REFERENCE NUMBER: __________

Republic of the Philippines

Department of Labor and Employment
BUREAU OF WORKING CONDITIONS
Labor Standards Review and Appealed Division

REQUEST FOR CERTIFICATION OF HAS/HAS NO PENDING CASE

(Please write legibly)

Name: JENNY D. DULALAS

ContactNo. 09272605608
Address: # 28 David Isaiah St., cor. Lot Metrogate, Lambakin Marilao Bulacan Area
Name if Company: SOTERIA MARKETING INC.
Address of Company: 1408 The One Executive Bldg. West Avenue Quezon City
Purpose: For Accreditation

Hon. JENNETH B. NAPIZA

Executive Labor Arbiter
NCR-NLRC, Banawe Avenue
Quezon City

Jenny D. Dulalas
Signature
DATE: August 2, 2019
___________________________________________________________________________
(to be filled-up by the Action Officer)

Requirements submitted

( ) Letter Request
( ) Photocopy of the official receipt of the bidding fee(if for bidding purposes)
( ) Photocopy of any document showing that the DOLE CLEARANCE is being required
( ) Photocopy of DOLE Registration under Rule 1020; and
( ) Photocopy of DOLE Registration under D.O. 18-02,. If the requesting company is a contractor /
subcontractor.

Date/Time of completion of all requirements ________________________________________

Action Officer: ________________________________________________________________

--------------------------------------------------------------------------------------------------------------------------
CLAIM STUB
REFERENCE NUMBER:__________

The certification of has/or no pending case on appeal before the Office of the Secretary of
Labor and Employment shall be released on______________________,
to___________________________. Please present this stub to the Action Officer.

__________________
Action Officer