ANNEX D.

Daily Time Record

KAPIT-BISIG LABAN SA KAHIRAPAN -

COMPREHENSIVE AND INTEGRATED DELIVERY OF SOCIAL SERVICES
KAPANGYARIHAN AT KAUNLARAN SA BARANGAY

CASH-FOR WORK PROGRAM FOR PERSON WITH DISABILITIES

DAILY TIME RECORD

Name of Worker : ____________________________________

Municipality : BALOI
Province : LANAO DEL NORTE
Region : 10
Category of Beneficiary : _________________________________
Name of Person with Disability : ___________________________
(If represented or under Category B3, N/A if not applicable)

AM PM
DAY DATE IN OUT IN OUT REMARKS

10

Total
Category of Beneficiary: B1-Poor PWD per NHTO List; B2-Poor PWD as per LSWDO Certification; or B3-PWD
Household Member Representative.

I certify in my honor that the above is a true and correct report of the hours of work/service/task performed,
record of which was made daily at the time of arrival and departure from work/service/task I am
stationed/deployed to.

________________________________
Signature over Printed Name of the Beneficiary/
Representative

Certified True and Correct By:

 ANNEX D. Daily Time Record
MUAWANAH S. AMBOR, RSW
Municipal Social Welfare Development Officer