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LTFRB Operator Data Sheet

This document is an operator data sheet for Haultech Reefer Trucks Corporation. [1] It provides information on the corporation such as ownership type, existing and pending franchises, and contact details. [2] The authorized representative is identified as Jennifer S. Sambajon who attests that the information provided is true and correct. [3] The operator undertakes to inform the board of any changes to the data sheet within 15 days.

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Haultech Trucks
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588 views3 pages

LTFRB Operator Data Sheet

This document is an operator data sheet for Haultech Reefer Trucks Corporation. [1] It provides information on the corporation such as ownership type, existing and pending franchises, and contact details. [2] The authorized representative is identified as Jennifer S. Sambajon who attests that the information provided is true and correct. [3] The operator undertakes to inform the board of any changes to the data sheet within 15 days.

Uploaded by

Haultech Trucks
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Department of Transportation and Communications

LAND TRANSPORTATION FRANCHISING AND REGULATORY BOARD


East Avenue, Quezon City

PASTE
OPERATOR DATA SHEET
2X2 PHOTO

TYPE OF OWNERSHIP Single Proprietorship ✘ Corporation

Partnership Cooperative

I. CASE NUMBER______________ NO. OF AUTHORIZED UNITS ___________


1
TYPE OF SERVICE PUJ SB AUV

✘ TH TX PUB ___ AC ____REG

TTS SHS

NO. EXISTING FRANCHISE_________________________________________


2

CASE NUMBER NO.OF AUTHORIZED UNITS


2020- 5575 9
2021- 10171 2

NO. OF PENDING APPLICATIONS__________________________________

CASE NUMBER TYPE OF APPLICATION


2019-14417 extension of franchise
2018- 36550 new cpc
2020- 7844 with motion for correction of entry
2021-11837 new cpc
2022- 16471/ 2023- 0115 new cpc
II. FOR INDIVIDUAL OPERATOR:

LAST NAME______________________________________________________
FIRST NAME_____________________________________________________
MIDDLE NAME____________________________________________________

DATE OF BIRTH__________________SEX: F M
TIN NO._________
BUSINESS ADDRESS______________________________________________
MAILING ADDRESS_______________________________________________
PHONE NUMBER_________________________________________________
E-MAIL__________________________________________________________

SPECIMEN SIGNATURE

III. FOR CORPORATION/COOPERATIVE/OTHERS

NAME OF CORPORATION/COOPERATIVE/OTHERS____________________
________________________________________________________________
HAULTECH REEFER TRUCKS CORPORATION
SEC/CDA REGISTRATION NO. ________________TIN
CS201712486 NO._______________
009633743
BUSINESS ADDRESS______________________________________________
LAGUMEN-BACHILLER BLDG WASHINGTON DRIVE
MAILING ADDRESS_______________________________________________
LEGAZPI CITY (SAME)
PHONE NUMBER_________________________________________________
(917) 102-7677
E-MAIL__________________________________________________________
haultech.trucks@gmail.com

IV. Authorized Representative [Note: Only the authorized representative identified


in this sheet will be allowed to transact business in the agency for and on behalf
of the owner]

LASTNAME______________________________________________________
SAMBAJON
FIRST NAME_____________________________________________________
JENNIFER
MIDDLE NAME____________________________________________________
SALANDO
DATE OF BIRTH_______________SEX
01/29/1979 M ✘ F TIN NO.___________
920478865
BUSINESS ADDRESS______________________________________________
Lagumen- Bachiller Bldg. Bgy 16 Washington Drive Legazpi City
MAILING ADDRESS_______________________________________________
same as above
PHONE NUMBER_________________________________________________
(917) 102-7677
E-MAIL__________________________________________________________
haultech.trucks@gmail.com

Operator undertakes that all information stated in this sheet are true and correct.
Any misrepresentation and/or unlawful withholding of information will warrant
outright denial and/or cancellation of the franchise in accordance with the Public
Service Act. The Board reserves the right to VERIFY all information in this
datasheet and to institute appropriate criminal prosecution for any act prejudicial
to the public interest.
ATTESTATION AND UNDERTAKING

I,_________________________________,
JENNIFER S. SAMBAJON do hereby ATTEST that the
foregoing information are complete, true and correct to the best of my knowledge
and belief. I commit to inform the Board in writing any subsequent changes in
this data sheet within 15 days from knowledge thereof.

_______________________________
Signature over Printed Name

SUBSCRIBED AND SWORN TO before me this __________________, a


notary public for and in the city of _________________________________, the
affiant showing to me his/her identification card with
no.________________________.

NOTARY PUBLIC

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