Form 3

BARANGAY MASTERLIST
Quarterly Report
For the Period ________________________

Region X
Province Misamis Occidental
Municipality/City Tangub City
Barangay

EDUCATIONAL NATURE OF EMPLOYMENT

WORK SALARY
ATTAINMENT ARRANGEMENT
1- Elem. Undergrad 1- Gen. Household 1- Live-in 1- _1,500-P1,999
(all-around) MEMBERSHIP (Write Y
REGISTRAT NAME OF KASAMBAHAY 2- Elem. Grad 2- Yaya 2- Live-out 2- P2,000-P2,499 for Yes and N for No) EMPLOYER'S
ION CIVIL NAME OF
CONTROL SEX AGE STATUS 3- HS Undergrad EMPLOYER COMPLETE
3- Cook 3- P2,500-P4999 ADDRESS
No. 4- HS Grad 4-Gardener 4- P5,000- and above
5- Col. Undergrad 5- Laundry Person
6- Col. Grad 6- Others
Family First Name Middle Name SSS Pag-IBIG PhilHealth
7- Vocational

Prepared and submitted by:

(Signature Over Printer Name)

Kasambahay Desk Officer

(Position/Designation)