PHILIPPINE PORTS AUTHORITY

APPLICATION FOR PERMIT TO OPERATE

ANCILLARY SERVICES
Application No : M102-T-20211004
Date : April 23, 2021

APPLICANT PROFILE
Name of Applicant/Company:
RVR Trading
Name of Authorized Representative (as applicable):
Racquel G. Francisco
Office Address: Tel. No.:
Daan na Cruz, Maasim ,San Rafael NA
Billing Address: Tel. No.:
Daan na Cruz, Maasim ,San Rafael NA
Email Address: Fax No.:
geronimo.racquel@gmail.com NA
Tax Identification No.(TIN) SEC Reg./DTI No.: CDA No.:
189-253-895-0000 - -
Business Type:
Single Proprietorship x Partnership Corporation
Nature of Business:
Trading

Please mark(X) on appropriate box New x ReNewal

TYPE OF ANCILLARY SERVICE(S)

Transport/Trucking Services Vessel Maintenance/Repair Services
Security Services Cargo Suveying Service
Waste Disposal Service Container Repair
Bunkering Cleaning Service
Chandling Communication Service
Water Supply Fumigation
Shops/Stores/Canteen Laundering
Ligtherage/Barging Parking/Garage
Reproduction Service Towing/Tugging Service
Water Taxi Weighbridge/Truck Scale
Brokerage x Others - Shipper/Consignee
Duration: Day/s Month/s Year/s
3

VALIDATION FOR PPA USE ONLY

Documentary Checklist
Permit Fee
New Renewal
OR No.
Date of Payment Application Form Application Form
Customer Registration Form Omnibus Undertaking
Recommeding Approval:
Omnibus Undertaking
-
Area of Operation with Sketch
Business Development/Marketing Officer

Approved:

-
Port Manager