SEARCH
Philippine Government Forms All in One Location
Tweet
Share
15-06 License to Possess Explosive (Foreman's License) Application
MGB foreman's license application form to possess explosive
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: MGB Form No. 15-6
Republic of the Philippines
Department of Environment and Natural Resources
MINES AND GEOSCIENCE BUREAU
Norht Avenue, Diliman, Quezon City
LICENSE TO POSSESS EXPLOSIVE (FOREMAN’S LICENSE)
APPLICATION
INSTRUCTION - This application must be filled out in ink and in the applicant’s handwriting.
All statements are subject to verification and falsification made herein are grounds for
disqualification. (To be prepared in two copies.)
Applicant’s Name (Print in Bold Letters)
Date of Birth
Age
Sex
(Surname)
(Given Name)
(Middle Name)
Status
Permanent Address or Mailing Address
Place of Birth
(City/Town and Province)
School were Graduated/Address/Year
Degree
Lic. No.
(R.A. 1080)
Work Experience/s (Company/Location)
_________________________________________
_________________________________________
_________________________________________
Position
_____________________
_____________________
_____________________
Period
____________
____________
____________
WE HEREBY CERTIFY THAT THE HEREIN APPLICANT IS PERSONALLY KNOWN TO US TO BE
OF GOOD MORAL CHARACTER. (TO BE SIGNED BY TWO PERSONS WHO CAN VOUCH FOR THE
APPLICANTS’S MORAL QUALIFICATION).
Signature (over Print Name)
Signature (over Print Name)
Address
Address
I HEREBY CERTIFY THAT THE INFORMATION
AND DATE WRITTEN BY ME ABOVE ARE TRUE
AND CORRECT TO THE BEST OF MY
KNOWLEDGE AND BELIEF.
Date Filed
SUBSCRIBE AND SWORN TO BEFORE ME,
THE AFFIANT EXHIBITED TO ME HIS COMMUNITY TAX CERTIFICATE AS INDICATED
HEREUNDER.
Community Tax Certificate
(Number)
Applicant Signature
(Affix Documentary
Stamp)
(Date)
Signature and Title of Administering Officer
DO NOT FILL BEYOND THIS POINT
DATE OF EXAM
RESULT OF EXAM:
______ PASSED
(Place of Issue)
EXAMINER
______ FAILED
_____________________
COMPLETE NAME
ACTION TAKEN ON APPLICATION:
_____ APPROVED _____ DISAPPROVED ____ FOR COMPLIANCE
______________________
POSITION
