LMB Form No.

GSD-E-4

TRANSMITTAL OF SURVEY RETURNS

SUBJECT:

Kind of Survey : SUBDIVISION Office Address: St. Paul Subdivision,

Location of Land: SAN VICENTE, BAAO, CAMARINES SUR Palestina, Pili, Camarines Sur
Claimant : CHRISTIN BRIGOLA Date: _____________________
Address : SAN VICENTE, BAAO, CAMARINES SUR
The Regional Technical Director
RLO_________________, Lands Management Services
_____________________,_______________________

Sir:
I am forwarding herewith for verification and approval, the returns of the above survey executed by me
consisting of:

___________1____________ (Sheets) Original Plan with tracing cloth

___________2___________ (Sheets) Field Notes with cover duly notarized
________________________ (Sheets) Field Notes (Astronomical Observation for Azimuth)
___________4____________ (Sheets) Traverse Computation, original and duplicate
___________18__________(Sheets) Lot Data Computation, original and duplicate
________________________ (Sheets) Astronomical Observation Computation, original and duplicate
________________________ (Sheets) Geodetic Engineer’s Certificate, duly notarized
___________2____________ (Sheets) Common Points Computation, original and duplicate
________________________ (Sheets) Certified True Copy of Title
___________3____________ (Sheets) Monument Recovery Report

Enclosed is ________________________________________________ pesos (P __________________)

In money order / check to cover the following expenses against my deposit, Swo._______________________:

Verification ___________________P
Technical Description___________ P
Total ________________________ P
Upon approval, please send the tracing cloth plan and other papers to __________________________

Very truly yours,

ANGEL T. PORMALEJO
Geodetic Engineer
……………………………………………………………………………………………………………………………………………………………………………
ACKNOWLEDGEMENT SLIP
FOR LANDS MANAGEMENT SERVICES ONLY
SUBJECT:
Kind of Survey: __________________________________ LANDS MANAGEMENT SERVICES, RLO NO._______
Location of Land: ________________________________ _________________________________________
________________________________ Date: ____________________________ 20______
Claimant : ________________________________
Address : ________________________________
________________________________
Received from M__________________________________ Geodetic Engineer the above survey returnsfor verification
and approval and the amount of __________________________________________________
pesos (P_________________ )
In case of any inquiry please refer to Survey No. _____________________________
NAME:_________________________________________
DESIGNATION: ___________________________________
Original and Other Surveys Section

INSTRUCTIONS: Accomplish this for in triplicate and enclose it with every survey returns for verification and approval. Duplicate
and triplicate copies of the acknowledgement slip shall be issued to the Geodetic Engineer or his authorized representative and to
the land claimant respectively.