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HLURB FORM No.

1257
(To be accomplished
in duplicate)

APPLICATION FOR ADVERTISEMENT APPROVAL

_____________________
Date
The Regional Officer
Region: _________________
Housing and Land Use Regulatory Board
_______________________________________
_______________________________________

S i r :

Pursuant to Section 4, Rule III of HLURB Administration Order No.


83-01.the undersigned respectfully applies for approval of this
proposed advertisement for ___________________________________________
(Name of Project)
located at ___________________________________________________________
which is due for publication/broadcasting on _________________________
Date

Attached herewith are the following:

/ / 1. Three (3) copies of the proposed advertisement

/ / 2. Copy of Certificate of Registration and License to


Sell;

(if the person/entity advertising is a real estate salesman, broker or


dealer, the following additional requirement shall be submitted)

/ / 3. Two (2) copies of his Certificate of Registration

/ / 4. Prior consent of owner/developer for said


advertisement.

_____________________
(Applicant)

Address: _____________________
_____________________
Tel. No. _____________________

Subscribed and sworn to before me this _______ day of ________________


20___. Affiant exhibitng his/her Residence Cert. No. _________________
issued at _____________________ on ______________________.

Doc. No. __________


Page No. __________ NOTARY PUBLIC
Book No. __________
Series of __________

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