Name of Project: TUPAD

DOLE Regional Office: MIMAROPA

Province:
Municipality:
Barangay:

LIST OF BENEFICIARIES

Name of Beneficiary Address 2 E-payment/

Birthdate1 Bank
Type of ID Account No.
Extensi City/ (indicate the Type of Civil
Street/
District (e.g. SSS,
No. ID Number Contact No. Occupation4 Sex5 Age
First Name Middle Name Last Name on Barangay Municipalit Province type of Beneficiary3 Status6
(YYYY/MM/D Sitio Voter's ID) account and
Name y
D) no. as
applicable)
1 Gilbien Rafael Manao Siman 2000/10/18 Purok Rosal PORAS Boac Marinduque District I Provincial ID 000-139 9691102577 None None NOne M S 21

2 Harold Menor Jandusay 2000/08/22 Purok Sagumay PORAS Boac Marinduque District I Provincial ID 000-194 9511567732 None None None M S 22

3 Renz Maui Quinto Labrador 1998/05/24 Purok Rosal PORAS Boac Marinduque District I Provincial ID 000-066 09198848302 None None None M S 24

4 Ira Mae Casimiro Sotto Marc 5,2003 Purok Rose PORAS Boac Marinduque District I Provincial ID 000-609 9091536757 None None Self Employed F S 19
December 02.
5 Lanie Marmol Purok Rose PORAS Boac Marinduque District I Provincial ID 000-552 09613327659 None None Self Employed F S 26
1995
6 Jhun Orilla Magcamit 2004/06/11 Hidalgo ISOK 1 Boac Marinduque District I School Id 10980100150 09632530838 None None Student M S 18

7 Joaquin Romualdo Gramaje Luarca 2004/01/17 Canobas ISOK 1 Boac Marinduque District I Provincial ID 000-0624 09701830146 None None None M S 18
Bird of
8 Mike Ezekiel Besimo Moran 2002/09/23
Paradiese
ISOK 1 Boac Marinduque District I Provincial ID 000-533 None None None M S 19

9 Aeron John Cortez Manay 2004/08/29 Pamintuan St. ISOK 1 Boac Marinduque District I Provincial ID 000-0909 9150182534 None None None M S 18

10 Marc Jefferson Huerta Leva 2003/01/29 Hidalgo ISOK 1 Boac Marinduque District I Driver Licence DO3-21-200098 09267452388 None None None M S 19

11 Joshua Bunag Arevallo 2001/03/22 Hidalgo ISOK 1 Boac Marinduque District I Provincial ID 0000-0656 9065601263 None None None M S 21

12 Peter Joseph Medeja Lupig 2003/12/15 Canovas ISOK 1 Boac Marinduque District I Provincial ID 000-0615 09260464608 None None None M S 19
September
13 Kenjie Orilla Manay
18,2002
Hidalgo ISOK 1 Boac Marinduque District I Provincial ID 000-0808 0926046499 None None None M S 19

14 Judylyn Montano Jabal 1975/01/01 Hidalgo IHATUB Boac Marinduque District I SSS ID 04-3115002-4 9517144648 None None House Wfe F M 46

15 Johnvic Mascarenas Manao 2001/12/06 Purok 7 IHATUB Boac Marinduque District I Provincial ID 000-860 9664224641 None None None M S 20

16 Kent Anthonny Malabanan Jabal 2001/03/11 Purok 1 IHATUB Boac Marinduque District I Driver Licence DO3-19-000861 09076727519 None None None M S 21

17 Christ Ruazelle Orilla Majaba 1998/07/23 Purok 6 IHATUB Boac Marinduque District I National ID 3280-9820-4590 9308817505 None None None M S 24

18 Ronalyn Mingi Malimata 1980/04/24 Purok 6 IHATUB Boac Marinduque District I Voters ID D24800RMM20000 09616054595 None None None F M 42

19 Vergel Encinas Opis 1998/04/18 Uno CAWIT Boac Marinduque District I Provincial ID 001-577 9493116374 None None None M S 24

20 Mardy Fernando Pineda Laylay 2000/09/18 DOS CAWIT Boac Marinduque District I Voters ID 4001-1800MPL1-6 09480615970 None None None M S 21

21 Ranie Cosejo Castillano 2001/06/22 Dos CAWIT Boac Marinduque District I Provincial ID 001-706 09506201448 None None None M S 21

22 Lynet Tungala Merencillo 2000/10/11 Kwatro CAWIT Boac Marinduque District I Provincial ID 001-442 09487689296 None None None F S 21

23 Khylle Masangkay Morales 2000/05/04 Purok 7 CAWIT Boac Marinduque District I Provincial ID 001-106 9665511546 None None None F S 22

24 Angelo Mondilla Maling August 15,2001 Patak-Patak BINUNGA Boac Marinduque District I Provincial ID 600-320 9636339099 None None Farmer M S 21

25 Dheza Marie Caimony Mascareᾗas January 21,1999 Proper BINUNGA Boac Marinduque District I Provincial ID 000-597 09632532005 None None Farmer F S 23
26 Joel Mascarenas Lacarras 1998/09/06 Proper BINUNGA Boac Marinduque District I Provincial ID 000-028 09389482406 None None Farmer F S 24

