Name of Project: TUPAD OSEC-FMS Form No.

4
DOLE Regional Office:
Province: NCR
Municipality: MAKATI
Barangay: STA. CRUZ

LIST OF BENEFICIARIES

Name of Beneficiary Address2

Birthdate1 Type of ID Type of Dependent7 (Name of
No. Complete Address City/ (e.g. SSS, Voter's ID Number Contact No. Sex5 Civil Status6 Age Beneficiary of the Micro-
First Name Middle Name Last Name Extension Name (YYYY/MM/DD) Barangay Province District ID) Beneficiary3 insurance Holder)
Municipality

1 CHRISTIAN CANDELEJA DAEF 2002-01-27 4305 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9532572657 M S 21

2 DOLORES MENDOZA AMARANTE 1964-11-17 3161 VISITA STREET STA. CRUZ MAKATI NCR 1 9295808906 F S 59

3 JOEMARI DELA CRUZ DOLOR 1981-03-27 3181 VISITA STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-201030567-1 9054379652 PWD M S 42

4 ERICSON REOTAN SANTECO 1971-10-14 MARTINEZ UNIDOS STREET STA. CRUZ MAKATI NCR 1 9162377217 M S 52 REBECCA REOTAN

5 CHERRY DIZON PAYCANA 1984-11-15 2847 MARTINEZ UNIDOS STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-026755553-8 9760044064 F S 38 HERBERT HONTALBA

6 JAY-VEE JAMILLA MACARAIG 1992-09-14 2832 MARTINEZ UNIDOS STREET STA. CRUZ MAKATI NCR 1 9391125082 M S 31

7 ARA PAJARILLA AUCINA 1999-04-20 2832 MARTINEZ UNIDOS STREET STA. CRUZ MAKATI NCR 1 9187317045 F S 24

8 EONA DALTON VEGA 1980-06-15 3167 VISITA STREET STA. CRUZ MAKATI NCR 1 9506366725 F M 43

9 ROGEL GARCIA SEREÑO JR 2003-11-28 2832 MARTINEZ UNIDOS STREET STA. CRUZ MAKATI NCR 1 9291992693 M S 19

10 EMILIO COCJIN PETROLIA JR II -3-12 2975 KAKARONG STREET STA. CRUZ MAKATI NCR 1 M S

11 ARMANDO SEBUANO TALION JR 1956-06-15 4301 BLISS I DAVILA STREET STA. CRUZ MAKATI NCR 1 SSS 03-4943529-7 9564927380 SC M M 67 JOSIE F. TALION

12 IMELDA PORLIT MAGNAYE 1965-11-11 3938 YAGUE STREET STA. CRUZ MAKATI NCR 1 9494277744 F M 58 ROWLAND H. MAGNAYE

13 LORDALYN GARDOSE ANDRADE 1977-11-16 2985 KAKARONG STREET STA. CRUZ MAKATI NCR 1 9156728915 F S 43

14 ARLENE - JIMENEZ 1976-05-16 2985 KAKARONG STREET STA. CRUZ MAKATI NCR 1 9959532403 F S 47

15 CLARENCE MAE DE MESA BOHOL 1990-07-06 2985 KAKARONG STREET STA. CRUZ MAKATI NCR 1 9150425860 F M 35

16 JENALYN ABANES IGNACIO 1992-06-03 3015 KAKARONG STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-200029315-4 9454409182 F S 31

17 CAROLYN ORDINARIO TRINIDAD 1983-12-12 2970-A KAKARONG STREET STA. CRUZ MAKATI NCR 1 9267063755 F S 39

18 CECILLIA TRINIDAD LOCSIN 1975-04-04 9840-A LEGASPI STREET VALENZUELA MAKATI NCR 1 SSS 0111-1056986-7 9151467101 F M 48

19 LILIA CONCEPCION VENTURA 1968-07-15 4305 MONTOJO STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-200528225-6 9851776938 F S 55 ERLINDA LEYVA

20 ERY JANE CORDOVA LAYUG 1996-05-14 5403 BLISS I DAVILA STREET STA. CRUZ MAKATI NCR 1 9206331925 F S 27

21 CARLO AUSTE BILAZON 1999-01-09 5205 BLISS I DAVILA STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-251831339-6 9266378466 M S 24 CHRISTOPHER BILAZON

22 JOHN AQUINO PASCUA 1996-09-02 3102 DAVILA STREET MAKATI BLISS I STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-026609490-1 9565675692 M S 27 JANET AQUINO

23 CATHY DABU SERRANO 2004-12-21 4307 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9298053251 F S 18

24 ROWENA DINEROS MATI-ONG 1981-06-03 4309 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9957545643 F M 42

25 GENEVIEVE MARCELO DURAN 1976-08-22 4307 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9325451391 F M 47

26 NIÑO BENITEZ BONITO 1981-07-25 4311 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-090371327-9 9394789859 M S 42

