10/2/2019 Printing

BALIK-MANGGAGAWA INFORMATION SHEET

Appointment Date: October 04, 2019 10:00 AM
Processing Site: POEA Main Office (Ortigas)

PERSONAL DATA

REY JOLYNA TUNGO

Last Name First Name Name Ext. (e.g. Jr.,III) Middle Name
P6605180A June 18, 1983 LUCENA CITY FEMALE MARRIED
Passport Birth Date Birth Place Sex Civil Status
PUROK MASAGANA IBABANG IYAM Lucena City QUEZON
Home Address in the Philippines

SSS Pag-IBIG RTN/MID

09369257535 jolynarey2@gmail.com
Telephone/Cellphone No. E-mail Address
Mother's Full Maiden Name:
PARANGALAN MELBA FRIAS
Last Name First Name Middle Name
Name of Spouse (If married)
REY RUDY ORDAZA
Last Name First Name Middle Name

CONTRACT PARTICULARS OF OFW

IBRAHIM ABDULLAH ALJASSIR

Name of Company/Employer
HETTEN RIYADH SAUDI ARABIA SAUDI ARABIA
Address of Employer Country
966562274444 / - 1800.00 SAR
Tel. No./Fax No./E-Mail Address Salary / Currency
DOMESTIC HELPER/BABYSITTER 24 months
Position Contract Duration
July 31, 2016 July 17, 2019
Last Deployment Date Last Arrival Date

LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS

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

RUDY ORDAZA REY MALE SPOUSE October 10, 1976

I hereby certify that the above statements are true and correct.

Control Number: R0005315536

Worker's Signature Over Printed Name

https://www.bmonline.ph/receipt/appointment/929feb8164979db50f0faff0a6a0318d 1/1