Annex A-2 For Clustered CTPO

PROFILE OF INDIVIDUAL CLUSTER MEMBER

NAME: FELIX A. TALUBAN Age: 59 Occupation: Farming

Sex: Male Civil Status: Married Citizenship: Filipino TIN: N/A

Home Address: Deet tayum, Abra Tel No./Mobile No. 099551483858

BENEFICIARY:
NAME RELATIONSHIP AGE NAME RELATIONSHIP AGE
Mary Rose E. wife 58
Taluban

PLANTING STOCK
Ave.
Year No. of Ave. Volume
Species Diameter
Planted Trees Height (m) (cu.m.)*
(cm)
1. Acacia 1995 15 38.50 8.00 13.85
2. Ipil-ipil 2012 52 13.29 6.14 4.70
3. Madre Cacao 2014 7 8.00 4.00 0.15
4. Mangga 2000 15 26.50 7.00 5.73
5. Sampalok 2005 15 24.00 7.00 4.70
6. Kalios 30 14.75 4.00 2.04
7. Himbabao 7 11.00 6.00 0.42
8. Balete 7 32.00 8.00 4.78
9. Banaba 15 13.50 7.00 1.49
10. Mulberry 7 25.00 8.00 2.91
11. Binunga 52 23.86 7.29 16.94
*For matured plantations registered for harvesting purposes, volume shall be required.

Location of Private Tree Plantation:

Sitio: Barangay: Budac Municipality: Tayum Province: Abra Under Lot No. N/A covered by:
with a woodlot area of .37 (ha) out of the total area of
.37 (ha).

I hereby attest to the truthfulness of each and every statement in this application.

(Applicant)

Finding/Remarks:

Evaluated/Inspected by:

(Forest Officer)
Evaluation/Comment:

(Forest Utilization Officer) (Chief, Utilization Officer)

Attachment to this application: Copy of TCT/OCT/Tax Declaration; Barangay Certification; Shapefile/Map of the
Tree Plantation; Geotagged photos
 Annex D
Control No.

SELF-MONITORING FORM

TO ALL CONCERNED:
Be informed that the undersigned is a holder of Certificate of Tree Plantation Ownership
(CTPO) located at with CTPO Registration No.
issued on . That I am transporting the following forest products gathered
from the private tree plantation described as follows, to wit:

1. Kind of Species and quantity/estimated volume of forest products

2. Conveyance:
3. Consignee/Destination:

(Owner/Authorized Representative)

CERTIFICATION
TO WHOM IT MAY CONCERN:

This is to certify that the above described forest products had been verified by this Office to
have cut/harvested private tree plantation mentioned above and is hereby allowed to be transported
with the following particulars:

Described Route From:

To :

Validity Date From:

Until:
Others:

This is to certify further that the shipper shall be held liable to any forest products inserted or
included in this shipment which is not mentioned on this Self-Monitoring Form.

Certification and Inspection Fee in the amount of in favour of the

Department of Environment and Natural Resources (DENR) was paid under O.R. No.
dated .

(Scaler/Verifier)
Attested by:

(CENRO Officer)

SUBSCRIBED AND SWORN to before me this day of .

Doc. No.
(Authorized Person to Administer Oath)
Page No.
Book No.
Control No.
Annex E

CTPO & SMF Status Monitoring Report

Cluster No.:
Cluster Leader:
Reporting Period:

(C) Volume harvested (Cu.m) Destination (G)

Address/ (A) (B) No. of Date
Farmer Species Beginning Remaining (H)
Location Woodlot Planted Seedlings/ (F) Transported
Name Planted Volume (D) Non- Name of Balance Remarks
of Area (Ha) Area (Ha) Trees (E) Coppicing Silvicultural Address (dd/mm/yy)
(Cu.m) coppicing Buyer (Cu.m)
Woodlot Treatments

TOTAL

Note:
(A) Total woodlot area
(B) Woodlot area planted with trees
(C) Beginning volume of matured plantation based on inventory
(D) Tree species that do not naturally re-sprout/re-grow after the whole tree has been cut
(E) Trees that have the ability to re-sprout/re-grow after the whole tree has been cut such as but not
limited to Ipil-ipil, Kakawate, Aludig, Alibangbnag, Alim, Binunga, Duhat, and Samak
(F) Pruning/removing of tops and branches
(G) (C) less (D) and (E). It is estimated that fast growing coppicing trees grow at an average of 2.5cm
diameter every year and are harvested every 3-4years.
(H) Report replanting, incidence of fire, damage due to typhoon, pests & diseases and/or conversion to other land usage