Republic of the Philippines

Presidential Council for Forest Ecosystem Management

CERTIFICATE OF TREE PLANTING/SURVIVAL/COMPLETION
(In accordance with PD 1153)

Name: Date of Birth: Address:

Civil Status: Single Married Widowed/Separate Sex: Male Female Tel. No.:

Name/Address of Institution, Office, School, Barangay, etc.:

Certifying Officer for Planting Survival after 2 years Certifying Officer

Species Date Planted Site Planted Position No. of Trees
No. of Trees Name Date Remarks Name Date Position/Address
Planted Address Planted

Note: Certifying Officer:

1 Certification for completion will only be
made when the required number of trees Name/SignatureDate:
(One tree/month) have been planted and
surviving for at least two years. Position/Address: