NWRB-WUD-14-r3
Republic of the Philippines
NATIONAL WATER RESOURCES BOARD
8th Floor NIA Building, EDSA, Quezon City
Telefax (02) 8202-2714
APPLICATION FOR
CHANGE OF NAME
Accomplish this form in six (6) copies.
Attach separate sheet if more space is required.
Water Service
Provider (WSP)
Category¹ {{$application->cat_id ?? 'N/A'}}
Case Number
{{ $application->docket_code ?? 'N/A' }}
Name of Applicant
FROM:
{{ $application->name_from ?? 'N/A' }}
TO:
{{ $application->name_to ?? 'N/A' }}
Mailing Address
{{ $application->mailing_address ?? 'N/A' }}
Email Address
{{ $application->email_address ?? 'N/A' }}
Contact No.
{{ $application->contact_number ?? 'N/A' }}
Citizenship
{{ $application->citizenship ?? 'N/A' }}
TIN
{{ $application->tin ?? 'N/A' }}
Year Operations Started
{{ $application->year_operation ?? 'N/A' }}
Acquisition Cost/ Fee
Filing Fee Amount
OR No.
Date Paid
Location of Service Area
@php $subdivisions = $application->subdivision ?? []; $allSubs = collect($subdivisions) ->flatMap(fn($division) => $division) ->filter() ->values() ->all(); $barangays = $application->brgys ?? []; $municipalities = collect($application->muniData ?? [])->pluck('name')->all(); $provinces = collect($application->provsData ?? [])->pluck('name')->all(); $hasManyColumns = count($allSubs) > 3 || count($barangays) > 3 || count($municipalities) > 3 || count($provinces) > 3; @endphp @if ($hasManyColumns)
Subdivision

See the Checklist Location of Service Area Below

Barangay
Municipality
Province
@else {{-- Subdivision --}} @foreach ($allSubs as $sub) @endforeach {{-- Barangay --}} @php $data = $barangays; $count = count($data); $i = 0; @endphp @while ($i < $count) @php $current = $data[$i]; $colspan = 1; while (($i + $colspan) < $count && $data[$i + $colspan] === $current) { $colspan++; } @endphp @php $i += $colspan; @endphp @endwhile {{-- Municipality --}} @php $data = $application->muniData; $count = count($data); $i = 0; @endphp @while ($i < $count) @php $current = $data[$i]['name']; $colspan = 1; while (($i + $colspan) < $count && $data[$i + $colspan]['name'] === $current) { $colspan++; } @endphp @php $i += $colspan; @endphp @endwhile {{-- Province --}} @php $data = $application->provsData; $count = count($data); $i = 0; @endphp @while ($i < $count) @php $current = $data[$i]['name']; $colspan = 1; while (($i + $colspan) < $count && $data[$i + $colspan]['name'] === $current) { $colspan++; } @endphp @php $i += $colspan; @endphp @endwhile
Subdivision{{ $sub }}
Barangay 1) colspan="{{ $colspan }}" @endif> {{ $current }}
Municipality 1) colspan="{{ $colspan }}" @endif> {{ $current }}
Province 1) colspan="{{ $colspan }}" @endif> {{ $current }}
@endif
Type of Water Service Provider
Meters tested?
{{-- @dd($application->meters_tested) --}}
Kind of Water System
For Bulk Water Seller/Peddler,
Average volume of water delivered per day
(in cu. m.)
{{-- --}}
Water Permit Information
@if ($rows <= 4) @foreach ($rowsData as $row) @endforeach @else {{-- additional empty rows if needed --}} @for ($j = 0; $j < 3; $j++) @endfor @endif
CWP/Water Permit No. Source Latitude Longitude Barangay Location of Source
Deg.Min.Sec. Deg.Min.Sec.
{{ $row['permit_no'] }} {{ $row['source'] }} {{ $row['deg_latitude'] }} {{ $row['min_latitude'] }} {{ $row['sec_latitude'] }} {{ $row['deg_longitude'] }} {{ $row['min_longitude'] }} {{ $row['sec_longitude'] }} {{ $row['barangay_source'] }}
See the Checklist Water Permit below.
If water is bulk supplied, copy of agreement/contract/receipt
See back page for pertinent requirements
I hereby certify that the information given above and the documents submitted are true and correct to the best of my knowledge and belief.
Signature over printed name of Water Utility Representative
Subscribed and sworn to before me on this date:
Notary Public / Administering Officer
Date
¹ How to Determine the Water Service Provider Category
Category A
Category B
Category C

