Rental Services - Parang Municipality

Transaction Information

TRANSACTION FORM NO.

TRACKING NO.

DATE OF APPLICATION

Customer Details

LAST NAME

FIRST NAME

MIDDLE INITIAL

EXT. NAME

CONTACT NO.

EMAIL ADDRESS

HOME ADDRESS

OFFICE / BUSINESS NAME

BUSINESS ADDRESS

OFFICE PHONE NO.

OFFICE EMAIL

Community Tax Certificate (CTC)

CTC NUMBER

DATE ISSUED

PLACE ISSUED

Rental Details

FACILITY / PROPERTY FOR RENT

PLEASE SPECIFY IF OTHER

DATE FROM

DATE TO May extend to several months as needed

COST OF RENTAL (PHP)

₱

AMOUNT PAID (PHP)

₱

LGU OFFICIAL RECEIPT #

ADDITIONAL DOCUMENTS ATTACHMENT (Optional)

Accepted formats: JPG, PNG, PDF, DOC, DOCX (Max: 10MB per file, up to 5 files)

Payment Details

PAYMENT TYPE

PLEASE SPECIFY IF OTHER

UPLOAD PAYMENT SCREENSHOT / RECEIPT (Optional) Accepted: JPG, PNG, PDF (Max: 5MB)

Certification & Consent

Certification of Truthfulness
I hereby certify that all the information provided in this application is true, correct, and complete to the best of my knowledge. I understand that any false statement or misrepresentation may result in the denial of this application or the revocation of any rental grant issued in connection with it, and may subject me to legal action under applicable laws of the Republic of the Philippines. *

Data Privacy Consent
I hereby give my free and voluntary consent to the Local Government Unit to collect, process, store, and share my personal information for the purpose of evaluating this rental application and for related administrative, regulatory, and legal purposes, in accordance with Republic Act No. 10173 (Data Privacy Act of 2012) and its Implementing Rules and Regulations. *

Both checkboxes are required before this application can be submitted.

Please review all information before submitting

For assistance, please contact the LEIPO Office at (064) 123-4567 or email leipo@parang.gov.ph

Office Hours: Monday to Friday, 8:00 AM – 5:00 PM