR Officer
Reg. Cert. No. _____ Date: _____

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Above stated requested confirmed: Issuance of Survey Authority Recommended

________________________
(1) Claimant (2) ___________________________________
Rep. By: Signature/Name
_________________ __________________________________
Co-Heir
_______________________________ Investigation issued on: ______________________
Address

Ref. _______________________
Cad. Cost _______________________
Paid under O.R. No. __________________
Date: _______________________

Note: For this survey Authority to be valid, the four (4) require signatures must be present.