Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT

Regional Office No. VIII
Trece Martires St., Tacloban City

NOTICE OF VOLUNTARY COMPLIANCE

Name of Principal: ______________________________________ Name of Contractor/Sub-contractor: ________________________________

Address: _______________________________________________ Office Address: __________________________________________________
Nature of business: ______________________________________ __________________________________________________
Contact No.: ____________________________________________ Contact No.: _____________________________________________________

PROOF OF COMPLIANCE
Absorbed Date Absorbed/ Check ( √ ) if applicable
No. Name of Worker/s Age Position Date Started Regularized Proof of
With Principal (Yes) (No) Payroll DTR Employment Coverage &
Y N Contract Remittance
of SWB
1
2
3
4
5
6
7
8
9
10

I hereby certify that the entries above are true and correct to the best of my knowledge.

______________________________________
Authorized Representative
(Signature above Printed Name)

Date: _________________________________