Water utilities operating for profit:

  1. Privately-owned or privately run WUs; or
  2. Government-owned and government-run WUs that opted to be classified or NWRB has classified as Category A; or
  3. Community-based WUs that:
    1. Have expanded/ are expanding outside original area of jurisdiction, or
    2. Opted to be classified or NWRB has classified it as Category A
Government-owned or controlled, and government-run WUs that do not opt to be classified as Category "A" or NWRB has classified as Category B

Community-based WUs that:

  1. Are not operating for profit;
  2. Have not expanded/ are not expanding outside their original area of jurisdiction; or
  3. Do not opt to be classified as Category "A"/"B" or NWRB has classified as Category "A"
{{--
--}}
National Water Resources Board
APPLICATION FOR
CHANGE OF NAME
Name of Applicant
FROM

TO
Water Service Provider Category
Case Number
Documentary Requirements Cat. A Cat. B Cat. C
Articles of Incorporation/Partnership or DTI/CDA Registration under the new name
Authority to sign and file the application
  • Board Resolution for corporations and partnerships or Board Secretary's Certificate
  • For single proprietorship, signed by owner or Special Power of Attorney
Copy of approved/transferred Water Permit/s (with Resolution) If water is bulk-supplied, copy of agreement/contract/receipt
Copy of latest Official Receipts of Annual Water Charge/s
Copy of latest Official Receipts of Supervision and Regulation Fee
    Copy of recent Certificate of Potability (within 6 months) issued by the City/Municipal Health Officer where the source is located, with results of bacteriological (within 3 months), physical and chemical (at least one year) impurity tests conducted by a Department of Health accredited laboratory
Copy of latest Annual Report under the old name with NWRB received stamp
Tariff schedule to be implemented (please attach NWRB Board resolution)
Copy of CPC Certificate
{{-- 3rd PAGE Checklist Location of Service Area --}} @if ($hasManyColumns)
Checklist Location of Service Area
APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE - {{ strtoupper($application->applicant_name) }}
@foreach ($grouped as $provinceName => $rows)
PROVINCE: {{ strtoupper($provinceName) }}
@php $chunks = array_chunk($rows, 5); @endphp @foreach ($chunks as $chunk) @php $mergedBrgy = $uniqueBrgy($chunk); $mergedMuni = $mergeCells($chunk, 'muni'); @endphp @foreach ($chunk as $item) @endforeach @foreach ($mergedBrgy as $cell) @endforeach @foreach ($mergedMuni as $cell) @endforeach @foreach ($chunk as $item) @endforeach
Subdivision{{ $item['sub'] }}
Barangay{{ $cell['value'] }}
Municipality 1) colspan="{{ $cell['colspan'] }}" @endif> {{ $cell['value'] }}
Province{{ $item['prov'] }}
@endforeach @endforeach
@endif @if ($rows > 4) div class="page page-break">
Checklist Water Permit
APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE - {{ strtoupper($application->applicant_name) }}
@foreach ($rowsData as $row) @endforeach
CWP/Water Permit No. Source Latitude Longitude Barangay Location of Source
Deg.Min.Sec. Deg.Min.Sec.
{{ $row['permit_no'] }} {{ $row['source'] }} {{ $row['deg_latitude'] }} {{ $row['min_latitude'] }} {{ $row['sec_latitude'] }} {{ $row['deg_longitude'] }} {{ $row['min_longitude'] }} {{ $row['sec_longitude'] }} {{ $row['barangay_source'] }}
@endif