Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT

Regional Office No. 6

LIST OF AFFECTED WORKERS DUE TO COVID-19

Instructions: If necessary, use additional sheets following the same format.

Profile of Affected Workers

Employment
Name of Worker*
Home Contact Status
No. Age* Sex* Designation
Address* Number* (regular,
Last Name First Name MI
contractual, etc.)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

Prepared by:

Signature over Printed Name

Date
 Bank Account Details
Salary1 (For LBP only; N/A if
others or none)