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12-1 Ore Transport Permit

MGB permit form for ore transport

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Republic of the Philippines
Department of Environment and Natural Resources
MINES AND GEOSCIENCES BUREAU
North Avenue, Diliman, Quezon City

ORE TRANSPORT PERMIT
Date _________________

1. ___________________________________________________________________
(Name of Permittee)
2. Permit No. ____________________________ Date of Issue __________________
3. Operator ___________________________________________________________
(Name and Address)
4. Transporter _________________________________________________________
(Name & Address of Company)
Truck Registry No. _________________ or Ship Registry No. ________________
5. Buyer ______________________________________________________________
(Name and Address)
6. Commodity _________________________________________________________
(Mineral/Mineral Products/Tailings)
7. Tonnage or Volume __________________________________________________
(Metric tons/cu. meters)
8. Value P ____________________________________________________________
9. Source _____________________________________________________________
(Barangay and Municipality, Province)
10. Destination __________________________________________________________

_______________________
Certifying Official

_______________________
Regional Director
MGB Regional Office _____
 
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