REPUBLIC OF THE PHILIPPINES

Department of Transportation
LAND TRANSPORTATION FRANCHISING AND REGULATORY BOARD
East Avenue, Quezon City

MARIANITA DIN GALVEZ CASE NO.

Applicant

Application for a
Certificate of Public Convenience to Operate a
TRANSPORT NETWORK VEHICLE SERVICE
X——————————————-X

APPLICATION FOR
CERTIFICATE OF PUBLIC CONVENIENCE
WITH MOTION FOR PROVISIONAL AUTHORITY

Applicant, most respectfully applies for the issuance of a Certificate of Public Convenience (CPC) to
operate a Transport Network Vehicle Service (TNVS) (the Application) and, in support thereof, states:

1. Applicant is a Filipino citizen / corporation existing and duly organized under Philippines laws and with
business address at PH5 BLK 38 LOT 2 CENTELLA HOMES SAN ISIDRO RODRIGUEZ,RIZAL
1860
2. Applicant applies for a TNVS CPC for the transportation of passengers and freight within METRO
MANILA which includes MUCEP area, accessible to motor vehicle traffic and vice versa, with the
use of ONE(1) unit, to wit:
PLATE/
MAKE MOTOR NO. CHASSIS NO. COND NO. MODEL
MITSUBISHI MI- 1301-00001016340 PAEA13TXHHA0 B0G156 2017
RAGE 000400
X– Nothing Follows –X
3. Applicant is financially capable to operate as a TNVS.
4. Applicant will comply with all the requirements of this honorable board and will abide with the existing
LTFRB rules and regulations, the public service act, and other pertinent / policies.
5. Applicant has completed / currently completing all the documentary requirements for the Application.
Marked as Annex A LTO OR/CR, Annex B DTI, Annex C OPERATORS DATA SHEET (ODS) with
Complete Details and valid Drivers License/s of authorized Driver.
6. With the consideration and approval of this Application, public necessity and convenience will be
promoted in a suitable manner.
 PRAYER

WHEREFORE, it is most respectfully prayed that (a) a Notice of Hearing be issued by this honorable
board, as may be necessary (b) This Application for a Certificate of Public Convenience to Operate a
TNVS is accepted, considered and approved; and (c) in the meantime, a Provisional Authority be issued in
Applicant’s favor.

Other reliefs just and equitable under the premises are likewise prayed for.

Quezon City, Metro Manila,

MARIANITA DIN GALVEZ

Applicant

WAIVER

I, MARIANITA DIN GALVEZ,hereby grant authority to LTFRB, to verify the authenticity of all
the documents herein submitted together with this application from both government and private sources.

MARIANITA DIN GALVEZ

Applicant
 VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, MARIANITA DIN GALVEZ, Filipino and with business address at PH5 BLK 38 LOT 2
CENTELLA HOMES SAN ISIDRO RODRIGUEZ,RIZAL 1860, after having been duly sworn to
in accordance with law hereby depose and say that:

1. I am the applicant in the above-entitled case;

2. I have caused the preparation of the forgoing application;

3. I have read the contents thereof and the same are true to the best of my knowledge and belief on the
basis of the information and documents provided to me by the applicant;
4. To the best of my knowledge, I have not commenced any other action or proceeding involving the same
issues in any other LTFRB office;

5. To the best of my knowledge, no such other application, petition or pleading is pending therein; and
6. If I learn of the same or similar application, petition, or pleading has been filed or is pending, I shall
report of such fact within five (5) days therefrom to the honorable board.

MARIANITA DIN GALVEZ

Applicant

SUBSCRIBED AND SWORN to before me this day of

at Affiant exhibited to me his issued at
on .

Doc. No.:
Book No.:
Page No.:
Series of 2017.