LTC VEHICLE STICKER APPLICATION FORM

Control No.______________________
Application type:
New Renewal

I. To be filled up by applicant:
a. Vehicle User Information
Locator Non-Locator

Company name :____________________________________________________________________________________________

Name of Designated Driver (s) :____________________________________________________________________________________________
b. Vehicle Information: (Please check the appropriate box)
Plate No. / Conduction Sticker No.:__________________________ Brand/Make:___________________ Color:__________________________

b. 1 Type Motorcycle Car Van Trucks Others:____________________________

b. 2 # of Wheels 2 wheels 4 wheels 6 wheels 10 wheels Others:____________________________

c. Applicant's Undertaking

I hereby bind my self and agree to follow all LTC Traffic rules and regulations and that upon sale or disposal of my vehicle, the vehicle
pass/sticker is

Signature over printed name of applicant Signature over printed name of driver/s

II. To be filled up by applicant:

a. Locators certification and undertakings:
I hereby certify the following:
1) that the applicant is a bonifide employee/ contractor/ subcontractor/ service provider/ supplier/ guest of our guess of our company
2) that the driver was fully briefed and agrees to follow all LTC rules and regulations;
3) That we will take responsibility in ensuring all cases are settled in the event that the vehicle is involved in an accident and/ or cause
damge inside the zone;
4) That the vehicle in the absence of deed of sale tranceability is in applicants legal possession;
5) That all information declared herein are true and correct to the best of my knowledge.

Locator's Name Printed Name and Signature of Authorized Signatory Official Designation

III. To be filled up by LTC

PR No.:_______________________________ Control # :__________________________
LTC Approval
Application Verified by:________________________________________________________________________________________
Date/Time:__________________________________________________________________________________________________
Oriented by:_________________________________________________________________________________________________
LTC Traffic Rules and Regulation Orientation Date:__________________________________________________________________
Remarks:__________________________________________________________________________________________________________________

IV. Requirements:
1. Photocopy of Certificate of Registration ( CR )
2. Photocopy of Official Receipt ( Current ) (Sales Invoice for new vehicles only)
3. Photocopy of Driver's License
4. Photocopy of Company ID ( Valid and Current, front and back )
4.1 Locator issued ID for direct employees or
4.2 Locator issued Service Provider ID aligned to template provided by LTC for Service Provider employees (such as agency-
based employees, janitorial services, security services, canteen operators, maintenance work, and etc.)
5. Photocopy of Deed of Sale or Certification of ownership and / or transfer for installment vehicle only (Photocopy & original - for
verification if applicant is not registered owner )

Note:
1. Applications will not be received by LTC with incomplete / insufficient requirements.
2. Other documents may be required by FPIP depending on nature of application
3. Please see and sign Data Privacy Act Notice at the back prior to processing of application.
FO- PM 24
Rev. No.04