Form No.

012: with hearing

Revised as of 5/10/2021

Republic of the Philippines

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

Application for the issuance of a Certificate of

Public Convenience to operate a TRANSPORT
NETWORK VEHICLE SERVICE pursuant to Board
Resolution No. 185 dated 14 December 2022,

CASE NO. _______________

Juan dela Cruz,
Applicant.
x ---------------------------------------x

APPLICATION
FOR A CERTIFICATE OF PUBLIC CONVENIENCE
WITH PRAYER FOR ISSUANCE OF A
PROVISIONAL AUTHORITY

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

1. Applicant is a Filipino citizen and may be served with legal processes at 123 Sta Cruz
Manila [Email Address: juandelacruz@email.com/ Mobile Phone No 09123456789].

2. Applicant, pursuant to Board Resolution No. 185 dated 14 December 2022, hereby
applies for a Certificate of Public Convenience to operate a TRANSPORT NETWORK VEHICLE
SERVICE for the transportation of passengers and freight within Metro Manila including the MUCEP
Area accessible to motor vehicle traffic and vice versa, with the use of ONE (1) unit described hereunder,
to wit:

MAKE MOTOR NO. CHASSIS NO. CS / PLATE NO. YR. MODEL

TOYOTA VIOS 1NRX342343 PA1B2335355583 ABC123 2021
X- Nothing Follows -X

3. Applicant is financially capable to operate and maintain the service being applied for.

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, as amended, and other pertinent
land transportation laws, policies, rules and regulations.

5. Applicant has completed/currently completing all the documentary requirements for the
Application, copies of which are hereto attached as Annexes.

6. With the consideration and approval of this application, public necessity and convenience
will be promoted in a suitable manner.

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 PRAYER

WHEREFORE, it is most respectfully prayed that (a) Notice of Hearing be issued; (b) the
Application for a Certificate of Public Convenience to operate a Transport Network Vehicle Service be
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, Philippines, this 29th day of December 2022.

REDENTOR T. GUZMAN
Counsel for the Applicant
PTR No. 2555890; 01-25-2022/Quezon City
IBP Lifetime No. 011171
Attorney’s Roll No. 46050
MCLE Compliance No. VII-0018954, 04-14-2025

Rm. M-5 ARCHERUB Building

146 Timog Avenue cor. EDSA
Brgy. Sacred Heart, Quezon City
Cellular Phone No. 0917-7118894
Email Address: rmdr815@yahoo.com

WAIVER

I, MARVIN BRYAN ESPINAS LABATETE, hereby grant authority to LTFRB to verify

the authenticity of all documents herein submitted together with this application from both government
and private sources.

Juan dela Cruz

Applicant

VERIFICATION AND CERTIFICATION OF

NON-FORUM SHOPPING

I, MARVIN BRYAN ESPINAS LABATETE, Filipino, and with mailing address at 123 Sta
Cruz Manila , hereby depose and state:

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

2. That I have caused the preparation of the foregoing Application (with Prayer for
Issuance of a Provisional Authority);

3. That I have read and understood the contents hereof and the same are true and correct
to the best of my own knowledge and belief;

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 4. That I have not commence any other action or proceeding involving the same issues
in any other LTFRB Office;

5. That to the best of my knowledge, no such other application, petition or pleading is

pending therein; and

6. That if I learn of the same or similar application, petition or pleading has been filed
or is pending, I shall report such fact within five (5) days therefrom to this Honorable
Board.

IN WITNESS WHEREOF, I have hereunto set my hand this 29th day of December 2022.

Juan dela Cruz

SUBSCRIBED AND SWORN to before me this 29th day of December 2022 at Quezon City,
affiant exhibiting to me his/her TIN 41234-00000 bearing his/her photograph and signature.

Doc. No. _________

Page No. _________
Book No. _________
Series of 2022.

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