Republic of the Philippines Annex H

Department Of Transportation
LAND TRANSPORTATION OFFICE
APPLICATION FORM
RENEWAL DRIVING SCHOOL
Pursuant to MC No. VDM-2023-2460

NAME OF DRIVING SCHOOL:

_________________________________________________________________________
ADDRESS: _______________________________________________________________
OWNER: ________________________________CONTACT NO.: ___________________
EMAIL ADDRESS: ____________________________

DL CODE CORRESPONDING TO VEHICLE CATEGORY APPLIED FOR:

☐ Motorcycle ☐ Light ☐ Heavy
☐A ☐ A1 ☐B ☐ B1 ☐ B2 ☐ BE ☐C ☐ CE ☐D

LIST OF DOCUMENTARY REQUIREMENTS:

□ Application Fee;
□ Latest Audited Financial Statement filed with the BIR;
□ Valid Business Permit;
□ List of accredited instructors with their valid driver’s license and their certificate of
accreditation as theoretical and practical driving instructors;
□ Official Receipt (OR) and Certificate of Registration (CR) of the vehicles registered
under the name of the proprietor of the driving school or in the name of the driving
school in case of a sole proprietorship, or in the name of partnership or corporation,
whichever is applicable. For a corporation, motor vehicles registered under the
name/s of the incorporator/s shall not be allowed. Vehicles under lease contract
agreement with the driving school may be authorized provided it shall be limited to
one (1) manual and one (1) automatic for motorcycle and light vehicle per driving
school branch;
□ Previous Certificate of Accreditation; and
□ Accreditation payment receipt.

I hereby certify that the foregoing statements and information are true and correct to
the best of my knowledge. I understand that I will be liable for perjury for any false
statement or entry in this form and the driving school will be permanently disqualified as a
result thereof.

By signing this form, I consent to the collection, use, access, disclosure, processing,
and disposal of my personal and sensitive personal data by the LTO in consonance with the
agency’s Data Privacy Notice and in compliance with Republic Act No. 10173 or the Data
Privacy Act of 2012.

IN WITNESS WHEREOF, I have hereunto set my hand this

____________________________ at ____________________.

______________________________
SIGNATURE OVER PRINTED NAME
AFFIANT

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Subscribed and sworn to me this ______ day of __________________ affiant exhibit to me
his/her Residence Certificate No. _____________________ issued on _______________
at _______________________.

Doc. No. _________;

Page No. _________;
Book No. _________;
Series of _________.
…………………………………………………………………………………………………………..
THIS PORTION IS FOR THE REGIONAL ACCREDITATION COMMITTEE ON DRIVING INSTITUTIONS ONLY
(Failure of the RACDI to fill out this part shall result in the disapproval of the application)
Received by: Evaluated by:

_______________________ _____________ _______________________ _____________

Signature over printed name Date Signature over printed name Date

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