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Title of Document and Notary Public
Certification and Signature
uthried the
mmission of said plan to the Land Registration commissi
(Owner "Representative)
Republic of the Philippines)
355
ace
SUBCRIBED AND SWORN to before me this day
MSO btn Cae
ai nA NR
tat
2 i Oa apes HBR
a ae
hisTher Residence Cer siicate No. A-_
issued at on
NOTARY PUBLIC
ase
er beeanety
os
mae Sen
ee sa
NOTE: If signed by the representative of the owner, he should present a
special power of attorney forthe purpose.
LRA. Form No. Net
(Revised August 3,197)
FIELD NOTES COVER
Class of Sutvey LRA. P No.
Executive under Sec. 44 of Act. 496, as amended,
LRA, (GLRO) Cad. Record No.
For
Address:
Lot No. ___ Block No. PSD/PCS/PCN.
Pou, e or HUF.
Situated in the:
Barrio of. ——
Mun/City of
Province of
Island of, a
Bearings.
Declination, aaa
‘Surveyed (date) z
By__ = =
(Geodetic Engineer)
Address
Nature of Land:
Notes checked by: Date
(CR Examiner)
NOTE: This field notes cover should be properly accomplished by the
Geodetic Engineer who executed the survey noted herein,
Printed by: FRASCO ENTERPRISES
4# 51 Congressional Ave., Project 8, Quezon City
‘Authorized by the Land Registration Authority
‘until December 31, 2009,REMARKS OR ADDITIONAL INFORMATION
WITH REGARDS TOTHIS SURVEY
CERTIFICATION OF THESE NOTES.
1 hereby certify that the foregoing are the
complete original field notes indicating true and actual measurements
made in the __ Baue
(nature of Survey) Survey of the property / properties described in
Original / transfer Certificate (s) of Title No. (3)
Issued in the name(s) of
Island of __. = eee
from » 20 to
+20 inclusive.
‘on the ground along the boundary
notes and accompanying plan accuratel
subdivision /
ion plan are identical with those
pject matter thereof, and that the
with the knowledge and consent of the
registered owner(s).
‘The foregoing field notes were observed in the field by or
under my personal direction and supervision on the days and dates as
stated and were there and there recorded by me in person,
\is survey was executed with a
With Serial No.
‘ested and approved by the Bureau of Lands.
‘The work of transit man was performed by
‘(Signed and Sealed)
~~ Printed Name)
(GEODETIC ENGINEER)
Registration Cert. No. é
Livense (Professional) fee paid
Under O.R. No.
UWE hereby certify that the herein lots subject of the
subdivision plan do not constitute or form
defined in Section.
project as