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Mgbform8 3A
Mgbform8 3A
08-3A
APPLICATION FOR
COMMERCIAL SAND AND GRAVEL PERMIT
Sir :
In accordance with the provisions of the Philippine Mining Act of 1995 and its
revised Implementing Rules and Regulations, the undersigned __________________ for
and in behalf of __________________________, hereby applies for a Commercial Sand
and Gravel Permit to remove and dispose _____________ cubic meters of materials
authorized thereunder from the tract of land bounded as follows:
The area applied for is public and/or private land, lake, river, stream, creek or
other public waters (underline applicable term), located in the Sitio of
_________________, Barangay of _______________________, Municipality of
____________________, Province of ___________________________, Island of
_________________, Philippines.
3. This application is filed for the exclusive use and benefit of the applicant, and not
either directly or indirectly for the benefit of any other persons, corporation or
partnership, and for the sole purpose of removing and disposing of the said
materials;
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MGB Form No. 08-3A
4. 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 permit
that may be granted by virtue thereof, and any falsehood in these statements on
omission of facts which may later change or affect substantially the facts set forth
in said statements shall be sufficient cause for the cancellation of the permit
granted.
The foregoing statements are hereby certified to be true to the best of the
applications knowledge and belief.
___________________________
Applicant
TIN _______________________
ACKNOWLEDGEMENT
___________________________
NOTARY PUBLIC
Until Dec. 31, 19 ______
PTR No. ____________
Doc. No. _______
Page No. _______
Book No. _______
Series of _______
INSTRUCTION
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.