REPUBLIC OF THE PHILIPPINES

Department of Transportation and Communications

LAND TRANSPORTATION FRANCHISING AND REGULATORY BOARD

Application for Extension of Validity of Certificate of Public

Convenience to Operate a Public Utility Jitney (PUJ)
Service

__________________, CASE NO. ____________

Petitioner
x -----------------------------x

APPLICATION

COMES NOW the applicant, through counsel, unto this

Honorable Board most respectfully alleges:

That applicant is of legal age, Filipino citizen, married with

residence and postal address at ________________, Philippines.

That the applicant is a grantee of a CERTIFICATE OF

PUBLIC CONVENIENCE to operate a PUBLIC UTILITY
JITNEY SERVICE for the transportation of passengers and
freight on the route _______________________ which is valid until
____________________ with the use of ____________ UNIT
particularly described as follows:

MAKE MOTOR CHASSIS NO. PLATE NO.

NO.

That applicant requests to extend the validity of the said

Certificate of Public Convenience for a period of another five (5)
years or which this Honorable Board may deem necessary to
grant;

That applicant is still financially capable and legally

qualified to operate and maintain the service being applied for;

That applicant will continue to comply with the rules,

regulations, orders, resolutions under circulars issued by the
Honorable Board and those which may be issued and
promulgated from time to time pertaining to the operation of the
above service;

That with the consideration and approval of this application,

public necessity and convenience will be promoted in a suitable
manner.

Page 1 of 3 Pet. for extension of CPC validity –

 PRAYER

WHEREFORE, it is most respectfully prayed unto this

Honorable Board that this Application for Extension of Validity of
Certificate of Public Convenience to Operate a
______________________for the transportation of passengers and
freight on the route ________________________which is valid until
_________________ be considered and approved.

In Witness Whereof, I have hereunto affixed my signature

this ________________________ at La Trinidad, Benguet.

Lawyer

WAIVER
I, __________________, 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.

Grantee/Petitioner

VERIFICATION AND CERTIFICATION OF NON-FORUM

SHOPPING

I, ________________________, Filipino Citizen, and with

residence and postal address at Central Alno, La Trinidad,
Benguet , Philippines, after having been duly sworn to in
accordance with law hereby depose and say that:

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

2. I have caused the preparation of the foregoing petition;
3. I have read the contents thereof and the same are true to
the best of my knowledge and belief;
4. 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;
6. If I should 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 there from to this
Honorable Board.

Page 2 of 3 Pet. for extension of CPC validity –

 REPUBLIC OF THE PHILIPPINES
Department of Transportation and Communications
LAND TRANSPORTATION FRANCHISING AND REGULATORY BOARD

Grantee/Petitioner

SUBSCRIBED AND SWORN to before me

this__________________________, by petitioner whose identity is
personally known to me and acknowledged before me that the
same is her free act and deed.

Doc. No.____;
Page No. ___ ;
Book No. ___;
Series of 2019.

Page 3 of 3 Pet. for extension of CPC validity –