27 Aires Lunar Mascareᾗas July 27,1998 Labawan BINUNGA Boac Marinduque District I Provincial ID 000-625 09810784085 None None Farmer M S 24

28 Harvey Motol Lunar 2003/06/11 Kabilang BINUNGA Boac Marinduque District I Cedula 01817079 09304302726 None None Farmer M S 19

29 Clarion Rey Drece Nabing 2000/09/17 Rose BANTAD Boac Marinduque District I Cedula 1816678 9609121823 None None None M S 21

30 Shewin Militar Musnit 1983/10/03 Rose BANTAD Boac Marinduque District I Prinvincial ID 000-0112 9352340581 None None Carpenter M S 39

31 Shiela Mae Gases Consego 1998/03/02 Ilangi-ilang II BANTAD Boac Marinduque District I Provincial ID 000-0321 9153151494 None None None F S 24

32 John Christian Niepes Manay 1997/11/05 Ilangi-ilang II BANTAD Boac Marinduque District I Provincial ID 000-0322 9093822337 None None None M S 24

33 Edlin Malimata Mabunga 2000/02/11 Ilang-Ilang i BANTAD Boac Marinduque District I Provincial ID 000-1129 9107210605 None None None F S 22

34 Christine Joy Villanueva 1998/09/01 Ilang-ilang II BANTAD Boac Marinduque District I Provincial ID 000-0337 9707415636 None None None F S 24

35 James Gerald Largo Ligazon 1999/11/26 LAYLAY Boac Marinduque District I Philhealth ID 01-026300704-8 9276583493 None None Self Employed M S 22
Purok Pablo
36 Reygel Villela Bautista 2003/06/09
Mapacpac
BANGBANGALON Boac Marinduque District I Provincial ID 000-970 9165436433 None None None M S 19
Purok Pablo
37 Ma. Thel San Juan Miciano 1991/01/16
Mapacpac
BANGBANGALON Boac Marinduque District I Solo Parent ID 2019-0286 9512443340 None None Vendor F S 31
Purok Pablo
38 Joshua Fernandez Buenaventura 1999/09/12
Mapacpac
BANGBANGALON Boac Marinduque District I Provincial ID 000-216 09457766997 None None Tricycle Driver M S 23
Purok Pablo
39 Rosalie Montiel Carbon 1998/08/05
Mapacpac
BANGBANGALON Boac Marinduque District I Provincial ID 000-682 9653097613 None None Self Employed F M 25
Purok Pablo
40 John Patrict Dalida Natal 2001/12/13
Mapacpac
BANGBANGALON Boac Marinduque District I Provincial ID 000-774 9162762744 None None None M S 20

41 Renniel Macarang Mejico 1997/09/20 Lapu-Lapu LUPAC Boac Marinduque District I Provincial ID 000-0670 09463538234 None None Fishermen M S 25

42 Joevert Caribo Maculit 1996/12/08 Lapu-Lapu LUPAC Boac Marinduque District I Provincial ID 000-1166 09750799427 None None Fishermen M S 25

43 John Fredrick Maano Go October 28,1994 Lapu-Lapu LUPAC Boac Marinduque District I Provincial ID 000-2254 09762469987 None None Fishermen M S 28

Hermann Hermosa Ornedo 1980/07/11 9480616 LUPAC Boac Marinduque District I Provincial ID 000-009 0950236495 None None Fishermen M M 42

45 Ariel Lining Maculit 1979/08/22 Lapu-Lapu LUPAC Boac Marinduque District I Provincial ID 000-9687 9107043301 None None Fishermen M N 43

46 Maradel Morales Logmao 1994/10/30 Laurel BALARING Boac Marinduque District I Philhealth ID 09-202536838 9107960993 None None None F S 27

47 Ariel Matining Morales 1972/06/13 Laurel BALARING Boac Marinduque District I Provincial ID 000- 9126888781 None None Contruction Worker M M 50

48 Marineth Magculang Marcelino 2000/08/21 Quezon BALARING Boac Marinduque District I Provincial ID 000-489 915255357 None None None F S 21

49 Mark Jhonsen Mabuti Supleo 2004/07/09 Quezon BALARING Boac Marinduque District I Provincial ID 000-411 9091297124 None None None M S 18

50 Gerry Andrew Montalban 2004/12/28 Quezon BALARING Boac Marinduque District I Cedula 0109010 09514249821 None None None M S 18

Aaron Hernandez Leal 1994/02/09 Rose BANTAD Boac Marinduque District I Phil Health ID 09-201935710 9452703719 None None None M S 28

Renso Jay Mangui Jasa 2003/12/02 Zone 5 TABI BOAC Marinduque District I Provincial ID 000-061 9386456074 None None NONe M S 18

Liza Hipe Jandusay 1966/12/05 Zone 4 TABI BOAC Marinduque District I UMID 0111-3064440-3 09633287948 None None Housewife F M 55

Joachem Manibo Janda 2003/01/01 Zone 5 TABI BOAC Marinduque District I Provincial ID 000-184 9636911439 None NOne None M S 19