27 IMELDA LEONEN POLAN 1970-09-07 3969 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9054364235 F M 53
28 PEDRO AZORES ROCHA 1946-05-14 3945 YAGUE STREET STA. CRUZ MAKATI NCR 1 9151888510 SC M W 77

29 MARK JOEL FUENTES REYES 1999-09-26 3780 MASCARDO STREET STA. CRUZ MAKATI NCR 1 SSS 34-7848516-0 9274122489 M M 24 JULIE REYES

30 SOFIA VILLENA CIPRIANO 1952-09-18 3303 ZAPOTE STREET STA. CRUZ MAKATI NCR 1 9756129158 F M 71

31 SOUI VILLALUNA RODRIGUEZ 1970-06-10 3782 MASCARDO STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-201064966-4 9776838722 F M 53

32 JOCELYN GARCIA PANALIGAN 1978-07-09 3781 MASCARDO STREET STA. CRUZ MAKATI NCR 1 SSS 33-3838678-1 9052350082 PARENT F M 45

33 JANETTE FLORES SAMPOL 1976-07-26 3782 MASCARDO STREET STA. CRUZ MAKATI NCR 1 NATIONAL ID 5943-7215-00 9751255156 F M 47

34 TESSIE SANDOVAL MATEO 1965-05-13 3781 MASCARDO STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-200543704-7 9064314739 F M 58

35 DIVINA DELOS SANTOS PIMENTEL 1970-04-15 3787 MASCARDO STREET STA. CRUZ MAKATI NCR 1 SSS 33-4674973-4 9685928588 F S 53 LEONORA PIMENTEL

36 RENE SANTOS QUINITIO 1968-01-06 2748 SOUTH AVENUE STA. CRUZ MAKATI NCR 1 SSS CRN-0111-25151257 9366533367 M S 55 SCHERRAWE Q. DABU

37 ALBERTO VITUG CARIANGA 1950-10-12 3945 YAGUE STREET STA. CRUZ MAKATI NCR 1 9954426373 SC M 73

38 KENNETH - SANTECO 1991-08-20 2849 M. UNIDOS STREET STA. CRUZ MAKATI NCR 1 9668166460 M S 32

39 ANNALIZA MORENO TAMPOL 2005-11-25 3298 ZAPOTE STREET STA. CRUZ MAKATI NCR 1 F S 18

40 MARGIE CRUZ CHAVEZ 1971-01-07 2731 SOUTH AVENUE STA. CRUZ MAKATI NCR 1 9152428629 F S 52

41 VICTOR SANTOS NAVARRA JR 1987-09-21 4311 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-025363454-0 M S 36 CORAZON NAVARRA

42 IMELDA SABADO VALDEZ 1976-07-02 4309 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 PHILHEALTH 05-000047513-8 9363430457 F S 47

43 EDGARDO OTEY REALCO 1964-08-29 2747 SOUTH AVENUE STA. CRUZ MAKATI NCR 1 PHILHEALTH 2007-0194825 9361088942 M M 59

44 MA. IRENE PIZAMO TUPAS 1974-12-24 1103 BLISS BLDG I DAVILA STREET STA. CRUZ MAKATI NCR 1 9984336940 F M 48

45 AGUILUZ REALCO ALBARILLO 2004-11-03 2747 SOUTH AVENUE STA. CRUZ MAKATI NCR 1 9515515914 M S 19

46 ROMMER JOY ELEAZAR PONCE 1970-12-16 2851 MARTINEZ UNIDOS STREET STA. CRUZ MAKATI NCR 1 SSS 33-0512309-0 9151327670 M M 52 MERCEDES PONCE

47 ESTELITA ANTONIO CABANELA 1971-12-01 4311 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9282292539 F S 51 VICTOR PITOGO

48 GENELITA RONDRIGUE MERA 1974-01-19 4311 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9052845781 F S 49 NESTOR MERA

49 JOSEPHINE NACIONAL ANDEZA 1987-01-21 2722 SOUTH AVENUE STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-200775244-6 9669876308 F M 37

MA. THERESA
50 TAPIA DEL ROSARIO 1986-10-07 2985 KAKARONG STREET STA. CRUZ MAKATI NCR 1 9914233440 F M 37
DHAN

51 RONALDO DERONIA DE MESA 1963-10-31 2985 KAKARONG STREET STA. CRUZ MAKATI NCR 1 9923551841 M M 60

52 FE AGRISAN CAÑA 1968-12-25 2985 KAKARONG STREET STA. CRUZ MAKATI NCR 1 9653670531 F S 59

53 REY MARTE COMIA 1966-03-28 2976 KAKARONG STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-200528535-2 9554960701 M W 57

54 MARIO CELESTINO GUINTO 1956-09-02 2976 KAKARONG STREET STA. CRUZ MAKATI NCR 1 SSS 03-4086853-0 9179687222 M S 67

55 JONAH GUIMBAO MORELLA 1965-04-18 3783 MASCARDO STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-200154073-2 9563101278 M M 58

