FORM 1 Republic of the Philippines ENERGY REGULATORY COMMISSION 12IF Pacific Center Bldg., San Miguel Avenue, Pasig City COC No. Application No. Date Filed Application For Amendment of COC a PP a scr O Others 1, INFORMATION ON THE APPLICANT: Name of Owner: Name of Operator (if appli Name of IPPA (if applicable}: bie): 1.1 Business Nam Type of Organization: Business Address: y Number & Street: City/Town: Province &ZipCode; st Website (if available): E-mail Address: Tel. No yaaa Fax No 4.2 1.2. Chief Executive Officer ofthe = Name: Tel. No.: cd Fax No, Gay E-mail Mobile No. 4.3. Authorized niin Name and i Address: y Telephone: ©) : Fax No.: eee E-mail Mobile No. : 1.4 Nature of Amendment: ‘Change of Name Change of Ownership Change from Regular COC to FIT Eligible COC Change of Technical Specifications fl ‘Change of Status from SGF to IPP Change of Location of Generation Faciliies/Business Address Others: 1 ooooooo