DOCUMENT TRACKING FORM Effectivity Date:

NHA-QP-01-F06 FORM Revision No.

Document Title : Deed of Transfer and Acceptance

Date : July 23, 2018
Originating Office : NHA – Pagadian City District Office
Subject ` : Revision of Deed of Transfer and Acceptance for the Land Development
Laoy Village, Bgry. Olingan, Dipolog City, Zamboanga del Norte

I further certify that all the documentary requirements have been subjected to the principle of
“Complete Staff Work”, and have been evaluated with diligence and found in order in accordance
with the prescribed policies, guidelines and procedures.

Recommending Approval: ENGR. EUTEMIO A. SISICAN

Name/Signature

REMARKS/
NAME/POSITION/UNIT/SIGNATURE
INSTRUCTIONS
DATE
FOR/TO FROM

Transmitting herewith
the 8 sets of Revised
DOTA for review/
evaluation of the
Legal Department.
The Sangguniang
Bayan of Dipolog
referred the original
07/23/ AR. MARIA ALMA T. VALENCIANO EUTEMIO A. SISICAN
DOTA to their City
2018 Regional Manager OIC- Pagadian District
Legal and thus
resulting to a minimal
revision of the original
document. A copy of
the original is hereby
attached for reference
of the items being
omitted/ edited.