LTFRB - Gov.ph Media Downloadable OPERATOR DATA SHEET2
LTFRB - Gov.ph Media Downloadable OPERATOR DATA SHEET2
LTFRB - Gov.ph Media Downloadable OPERATOR DATA SHEET2
2X2PHOTO
OPERATORDATASHEET
TYPEOFOWNERSHIP
SingleProprietorship
Corporation
Partnership
Cooperative
CASENUMBER
TYPEOFSERVICE
NO.OFAUTHORIZEDUNITS
PUJ
TH
SB TX TTS
SHS
AUV
PUB AC REG
ForIndividualOperator(Pleaseaccomplishbelow)
LASTNAME
FIRSTNAME
MIDDLENAME
DATEOFBIRTH
BIRTH
SEX
M F
TINNO.
ForCorporation/Cooperative/Others(Pleaseaccomplishbelow)
NAMEOFCORPORATION/COOPERATIVE/OTHERS
SEC/CDAREGISTRATIONNO.
NAMEOFAUTHORIZEDREPRESENTATIVE
POSITION
TINNO.
SEXMF
DATEOFBIRTH
GeneralInformation
BUSINESSADDRESS
MAILINGADDRESS
GARAGEADDRESS
PHONENUMBER
MOBILENO.
(HOME)
(OFFICE)
EMAIL
(FAX)
WEBSITE
SPECIMENSIGNATURE
ATTESTATIONANDUNDERTAKING
I,__________________________________________,doherebyATTESTthattheforegoing
informationarecompleteandtruetothebestofmyknowledgeandbelief.IfurtherUNDERTAKEto
informtheBoardofanychanges/amendmentstotheabovedetailswithinfifteen(15)daysfrom
occurrenceofsaidchanges/amendments.
______________________________________
SignatureoverPrintedName