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Authority to Operate as Cargo Sales Agent (CSA) / BreakBulk for Licensed Airfreight Forwarder

CAB application form for authority to operate as cargo sales agent/breakbulk for licensed airfreight forwarder

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CAB-REF-06-001 J
Revised 08/2007

Republic of the Philippines
Department of Transportation and Communications

CIVIL AERONAUTICS BOARD
OLD MIA ROAD, PASAY CITY,
Metro Manila

APPLICATION FOR AUTHORITY TO OPERATE AS
CARGO SALES AGENT (CSA) / BREAKBULK
FOR LICENSED AIRFREIGHT FORWARDER
1. Identification of Applicant:

CAB CASE NO. EP ________

4. Address of principal office:

(a) Name:

(b) Name in which applicant wishes Operating Authorization to

5. Mailing address:

be issued:

2. Type of application:

Telephone No(s):

Original

Renewal
E-mail:

3. Date of filing:
Fax:
6. Form of organization:
Corporation

Partnership

Sole Proprietorship

7. Place of incorporation or under whose

Other (Specify)

8. Date of incorporation or

laws company is authorized to operate:

formation of company:

9. Stockholders, partners, owners, officers or members of applicant:
(a) Full Name:

(b) Address:

(c) Title:

(d) Citizenship

(e) % of stock or

(Country):

other interest:

10. Board of Directors of Applicant:
(a) Full Name:

(b) Address:

(c) Citizenship

(d) % of stock or

(Country):

other interest:

11. Description of current business activities and length of time engaged therein:

12. Previous business experience related to transportation activities:
Dates
Description

From

To

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13. Capitalization: authorized capital stock, subscribed and paid-up capital of applicant:
a.) Authorized

b.) Subscribed:

c.) Paid-up:

14. Principal to be represented by applicant as CSA for licensed airfreight forwarder:

15. Address of principal:

16.Previous principal represented by applicant CSA:

17.Submit with this application, in original and three (3) copies the documents enumerated in the attached list of requirements.

CERTIFICATION

I certify that the information contained in this application, and in the attachments hereto, is complete and accurate to the best of my
knowledge.

__________________________________
Signature over printed name of applicant
__________________________________
Date
__________________________________
Title / Designation
================================================================================================================

O A T H

Subscribed and sworn to before me this _______________ day of _____________________________, 20______. Affiant
exhibited to me his residence Certificate No. _________________________ issued on ________________________, 20______
at ___________________________________________________.

__________________________________________
Notary Public

My commission expires ______________________
Doc. No. _____________________________
Page No. _____________________________
Book No. ____________________________
Series of 20 __________________________

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