FUEL SUBSIDY PROGRAM 2021

DEED OF UNDERTAKING FOR ELIGIBLE PUJ OPERATOR (Individual Operator)

SO THE PUBLIC MAY KNOW:

That I, _______________________________________________, Filipino, of legal age,

single/married, a resident of __________________________________________, is a
grantee/holder of Certificate of Public Convenience to operate Public Utility Jeepney (PUJ),
particularly described as follows:

1. Franchise Number : _____________________________________________

2. Plate Number: _________________________________________________

3. Route Name: __________________________________________________

That as a bona fide recipient of fuel subsidy, I hereby agree to strictly observe the rules
on the usage of the fuel subsidy throughout the duration of the Program.

Foregoing considered, I, the Eligible Franchise Holder, confirm that have read and
understood, thus, undertake to abide by the following:

1. Use the Fuel Subsidy Card or Pantawid Pasada Card (PPC) issued by the Land
Bank of the Philippines (LBP), in accordance to the following terms and conditions of
the Fuel Cash Subsidy Program:

a. The Subsidy Card or Pantawid Pasada Card shall only be used by the eligible
franchise holder or his authorized driver exclusively for the purpose of fuel
purchases/payments with the participating Petroleum Retail Outlets throughout
the Program Duration;

b. The Eligible Franchise holder or his authorized driver, as the authorized bearer of
the Fuel Subsidy Card or Pantawid Pasada Card, shall be the one responsible for
the usage of the Card and the utilization or consumption of the amount loaded in
the card, who shall also monitor the usage of the Card on his/her own means.

c. The Eligible Franchise Holder shall allow his/her authorized driver to use the Fuel
Subsidy Card or Pantawid Pasada Card every time the PUJ is operated for
service so the latter will be able to use the card for refueling . Otherwise, the
Eligible Franchise Holder shall ensure that the PUJ is sufficiently refueled before
it is operated by his driver.

d. The Eligible Franchise holder, shall shoulder incidental service charges and other
costs relative to the transaction made for fuel purchase with the Participating
Petroleum Outlets, if there is any;

e. The amount loaded in the Fuel Subsidy Card or Pantawid Pasada Card shall be
deemed non-transferable, and shall not be sold to others nor converted into cash.
The Fuel Subsidy Card or Pantawid Pasada Card shall not be used for other
purposes than what is intended under the Program;

FUEL SUBSIDY PROGRAM: DEED OF UNDERTAKING FOR ELIGIBLE PUJ OPERATORS 1

 f. The Eligible Franchise Holder shall not use the Fuel Subsidy Card or
Pantawid Pasada Card (PPC) for Cash Withdrawal with the ATM Machines.

g. The eligible franchise holders/beneficiaries shall present the Fuel Card to the
pump attendant to check its fund balance prior to gassing up. The former may be
asked to key in their PIN to the pump attendant or cashier to facilitate the
transactions.

h. The pump attendant shall only dispense the fuel to the fuel tank provided the
amount of purchase is within the fund balance.

i. The Eligible Franchise holder understands that in the event he/she violates the
terms and conditions on the use of the Fuel Card, the card may be blocked and
the account may be closed.

j. Participating Petroleum Retail Outlets are enjoined to verify that the details of the
PUJ correspond to the details appearing on the Fuel Subsidy Card or Pantawid
Pasada Card (PPC), as well as to inquire and check on the balance. Participating
Petroleum Retail Outlets reserve the right to refuse the use of the Card for fuel
purchases by any PUJ operator/driver whose details do not match the details
indicated on the Card, and in case of insufficient balance/credits; and

k. In case of death of the eligible franchise holder, existing rules and procedures
from the LTFRB, as to the transfer of franchise in case of death, shall prevail and
be followed in the Program.

2. Failure of the Eligible Franchise Holder to allow their authorized driver to use the fuel
card shall also be considered as a violation of the terms and conditions of the
Program. In such case, the concerned authorized driver may file a written report on
the matter which shall be given due course by the Board;

3. Failure to comply with this undertaking, especially on the withdrawal of cash thru ATM,
may warrant disqualification in future fuel subsidies; and

4. The Eligible Franchise Holder shall reimburse the Government for the total amount
used for other purposes (e.g., ATM withdrawal or purchases other than the fuel)
within thirty (30) working days upon notice.

Signed this ___ of ______________, 2022.

