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08-3B
APPLICATION FOR
EXCLUSIVE SAND AND GRAVEL PERMIT/
GOVERNMENT/PRIVATE GRATUITOUS PERMIT
Application No. ____________________ Date Filed ________________________
Applicant ________________________________________________________
Address ________________________________________________________
Location/Area of Interest _______________________________________________
Sir :
In accordance with the provisions of the Philippine Mining Act of 1995 and the
Revised Implementing Rules and Regulations (IRR) promulgated thereunder, the
undersigned, _______________________________________, for and in behalf of
_____________________________________________, hereby applies for an Exclusive
Sand and Gravel Permit/Government/Private Gratuitous Permit to extract from a tract of
land containing sand and gravel materials and situated in Sitio _____________________,
Barangay _____________________, Municipality of _________________________,
Province of _________________________, Island of _________________________,
Philippines and bounded as follows:
4. This application is field for the exclusive use and benefit of the applicant, and not
either directly or indirectly for the benefit of any other person, corporation or
partnership and the area is applied for the sole purpose of its development and
operation, and for speculation.
1
MGB Form No. 08-3B
5. This application is for a period of sixty (60) days/coterminus with the construction
stage of the project but not to exceed one (1) year in public/private land/s.
6. The applicant agrees to pay the Government all the fees/taxes pursuant to the
provisions of RA No. 7729, amending Section 151 (a) of the National Internal
Revenue Code.
_______________________, Philippines ______________, 19____.
_________________________
Applicant
TIN _____________________
ACKNOWLEDGEMENT
___________________________
NOTARY PUBLIC
Until Dec. 31, 19 ______
PTR No. ____________
Doc. No. _______
Page No. _______
Book No. _______
Series of _______
INSTRUCTION
1. This application shall be accomplished in quintuplicate, two copies to be retained
by the applicant, the original and one copy to be forwarded to the Provincial/City
Mining Regulatory Board, and the remaining copy for the files of the MGB
Regional Office.
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.