REPUBLIC OF THE PHILIPPINES

Department of Transportation and Communications

LAND TRANSPORTATION FRANCHISING AND REGULATORY BOARD
Regional Office 1
San Fernando City, La Union

______________________ CASE NO:________________

Petitioner

Petition for extension of validity of a

Certificate of Public Convenience to
Operate a _______ __service
x- - - - - - - - - - - - - - - - - - - - - - - x

PETITION

COMES NOW Petitioner and unto this Honorable Board respectfully states:

That Petitioner is a Filipino citizen of legal age and resident of

That petitioner is a grantee of a certificate of Public Convenience to operate a _____ service on

the Line ________________________________________ and vice versa with the use of the following
units, to wit:

MAKE MOTOR NO CHASIS NO. PLATE NO.

That petitioner request authority to extend the validity of the Certificate of Public Convenience to
operate on the same line with the use of the same number of unit /s:_______.

That the petitioner is still financially capable to operate and maintain the said service;

That petitioner will continue to comply with all the rules and regulations of this Honorable Board
and with the provisions of the Public Service Law, as amended;

The Public necessity and convenience will be best served with the approval of this petition;

WHEREFORE, it is respectfully prayed that his petition be APROVED.

Laoag City for San Fernando City, La Union this____ day of ________________,______.

Petitioner
 VERIFICATION

I after being duly sworn in accordance with Law, hereby depose

and say;

That I am the petitioner in the above-cited Case;

That I have caused the preparation of the same and have fully read and understood all the
allegations contained therein;

That said allegation are true and correct of my own knowledge and belief.

Affiant

SUBSCRIBED AND SWORN TO before me this day of ,

at ,affiant exhibited to me his /her CTC NO. issued on
at Philippines.

DOC. NO.

PAGE NO.

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