BALIK-MANGGAGAWA INFORMATION SHEET

Appointment Date: April 13, 2018 11:00 AM

Processing Site: Taiwan (Taichung)

PERSON AL DATA
 

VALEROSO MICHELLE DELA CRUZ

Last Name First Name Name Ext. (e.g. Jr.,III) Middle Name

P1325444A September 05, 1983 San Carlos City Pangasinan FEMALE SINGLE
Passport Birth Date Birth Place Sex Civil Status

Purok 3 Panacol Aguilar PANGASINAN

Home Address in the Philippines

SSS Pag-IBIG RTN/MID

0905262493 Michellevaleroso10@yahoo.com
Telephone/Cellphone No. E-mail Address

Mother's Full Maiden Name:

Dela cruz Evelyn Faustino
Last Name First Name Middle Name

Name of Spouse (If married)

Last Name First Name Middle Name

CONTRACT PARTICULARS OF OFW

APTOS TECHNOLOGY
Name of Company/Emplo yer

1639 gongyi road zhunan township TAIWAN

Address of Employer Country

-/- 22000.00 TWD

Tel. No./Fax No./E-Mail Addr ess Salary / Currency

FACTORY WORKER (OPERATOR) 24 months

Position Contract Duration

November 28, 2015 February 13, 2017

Last Deployment Date Last Arrival Date

LEGAL BENEFICI ARIES / QU ALIFIED DEPE NDENTS

 

Complete Name Sex Relationship of OFW to Dependent/s Date of Birth

Evelyn dela cruz Valeroso FEMALE MOTHER January 21, 1958
Cassandra Miro V. Castro FEMALE DAUGHTER November 05, 2010
 LEGAL BENEFICI ARIES / QU ALIFIED DEPE NDENTS
 
I hereby certify that the abo ve statements ar e true and corr ect.

Control Number: V4623728118

Worker's Signature Over Printed Name