Co CPC Truck For Hire

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Form No.

010: 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

___________________________ CASE NO.__________________


Applicant.

Application for a Certificate of Public Convenience


to Operate a Truck for Hire Service with Prayer for
Issuance of PROVISIONAL AUTHORITY.
x----------------------------------------x

APPLICATION

Applicant, most respectfully request for the issuance of a Certificate of a Public


Convenience (CPC) to operate a Truck for Hire service and, in support thereof, states that:

1. Applicant is a (Filipino citizen/cooperative/corporation organized under Philippines laws


duly represented by its (position/name of the representative), may be served with legal
processes at (address)/email address: ______________ and contact details (mobile
number).

2. Applicant applies for a CPC for the transportation of freight from (point of origin) to any
point in _____________, accessible to motor vehicle traffic and vice versa, with the use of
______________ unit, to wit:

PLATE /
MAKE MOTOR NO. CHASSIS NO. MODEL
COND NO.

X- Nothing Follows –X

3. Applicant is financially capable to operate a Truck for Hire service.

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, and other pertinent
laws and policies.

5. Applicant has completed all the necessary documentary requirements for the Application,
copies of which are hereto attached in Annexes.
.
6. With the consideration and approval of this Application, public necessity and convenience
will be promoted in a suitable manner.

PRAYER

WHEREFORE, it is most respectfully prayed that (a) a Notice of Hearing be issue, (b)
this Application for a Certificate of Public Convenience to Operate a TH Freight Truck 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, Metro Manila, ____________________


WAIVER
______________________________________
Applicant
I, ______________________________________, hereby grant authority to LTFRB, to
verify the authenticity of all documents herein submitted together with this application from both
government and private sources.

______________________________________
Applicant

VERIFICATION AND CERTIFICATION OF NON-FORUM SHOPPING

I, ___________________________________, Filipino and with business address at


____________________________________________________________, after having been
duly sworn to in accordance with law hereby depose and say that:

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


2. I have caused the preparation of the forgoing application;
3. I have read the contents thereof and the same are true to the best of my knowledge and
belief on the basis of the information and documents provided to me by the applicant;
4. To the best of my knowledge, I have not commended any other action or proceeding
involving the same issue in any other LTFRB office;
5. To the best of my knowledge, no such other application, petition or pleading is pending
therein, and if I learn of the same or similar application, petition, or pleading has been
filed or is pending, I shall report of such fact within five (5) days there from to the
honorable board.

______________________________________
Applicant

SUBSCRIBED AND SWORN to before me this _________________ day of


__________________ at ______________________, Affiant exhibited to me his/her
________________________ issued at ___________________________ on
___________________________.

Doc. No.: ___________________


Book No.: ____________________
Page No.: ____________________
Series of 2021.

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