BALIK-MANGGAGAWA INFORMATION SHEET

Appointment Date: May 30, 2019 02:00 PM

Processing Site: Hong Kong

PERSONAL DATA
 

ETONG NOVIE MERIS

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

P0151454B November 19, 1983 San Gabriel,La Union FEMALE SINGLE

Passport Birth Date Birth Place Sex Civil Status

IC-166 Betag La Trinidad BENGUET

Home Address in the Philippines

3412559780 121054536040
SSS Pag-IBIG RTN/MID
61320469 novyitong1083@gmail.com
Telephone/Cellphone No. E-mail Address
Mother's Full Maiden Name:
Etong Catherine Punasen
Last Name First Name Middle Name

Name of Spouse (If married)

Last Name First Name Middle Name

CONTRACT PARTICULARS OF OFW

Leung Hei Man

Name of Company/Employer

3rd F Rear No,31-A Kia tak road kowloon city HONG KONG
Address of Employer Country

-/- 4210.00 HKD

Tel. No./Fax No./E-Mail Address Salary / Currency
DH 24 months
Position Contract Duration
January 29, 2018 February 01, 2018
Last Deployment Date Last Arrival Date

LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS

 

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

Odri Etong FEMALE SISTER October 04, 1990
 
I hereby certify that the above statements are true and correct.
 LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS

Control Number: E3523506677

Worker's Signature Over Printed Name