56 MAMERTA PANGANIBAN BARRIENTOS 1960-06-20 3781 MASCARDO STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 19-200528313-9 9976346938 F M 63 MICHELLE BARRIENTOS

57 JOVELYN DAGAN TAGUIBAO 1991-01-15 2957 KAKARONG STREET COR. KALAYAAN AVE STA. CRUZ MAKATI NCR 1 POSTAL PRN D85210267781 9164761217 M S 32 JUANA DAGAN TAGUIBAO

58 ROSALINDA CABASAG CODILLA 1980-09-17 3283 ZAPOTE STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-225012863-9 9270750592 INDIGENOUS F S 43 VIANI CORDOVA
 59 CENCIA ABATO DALION 1990-12-29 3280 ZAPOTE STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-052037544-4 93552771417 INDIGENOUS F S 32 REY JANLOU PRESTIN

60 DINA CAMPOS SEMILLA 1988-12-09 3273 ZAPOTE STREET STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-026286663-2 9569234260 INDIGENOUS F S 34 DELFA S. ESTOQUIA

61 LEA FE MEDRANO MANABAT 1973-01-20 6311 BLISS I DAVILA STREET STA. CRUZ MAKATI NCR 1 9354292761 F M 50

62 NGELA FRANCINE MAGALONG MANJARES 2004-11-11 3969 YAGUE STREET STA. CRUZ MAKATI NCR 1 SSS 35-1891106-7 9923727314 PARENT F S 19

63 NORMA AQUINO DEGOMA 1954-03-23 3969 YAGUE STREET STA. CRUZ MAKATI NCR 1 9491172736 SC F M 69

64 SEGUNDINA VIRTUDAZO SALVADOR 1969-04-29 3969 YAGUE STREET STA. CRUZ MAKATI NCR 1 SSS 34-16440563-6 9155680550 F M 54 ARIES SALVADOR

65 LETICIA ASIGURADO MIER 1956-09-13 3015 KAKARONG STREET STA. CRUZ MAKATI NCR 1 SSS 03-5869526-4 9093585215 SC F S 67 FUNDADOR A. MIER JR

66 AVELINO ISIDRO BREVA JR 1975-06-08 4293 MONTOJO STREET STA. CRUZ MAKATI NCR 1 9562139052 F S 48 MARGARITA CRUZ

67 ARABELA HADAP DELA CRUZ 1979-01-07 3151 VISITA STREET STA. CRUZ MAKATI NCR 1 9853880605 F M 44

68 KRISTIA MAE - PLATA 1993-12-08 4303 MONTOJO STREET STA. CRUZ MAKATI NCR 1 UMID 0111-8472944-2 9183907151 F S 29

69 NOEL BREVA CAPITO 1991-12-02 2726 SOUTH AVENUE STA. CRUZ MAKATI NCR 1 PHILHEALTH 01-200071547-4 9178263120 M S 31

70 BIANKA LEE - EUSEBIO 1995-11-05 2722 SOUTH AVENUE STA. CRUZ MAKATI NCR 1 SSS 34-5287596-1 9474730648 DISPLACED F S 28 MAGDALENA EUSEBIO

71 JOHNNY RECTO CANDELEJA 1972-09-21 4305 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 NATIONAL ID 6389740698718 9975845098 DISPLACED M S 51 FLORENCIA R. DAEF

72 GLORIA ELIZARIO PANGILINAN 1950-02-04 3143 VISITA STREET STA. CRUZ MAKATI NCR 1 9984826404 SC F W 73

73 PRISCILLA RAMOS DIZON 1955-03-03 3143 VISITA STREET STA. CRUZ MAKATI NCR 1 SSS 03-3704331-6 9060222850 SC F M 68

74 MISALINA VILBAR GARCIA 1954-01-23 2974 KAKARONG STREET STA. CRUZ MAKATI NCR 1 9452809653 F M 69 MANUEL R. GARCIA

75 MARLON DOMINGO ARCEGA 1973-12-15 4301 KALAYAAN AVENUE STA. CRUZ MAKATI NCR 1 9051995709 M M 49

76 GIOVANI ESTEPA MAGBANUA 1970-05-15 1405 BLISS I DAVILA STREET STA. CRUZ MAKATI NCR 1 9618483085 M M 53 TAMIE Q. MAGBANUA

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 DOLE’s TUPAD #BKBK and TUPAD as post COVID intervention, COVID Adjustment Measures Program (CAMP), Abot Kamay Ang Pagtulong (AKAP) for OFWs, DSWD under the Assistance to Individuals in Crisis Situation (AICS) and the Enhanced Pantawid Pamilyang Pilipino Program (4Ps), DA's cash assistance for rice farmers, and DOF's Small Business Wage Subsidy Program.

Prepared and Certified true and Correct by:

LGU Authorized representative

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:
• Underemployed/Self-employed
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 drivers, Laborer (please specify), Barangay Tanod, Barangay Health Workers
5• Others
– Sex: (please specify)
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