KR Form 2

KASAMBAHAY MASTERLIST
Quarterly Report
For the Period __________________, 20_____

Region:
Province:
City/Municipality:
Barangay:

Educational Nature of Work Salary Membership

Attainment
1. Elem Undergrad 1. Gen. Househelp (Write Y for Yes, and N for No)
Registration Home Civil 2. Elem Grad (all around);
Control Name of Kasambahay Sex Age Name of Employer
Address Status 3. HS Undergrad 2. Yaya
Number
4. HS Grad 3. Cook
5. Coll. Undergrad 4. Gardener
6. Coll. Grad 5. Laundry person
SSS Pag-IBIG Phil-Health
7. Vocational 6. Others

Prepared and submitted by:

Date: _____________________ _______________________________

(Signature over Printed Name)

Position / Designation
Employer's Complete
Address
KR Form 3
MONTHLY BARANGAY CONSOLIDATED KASAMBAHAY REPORT
For the Month of __________________, 20_____

Region:
Province:
City/Municipality:
Barangay:

SEX

Educational
(a) Nature of Work Salary Membership
TOTAL NO. OF Attainment
REGISTERED Home Civil
Sex Age 1. Elem Undergrad 1. Gen. Househelp (Write Y for Yes, and N for No)
KASAMBAHAY Address Status
(1) 2. Elem Grad (all around);
3. HS Undergrad 2. Yaya
4. HS Grad 3. Cook
5. Coll. Undergrad 4. Gardener
6. Coll. Grad 5. Laundry person
SSS Pag-IBIG Phil-Health
7. Vocational 6. Others

Prepared and submitted by:

Date: _____________________ _______________________________
(Signature over Printed Name)

Position / Designation
 Employer's Complete
Name of Employer Address