__________________________

Eligible PUJ Franchise Holder

(Signature over printed name)

Note:
Three (3) copies to be accoplished: Eligible PUJ Franchise Holder’s Copy, LTFRB’s Copy, LBP’s Copy

FUEL SUBSIDY PROGRAM: DEED OF UNDERTAKING FOR ELIGIBLE PUJ OPERATORS 2

FUEL SUBSIDY PROGRAM 2021
DEED OF UNDERTAKING FOR ELIGIBLE PUJ OPERATOR (Corporation/Cooperative)

SO THE PUBLIC MAY KNOW:

That I, _______________________________________________, a duly authorized

representative of (name of Coop/Corp) , with business address at
_______________________________, a grantee/holder of Certificate of Public Convenience to
operate Public Utility Jeepney (PUJ), particularly described as follows:

1. Franchise Number : _____________________________________________

2. Plate Number: _________________________________________________

3. Route Name: __________________________________________________

That as a bona fide recipient of fuel subsidy, the Coop/Corp hereby agree to strictly
observe the rules on the usage of the fuel subsidy throughout the duration of the Program.

Foregoing considered, for and on behalf of the Coop/Corp, I confirm that have read and
understood, thus, undertake to abide by the following regulations of the Program:

1. Use the Fuel Subsidy Card or Pantawid Pasada Card (PPC) issued by the Land
Bank of the Philippines (LBP), in accordance to the following terms and conditions of
the Fuel Cash Subsidy Program:

a. The Fuel Subsidy Card or Pantawid Pasada Card shall only be used by the
eligible franchise holder or his authorized driver for the sole purpose of fuel
purchases with the participating Petroleum Retail Outlets throughout the Program
Duration;

b. The Eligible Franchise holder or his authorized driver, as the authorized bearer of
the Fuel Subsidy Card or Pantawid Pasada Card, shall be the one responsible for
the usage of the Card and the utilization or consumption of the amount loaded in
the card, who shall also monitor the usage of the Card on his/her own means.

c. The Eligible Franchise Holder shall allow his/her authorized driver to use the Fuel
Subsidy Card or Pantawid Pasada Card every time the PUJ is operated for
service so the latter will be able to use the card for refueling . Otherwise, the
Eligible Franchise Holder shall ensure that the PUJ is sufficiently refueled before
it is operated by his driver.

FUEL SUBSIDY PROGRAM: DEED OF UNDERTAKING FOR ELIGIBLE PUJ OPERATORS 3

 d. The Eligible Franchise holder, shall shoulder incidental service charges and other
costs relative to the transaction made for fuel purchase with the Participating
Petroleum Outlets;

e. The amount loaded in the PPC shall be deemed non-transferable, and shall not
be sold to others nor converted into cash. The PPC shall not be used for other
purposes than what is intended under the Program;

f. The Eligible Franchise Holder shall not use the Fuel Subsidy Card or
Pantawid Pasada Card (PPC) for Cash Withdrawal with the ATM Machines.

g. The eligible franchise holders/beneficiaries shall present the Fuel Card to the
pump attendant to check its fund balance prior to gassing up. The former may be
asked to key in their PIN to the pump attendant or cashier to facilitate the
transactions.

h. The pump attendant shall only dispense the fuel to the fuel tank provided the
amount of purchase is within the fund balance.

i. The Eligible Franchise holder understands that in the event he/she violates the
terms and conditions on the use of the Fuel Card, the card may be blocked and
the account may be closed.

j. Participating Petroleum Retail Outlets are enjoined to verify that the details of the
PUJ correspond to the details appearing on the Fuel Subsidy Card or Pantawid
Pasada Card (PPC), as well as to inquire and check on the balance. Participating
Petroleum Retail Outlets reserve the right to refuse the use of the Card for fuel
purchases by any PUJ operator/driver whose details do not match the details
indicated on the Card, and in case of insufficient balance/credits; and

k. In case of death of the eligible franchise holder, existing rules and procedures
from the LTFRB, as to the transfer of franchise in case of death, shall prevail and
be followed in the Program.

2. Failure of the Eligible Franchise Holder to allow their authorized driver to use the
fuel card shall also be considered as a violation of the terms and conditions of the
Program. In such case, the concerned authorized driver may file a written report
on the matter which shall be given due course by the Board;

3. Failure to comply with this undertaking, especially on the withdrawal of cash thru
ATM, may warrant disqualification in future fuel subsidies; and

4. The Eligible Franchise Holder shall reimburse the Government for the total
amount used for other purposes (e.g., ATM withdrawal or purchases other than
the fuel) within thirty (30) working days upon notice.

Signed this ___ of ______________, 2021.

For: (Name of Coop/Corp)

__________________________
(Name of Authorized Representative)

FUEL SUBSIDY PROGRAM: DEED OF UNDERTAKING FOR ELIGIBLE PUJ OPERATORS 4

 (Signature over printed name)

Note:
Three (3) copies to be accoplished: Eligible PUJ Franchise Holder’s Copy, LTFRB’s Copy, LBP’s Copy

FUEL SUBSIDY PROGRAM: DEED OF UNDERTAKING FOR ELIGIBLE PUJ OPERATORS 5