Professional Documents
Culture Documents
A. Establishment Data
Name of Establishment*: (Please indicate registered name as reflected in the business permit)
CERTIFICATION
This is to certify as to the accuracy of the data provided in this report.
Name and Signature of Owner/Company Representative*:
Atty. Rea Jane Malcampo
Designation: Fax No.:
Lawyer/Owner of Law office
Contact No.: Email Address:
0917 503 7505 attyreamalcampo@gmail.com
Employment
Name of Worker* Contact Status
No. Age* Sex* Home Address* Designation Salary1
(Last Name, First Name, M.I.) Number* (regular,
contractual, etc.)
Charlotte V. Dago-oc 31 F Purok Gumamela, 09355960739 Secretary Contractual 8,000
1 Candau-ay, monthly
Dumaguete City
Virgelia P. Baliola 50 F North Poblacion, 09262713957 Titling Contractual 11,000
2
Bacong, Neg.Or. Processor monthly
Edric A. Venzuelo 24 M Calangag, 09155660920 Messenger Contractual 6,000
3
Bacong, Neg.Or. monthly
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1
Indicate whether per hour, per day or per month
* Mandatory fields to be accomplished by the company representative for COVID-19 AMP applications.