NWRB | Online Application Form

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Name of Applicant *

Mailing Address *

Telephone Number *

Tax Identification Number

Citizenship *

Email Address *

Bank Reference Number

NWRB Official Receipt Number

NWRB Official Receipt Date

WATER SOURCE DETAILS

Name of Water Source *

Type of Selected Source *

Additional Detail

Location of Diversion Point (Street, Brgy., Municipality/City, Province)

Street

Barangay *

Municipality/City *

Province *

Coordinates Address

LATITUDE *

LONGITUDE *

Method of Diversion

Months of Low-Flow

Water Needed in Liters/Seconds *

Purpose *

Purpose Level

Additional Detail *

PLEASE SPECIFY HERE *

CODE

Type code here. *

I hereby certify that the information given above and in documents submitted are true and correct to the best of my knowledge and belief.

I hereby understand that the data provided herein will only be used for purposes of my application for a water permit.

* Required fields