Orlando Jinang 1975/06/03 Ilang - Ilang I BANTAD BOAC Marinduque District I Driver's License DO3 09984568638 None None Self Employed M S 47
 Helen Malilom Candelaria 1995/10/03 Rosal BANTAD BOAC Marinduque District I Provincial ID 000-548 09358990867 None None None F M 26

Benito Malabayabas Prieto 1973/04/01 ROSe BANTAD BOAC Marinduque District I Provincial ID 000-1027 9606035983 None NOne ACOLYTE M M 49

Rhemarie Largo Blanco 1993/03/20 Masunurin BUNGANAY BOAC Marinduque District I Philheath ID 01-051821231 09696441238 None None Fish Vendor F M 29

Joel Morong Magturo Jr 1999/10/30 Masunurin BUNGANAY BOAC Marinduque District I Provincial ID 000-01057 09079601221 None None Fish Vendor M S 22
Candahon
Jhon Marlowie Waye Hirondo 1994/12/15
Mogpog
Mogpog Marinduque District I Cedula 09518680995 None None None M S 27
 I hereby certify that the above list of beneficiaries are displaced workers, underemployed or self-employed workers that have lost their livelihood or whose earnings were affected by the COVID-19 pandemic.
Further, I certify that they or any member of their families were verified to have not received cash assistance from the COVID Adjustment Measures Program (CAMP), Abot Kamay Ang Pagtulong (AKAP) for OFWs, DA's cash assistance for rice farmers, and DOF's Small Business Wage Subsidy Program.

Prepared and Certified true and Correct by:

(Signature over Printed Name)

Notes:
*Only the gray portion of this form should be submitted to concerned agencies, i.e DSWD for data matching/validation.
1 – Birthdate: Year/Month/Day (YYYY/MM/DD)
2 – Address: (Street No, Barangay, City/Municipality, Province, District)
3 –Type of Beneficiaries: (a.) Underemployed/Self-employed, (b.) Minimum wage/below minimum wage earners that were displaced due to: temporary suspension of business operations, calamity/crisis situation i.e. COVID-10 pandemic, earthquake, typhoon, volcanic eruption, global/national financial crisis, others (pls. specify), closure of company,
retrenchment, (c.) Person with Disability (PWD), (d.) Indigenous People, (e.) Former rebels, (f.) Former Violent Extremist Groups (g.) Senior Citizens)

4 - Occupation - Transport workers, Vendors, Crop growers (please specify, i.e tobacco farmer), Homebased worker (please specify, i.e sewer), Fisherfolks, Livestock/Poultry Raiser, SMALL TRANSPORT GROUP drivers, Laborer (please specify)
• Others (please specify)
5 – Sex: F for female, M for Male
6 – Civil Status: S for single, M for married
7 – Dependent: Name of the Beneficiary of micro-insurance policy holder.
8 - Trainings: Agriculture crops production, Aquaculture, Automotive, Construction, Welding, Information and Communication Technology,Electrical and electronics, Furniture making, Garments and textiles, Food Processing, Cooking, Housekeeping, Tourism, Customer Services, Others (please specify)

Note: Statement of Informed Consent

I understand the purpose of this profiling activity . I voluntarily and willfully give my consent to bepart of this undertaking. I certify that the information that I will give are true and correct and that any misrepresentation and falsification of information may void their application to TUPAD. I authorize the use, processing and sharing of my personal data for th
OSEC-FMS Form No. 4

Intereste
Dependent7 (Name of d for
If Yes,
Indicate
Beneficiary of the Skills
skills
Micro-insurance Training
training
(Y - Yes
Holder) N - No)
needed9

Mark Joval Siman

John Peter M. Jandusay

Necitas Labrador

Mildred Sotto

Anita M. Ranoso

Emma O. Magcamit

Angela B. Moran

Jennifer Leva

Perla Lozano

Melissa Manay

Raul Jabal

Myrna Manao

Rufino L. Casicas

Helen S, Majaba

Avel Nataniel Sanchez

Catalina Pineda

Efren Castillo

Maricar Morales

Alma Maling

Rosie C. Mascarenas
 Argeo Larracas

Sonia Mascarenas

Herman Lunar

Clarence Rei D. Nabing

Charles L. Musnit

Linda Gases

Crispin Manay Jr

Mary Jean Manay

Michaellah V. Madrigal

Geraldo L. Ligazon

Rubilita Bautista

khen Chloe Viado

Ramil Buenaventura

Alvin Carbon

Jojie M. Natal

Ramil Mejico

Gilberto Maculit

Teresa Go

Aida Malicsi

Letecia Maculit

Marielle M. Logmao

Albert C. Morales

Mark Macelino

Glensen M. Supleo

Gerry Montalban

Gemma Leal

Sonia Jasa

Jhon Azil Jandusay

Josepine Janda

Herminia Jinang
 Rene Candelaria

Krystza Vannesa Prieto

Benrey Lanot

Anna Luz Magtruro

Nathania Shanova Hirondo

m.

sing and sharing of my personal data for the purpose that is intended for without prejudice to my rights stated in the Data Privacy Act of 2012.