Republic of the Philippines

Province of Antique
Municipality of Sibalom
Barangay ______________
-oOo-
OFFICE OF THE PUNONG BARANGAY

EXECUTIVE ORDER NO. ___

Series of 2018

SUBJECT : DESIGNATION OF _______________________ AS KASAMBAHAY DESK

OFFICER OF BARANGAY ____________________, SIBALOM, ANTIQUE

WHEREAS, Republic Act No. 10361 entitled “An Act Instituting Policies for the Protection and
Welfare of Domestic Workers” or the “Domestic Workers Act” or “Batas Kasambahay” was signed on
January 18, 2013;

WHEREAS, the Implementing Rules and Regulation of RA No. 10361 was promulgated on May
9, 2013, providing in Rule IX the registration system for Kasambahay, and mandating the Department of
the Interior and Local Government (DILG) to issue a circular prescribing standard Registration Form and
Protocols for Kasambahay registration;

WHEREAS, the DILG issued Memorandum Circular No. 2013-61 dated July 8, 2013 providing
guidelines for the barangay registration of all Kasambahay nationwide;

WHEREAS, said circular mandates the Punong Barangays to issue an Executive Order
designating Kasambahay Desk Officer/s to manage the Kasambahay Desk;

NOW THEREFORE, I, __________________, Punong Barangay of __________, Sibalom,

Antique, by virtue of the power vested in me by law, do hereby order:

Section 1. ________________________ is hereby designated as Kasambahay Desk Officer

of ______________, Sibalom, Antique.

Section 2. The Kasambahay Desk Officer shall:

1. Receive two (2) copies of accomplished Kasambahay Registration

Form (KR Form 1) with the attached Kontrata sa Paglilingkod sa
Tahanan;

2. Review and assess the completeness of data entries;

3. Stamp the date of receipt and assign a registration control

number at the upper right corner of the KR Form 1; and

4. Provide the employer or his authorized representative a duplicate

copy which will serve as proof of registration.

5. Take charge of the maintenance and updating of Kasambahay

Masterlist. He/she shall keep a copy of the KR Form 1 with the
corresponding signed contract for barangay safekeeping. He/she
shall record the information about the Kasambahay in the
Kasambahay Masterlist (KR Form 2).

6. Submit to the Municipal Public Employment Service Office (PESO) a

Monthly Kasambahay Report (KR Form 3) which includes data
regarding the registration of the Kasambahay.

Section 3. This order shall take effect immediately.

 Done this ____ day of __________________ 2018 in Barangay ______________, Sibalom,
Antique.

__________________________
Punong Barangay

Copy Furnished:

* Mayor’s Office
Sibalom, Antique

* DILG
Sibalom, Antique