LETTER OF DECLARATION

FOR PLAN CONSENT

This form may take you about 5 minutes to fill in.
We will notify you of the outcome of your application approximately within 10 working days
from your submission provided that full details and information are provided.

1. This notification shall be used for electronic submission of application made to Land
lanning !ivision under the "orenet e#$ubmission $ystem and where the %pplicant & 'wner
does not sign the application form & documents digitally.
(. The )ualified erson shall scan and attach a copy of this notification to the application. *e &
$he shall keep this notification as a proof of his appointment & authori+ation by the %pplicant &
'wner.
,. lease fill this form in -L%". /0.1 for clarity during scanning.
If you require any assistance, please contact:
Land lanning !ivision
The 2T" $ummit
3 2urong Town *all 4oad
$ingapore 5067,7
!/!8 533,,09,
:mail8 seekeong.foo;<tc.gov.sg
!/!8 533,,1,,
:mail: teochun .ng;<tc.gov.sg
Note:
Please note that JTC collects personal information in the course of processing your application. We may
share the necessary data with other Government agencies (or non-Government entities which have been
authorised to carry out specific Government services to process any application you have made or to
render you service! so as to serve you in a most efficient and effective way! unless such sharing is
prohibited by legislation.
age 1 of (
Te !TC Su""it 3 2urong Town *all 4oad $ingapore 5067,7
JTC(LPD)_SD-LD
(Updated as at 31 January 2012)
LETTER OF DECLARATION
FOR PLAN CONSENT
File Reference Nu"#er $if any%:

Description of #uil&in' (or)s:

Location Description:

/1 hereby authori+e the )ualified erson& to submit1 on =my & our behalf1 any application1
notification or document related to the said works & building bearing the above#stated >ile 4eference
0umber ?if any@ without =my & our digital signature1 whenever =my & our endorsement is reAuired.
This authori+ation shall continue to be in force until =/ & we revoke it in writing and you have
received notice of such revocation.
/1 hereby8
?a@ declare that the statements given in the form are true and accurateB
?b@ undertake to fully indemnify and keep 2T" "orporation indemnified from and against all
proceedings1 costs and expenses1 claims1 losses1 damages1 penalties and liabilities which arise
out of or in relation to or by reason of any falsehood1 inaccuracy or otherwise of any
information provided in this >ormB and
?c@ acknowledge and agree that8
?i@ the granting of consent by 2T" "orporation on the plans submitted shall not in any
way pre<udice1 nor be deemed to be or construed as a waiver of any of 2T"
"orporation Cs rights or remedies whatsoever8
?ii@ 2T" "orporation is under no obligation to verify the truth or accuracy of the
information and particulars provided in this >orm1 by checking its records or
otherwise and is entitled to grant consent on the plans submitted plan based on the
information provided without further AueryB and
?iii@ if any of the above statements have been falsely declared1 then any consent
granted by 2T" "orporation on the plans submitted shall be null and void.
0ame D %ddress of "ompany 0ame D $ignature of %pplicant

Tel 0o.8 !ate8
age ( of (
Te !TC Su""it 3 2urong Town *all 4oad $ingapore 5067,7
JTC(LPD)_SD-LD
(Updated as at 31 January 2012)