APPLICATION FOR CHAINSAW REGISTRATION

PENRO South Cotabato, DENR Region XII

Koronadal City, South Cotabato, 9506

Application Number

asterisk(*) = Required Fields/ Kailangan lagyan ng impormasyon.

TYPE*

New Renewal

HEREBY APPLIES FOR (please check appropriate box):*

Certificate of Registration of chainsaw (new)

Permit to import chainsaw

Permit to manufacture

Permit to purchase, sell, re-sell, distribute or transfer of ownership of chainsaw

PROVINCIAL ADDRESS

Province*

Municipality*

Barangay*

Cenro

CLIENT INFO

Lastname

Firstname*

Middlename*

Extension

Mobile Number*

Complete Address*

Email Address

Detailed Specification of Chainsaw (e.g. brand, model, engine capacity, etc.)*

Serial Number of Chainsaw*

Use of Chainsaw*

Brand*

Model*

Date of Acquisition*

Engine Capacity (HorsePower)*

Others Pls specify*

Max lenght of GuideBar*

REQUIREMENTS TO BE ATTACHED PURSUANT TO REPUBLIC ACT 11032 (EASE OF DOING BUSINESS) Note: Original copies of the documents still needs to be presented for review and evaluation of CENRO personnel. / KINAKAILANGANG MGA DOKUMENTO AYON SA REPUBLIC ACT 11032 (EASE OF DOING BUSINESS) Tandaan: Kailangan pa rin ang mga orihinal na kopya ng mga dokumento para sa pagsusuri at pag-evaluate ng mga tauhan ng CENRO.

Duly accomplished Application Form*

O.R. of Chainsaw Purchase or Affidavit of Ownership in case the original copy is lost.*

Stencil Serial Number of Chainsaw*

Photo of Chainsaw to be registered*

Are you the owner of the Chainsaw?* YES NO

Please upload SPA

Transfer of ownership?* YES NO

Please upload Notarized Deed of Absolute Sale

Are you a Tenurial Instrument holder?* YES NO

Please upload Forest Tenure Agreement

Are you a Business Owner?* YES NO

Please upload Business Permit

Are you Registered as Private Tree Plantation Owner?* YES NO

Please upload Certificate of Registration

Are you a licensed Wood Processor?* YES NO

Please upload Wood Processing Plant Permit

Is the Chainsaw owned by the government or GOCC?* YES NO

Please upload Certification from the Head of Office or his/her authorized representative that chainsaws are owned/possessed by the office and use for legal purposes (specify)

Please upload Latest Certificate of Chainsaw Registration

Note: Please review your information and upload your supporting documents before submitting your application. Once submitted the Application, this form can no longer be updated. Please make sure you can be reached through the contact number you provided. A personnel from the Cenros Office will call you for verification of your Application. / Paalala: Mangyaring suriin ang iyong impormasyon at i-upload ang mga kinakailangang dokumento bago isumite ang iyong aplikasyon. Pagkatapos isinumite ang aplikasyon, hindi na ito maaaring baguhin. Mangyaring tiyakin na maaari kang maabot sa pamamagitan ng contact number na inyong ibinigay. Tatawagan ka ng isang kawani mula sa CENR Office para sa veripikasyon ng iyong aplikasyon.

I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application

CERTIFICATION AND DATA PRIVACY CONSENT*

By completing this form, I hereby certify that the information I have provided is true, correct and complete. Any false information provided herein will render this application null and void. I hereby express my consent for the Regulation and Permitting Section, DENR Implementing PENR/CENR Office to collect and process my personal information, record, transmit and store the data provided herein subject to the rules and regulations set by Republic Act No. 10173, otherwise known as the Data Privacy Act of 2012.

Sa pamamagitan ng pagkumpleto ng form na ito, ako po ay nagpapatunay na ang impormasyon na aking ibinigay ay totoo, wasto, at kumpleto. Ang anumang maling impormasyon na aking ibinigay dito ay magpapawalang bisa sa aplikasyong ito. Aking ipinaaabot ang aking pahintulot para sa Regulation and Permitting Section, DENR Implementing PENR/CENR Office na kolektahin at prosesuhin ang aking personal na impormasyon, irekord, ilipat, at itago ang mga datos na ibinigay dito ayon sa mga alituntunin at regulasyon na itinakda ng Republic Act No. 10173, na kilala rin bilang Data Privacy Act of 2012.