Kasambahay Form 2

 

KR Form 2

KASAMBAHAY MASTERLIST Quarterly Report For the Period __________________, 20_____ Region: Province: City/Municipality: Barangay:

Educaonal Aainment Registraon Control Number

1. El Elem em U nde nderg rgra rad d

Name of Kasambahay

Home Address

Sex

Age

Civil Status

Nature of Work

Salary

1. Gen. Gen. H o ous useh ehel elp p

2. Elem Grad

Membership (Write Y for Yes, and N for No)

(all around);

3. HS Undergrad

2. Yaya

4. HS Grad

3. Cook

5 . C ol ol ll.. U nd nd e errg rra ad 6. Coll. Grad

4 . Gard en ene r 5. Laundry person

7. Vocaonal

6. Others

Name of Employer

SS SS S

Prepared and submied by:   Date: _____________________

_______________________________

Pa gg- IB IB IG IG P hil hil-- He Hea lt lt h

 

(Signature over Printed Name) Posion / Designaon

 

Employer's Complete Address

 

KR Form 3

MONTHLY BARANGAY CONSOLIDATED KASAMBAHAY REPORT For the Month of __________________, 20_____ Region: Province: City/Municipality: Barangay:

SEX

TOTAL NO. OF REGISTERED KASAMBAHAY (1)

Educaonal Aainment

(a) Home Address

Sex

Age

Civil Status

1. El Elem em Unde Underg rgra rad d 2. Elem Grad

Nature of Work

Salary

1. Gen. Gen. Ho Hous useh ehel elp p

Membership (Write Y for Yes, and N for No)

(all around);

3. HS Undergrad 4. HS Grad

2. Yaya 3. Cook

5 . Co llll. Un de derg ra rad

4 . Ga rrd de ne ner

6. Coll. Grad

5. Laundry person

7. Vocaonal

6. Others

Prepared and submied by:

SS S

Pag -I -I BI BIG Ph ilil -He -Hea alth

 

Date: _____________________

  _______________________________ (Signature over Printed Name) Posion / Designaon

 

Name of Employer

Employer's Complete Address