Control No.

________________
Brgy. Sta. Anastacia Tel. Nos.: (043) 405-6020 to 23
Sto. Tomas, Batangas Fax No.: (043) 405-6031

FPIP VEHICLE STICKER APPLICATION FORM

I. To be filled up by applicant:
a. VEHICLE USER INFORMATION

Locator : ___________________________ Gen-contractor : _________________________

Service Provider : ___________________________ Sub-contractor : _________________________
(includes manpower agencies, locator canteen operators, waste haulers, trucking, etc.)

Name of Designated Driver (s) : ____________________________________________________________

Project Name / Scope of Work : __________________________________________________________________
(Please check the appropriate box)

 Construction  Maintenance  Vendor / Delivery  Locator Canteen Operator

(Civil, Structural, Electrical,
 Manpower Agency  Locator Shuttle Provider
Mechanical, Sanitary / plumbing works)  ESP
 Machine Setting / (Accredited Environmental  Others _______________
Service Providers) (Please specify)
Equipment Installation
DURATION OF PROJECT / SERVICE: Start: __________________ Finish: _________________ (up to current year only)
(mm/dd/yy) (mm/dd/yy)
b. VEHICLE INFORMATION: (Please check the appropriate box)
Plate No. / Conduction Sticker No/ MV File No..: _________________ Brand : ________________ Color: _______________

b.1 Type  Motorcycle  Car  Van  Trucks  Others : _________________

b.2 # of Wheels
b.3 Vehicle owned by
 2 wheels  4 wheels  6 wheels  10 wheels  Others : _________________
 Employer  Mother / Sister Company  Relatives  Others :
(company name) ___________________ ______________ ____________________
(Attached Affidavit signed by the Owner
___________________ (Please specify)
 Spouse (Please specify company name)
allowing the Applicant to use the vehicle)

c. APPLICANT’S UNDERTAKING
I hereby bind myself and agree to follow all FPIP park rules and regulations and that upon sale or disposal of my vehicle, the vehicle pass / sticker is
considered void and revoked. I further certify that all information declared herein are true and correct to the best of my knowledge.

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

II. To be filled up by Locators:

a. LOCATORS CERTIFICATION AND UNDERTAKINGS:
I hereby certify the following: (1) that the applicant is a bonafide employee / contractor / subcontractor / service provider / supplier / guest of our
company; (2) that the driver was fully briefed and agrees to follow all FPIP 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 damage inside the park; (4) that the vehicle in the absence of deed
of sale traceability 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 FPIP:

Sample Only
PR No. : ________________ Control # : __________________
For the application of: (Please check the appropriate box)
 Locator Sticker  Contractor / Subcontractors / Service  Contractor / Subcontractors /
 Locator Guest Pass Provider / Vendor Sticker Service Provider / Vendor Sticker
(for 4 wheels and above) (for motorcycles)
a. FPIP APPROVAL

Application Verified by:

Date:
Remarks:

IV. Requirements:
A. BASIC
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 ( Valid and Current )
4. Photocopy of Company ID ( Valid and Current, front and back )
a. Locator issued ID for direct employees or
b. Locator issued Service Provider ID aligned to template provided by FPIP for Service Provider employees (such as agency-
based employees, janitorial services, security services, canteen operators, maintenance work, and etc.) or
c. FPIP issued Park Pass ID for contractors, sub-contractors & Service Providers
B. OTHERS
1. 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 )
2. Copy of lease purchase agreement or lease/rental agreement ( if applicable )
3. Copy of Decision from LTO for change plate # ( if applicable )
4. Copy of shuttle service contract ( if Shuttle Service of Locator )
5. Valid Business Permit ( if Canteen Operators )
Note:
1. Applications will not be received by FPIP 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.
Rev. 14 (OPN-PF-SEC)
08/01/2018
 DATA PRIVACY NOTICE

By filling-up, signing and submitting this form, you are consenting to the collection,
processing, use and retention of your personal data based on the Privacy Policy of the Company.
Your personal information is also collected through phone calls, emails, SMSs or verbal
communication with our authorized representatives, as applicable. In particular, we are using
your information to process your access permit and monitor entry to the park in connection
to your performance of work, to comply with government requirements, and to perform such
other processing that may be required in the course of business. You attest that all such
personal data is accurate, complete and up-to-date.

As a general rule, we are not allowed to share your data to third party, except in limited
circumstances. By giving your consent, you authorize the Company to disclose your personal data
to accredited/affiliated or independent/non-affiliated third parties, as necessary for the proper
execution of processes related to the declared purpose, and when the use or disclosure is reasonably
necessary, required or authorized by or under law. However, such third parties may only use
personal data for the purpose disclosed and may not use it for any other purpose.

The Company strictly enforces its Privacy Policy and have implemented technological,
organizational, and physical security measures to protect your information. The Company stores
electronic and physical document in both local and off-shore facilities in accordance with the
Company’s Retention Policy. As a data subject, you have the right to be informed, to object, to
access, to rectify or correct erroneous data, to secure data portability, and to be indemnified for
damages. The Company’s decisions to provide access, consider requests for correction or erasure,
and address objection to process personal data as it appears in the Company’s official records, are
always subject to applicable and relevant laws and/or the DPA, its IRR and other issuances of the
NPC. Should you have any inquiry, feedback, and/or complaints to the Company’s Privacy Policy,
you may reach our Data Protection Officer at fpipdpo@fpip.com.

_________________________________________________
Printed Name and Signature of Authorized
Signatory of Locator/ General Contractor

Rev. 14 (OPN-PF-SEC)
08/01/2018