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Affidavit of Designated Representative of The Proponent

This document is an affidavit designating a representative for a project to file a Compliance Monitoring Report (CMR) in accordance with DENR regulations. The proponent confirms the accuracy of the CMR and acknowledges responsibility for any penalties due to misrepresentation. The designation remains effective until revoked in writing.

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Marie Fe Egar
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366 views1 page

Affidavit of Designated Representative of The Proponent

This document is an affidavit designating a representative for a project to file a Compliance Monitoring Report (CMR) in accordance with DENR regulations. The proponent confirms the accuracy of the CMR and acknowledges responsibility for any penalties due to misrepresentation. The designation remains effective until revoked in writing.

Uploaded by

Marie Fe Egar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

AFFIDAVIT OF DESIGNATED REPRESENTATIVE OF

THE PROPONENT

I, ____(Name of Company Head)___, hereby designate ___(Name of Representative)____, as my


official representative on ___(Name of Project)____ with respect to the filing of Compliance Monitoring
Report (CMR) in accordance with Section 19 (a) of the Revised Procedural Manual for DENR
Administrative Order No. 30, Series of 2003 and to confirm THAT:

1. All the information and commitments in this Compliance Monitoring Report (CMR) dated
___________________ for the _____(Name of Project)_____ with ECC Ref. No.
________________________________ are accurate and complete to the best of our
knowledge and documents available on file;

2. No DENR-EMB personnel was directly involved in the preparation of this Compliance


Monitoring Report (CMR); and

3. I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this CMR REPORT;

This designation will remain in effect until revoked by written notice.

IN WITNESS WHEREOF, I hereby set my hand this _____ day of ________________ at


_____________________________________.

_________________________
NAME OF PROPONENT HEAD
(Position)__________________
(Company Name)___________
(Valid ID No.)_______________

CONFORME:

_________________________
Name of Representative
(Valid ID No.)______________

SUBSCRIBED AND SWORN to before me this _____ day of _____________________, Affiant


exhibited to me his/her respective official identifying documents as stated above which are competent
evidence of identity.

Doc. No._______
Page No._______
Book No._______
Series of _______

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