‘D0 NOT WAITE ON Tis SPace ta A fa Br BALIK-MANGGAGAWA INFORMATION SHEET Appointment Date: January 29, 2021 10:00 AM Processing Site: Region 8 (Tacloban) PERSONAL DATA MERIDA MA. AZYL VERDEFLOR Last Name First Name Name Ext. (0.9. J.tll) Middle Name P7294784A April 12, 1991 Catbalogan City FEMALE SINGLE Passport Birth Date Birth Place ‘Sex Civil Status Purok 2 San Agustine Gandara SAMAR Home Address in the Philippines sss Pag.iBiG RTNMID 09271276140 nurseazyl@gmail.com ‘Telephone/Celiphone No E-mail Address Mother's Full Maiden Name: Merida Zenaida Verdeflor Last Name First Name Middle Name Name of Spouse (If married) Last Name First Name Middle Name ‘CONTRACT PARTICULARS OF OFW. Al Ain UNITED ARAB EMIRATES. ‘Address of Employer Country ote 7000.00 AED Tel. No./Fax No./E-Mail Address Salary / Currency NURSE GENERAL FEMALE 24 months Position ‘Contract Duration January 30, 2020 February 14, 2020 Last Deployment Date Last Arrival Date LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS Complete Name Sex Relationship of OFW to Dependent/s Date of Birth hon Zoryl Arias MALE SON January 05, 2010 | noreby cert thatthe above statements are true and correc. Control Number: M6305552643 Workers Signature Over Printed Name