REPUBLIC OF THE PHILIPPINES

Department of Transportation and Communications

LAND TRANSPORTATION FRANCHISING AND REGULATORY BOARD
City of San Fernando, Pampanga

NAME
Petitioner CASE NO.________

Petition for Extension of Provisional Authority

Of a Certificate of Public Convenience to Operate
A TH Freight Truck Service
x--- --- --- --- --- --- --- --- --- --- ---x

PETITION FOR EXTENSION OF PROVISIONAL AUTHORITY

Comes Now, the petitioner, unto this Honorable Board, respectfully alleges:

That petitioner/s filed an Application for issuance of a Certificate of Public Convenience to operate
a TH Freight Truck Service on the route: Municipality of ________________________________________
Under the above case number with the use of ________________________;

Considering the said Application is not yet approved, Petitioner request for extension of
provisional authority issued on the above case number with the use of the same number of units which
described as;
MAKE MOTOR# CHASSIS# PLATE#

That petitioner is still financially capable in the operation of the aforementioned units, that public
necessity and convenience will be promoted in a proper and suitable manner.

That petitioners will still comply with the Public Service Laws as amended, the Rules and
Regulations of the Board and such other rules and regulations now in force or may hereafter be enforced.

WAIVER

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

Name
Petitioner/s