USER ENROLMENT FORM v1

* all fields are required

* Do not directly edit here. Download this sheet first, fill-up necessary fields, and submit to your BTr field office

USER INFORMATION FOR BARANGAY CHAIRMAN

Email Address Alberto001@gmail.com
First Name ALBERTO
Middle Name ORTULA
Last Name CUARTERO
Position Title BARANGAY CHAIRMAN

ACCESS RIGHTS
Usergroup LGU/NGA/GOCC/GFI if LGU/NGA/GOCC/GFI: LGU
System Role Approver

USER INFORMATION FOR BARANGAY TREASURER

Email Address mezjhane@gmail.com
First Name MARY JANE
Middle Name ALVARADO
Last Name CHATO
Position Title BARANGAY TREASURER

USER INFORMATION FOR SK CHAIRMAN

Email Address jeffanthonybeloria@gmail.com
First Name JEFF ANTHONY
Middle Name DELA PEÑA
Last Name BELORIA
Position Title SK CHAIRMAN

ACCESS RIGHTS
Usergroup LGU/NGA/GOCC/GFI if LGU/NGA/GOCC/GFI: LGU
System Role Admin

ORGANIZATION
Department Department of Interior and Local Government Unit
Agency (Whole Name) (Acronym) Barangay Local Government Unit BLGU
Operating Unit

LOCATION
Region CARAGA
Province/District SURIGAO DEL SUR
City/Municipality CARMEN

Signatories

Signature of the User

Fullname of User MAUREEN SHIELA J. GOMA
Position of User SK Treasurer
Date Filed (mm/dd/yyyy) January 9, 2024

Signature of Head of Agency

Fullname of Head of Agency JEFF ANTHONY D. BELORIA
Designation of Head of Agency SK Chairman

this part is to be filled up by the BTr admin

generated username
date created (mm/dd/yyyy)

Signature of User Admin

Fullname of User Admin
Designated BTr office CARAGA - SURIGAO DEL SUR