REPUBLIC OF THE PHILIPPINES REPUBLIC OF THE PHILIPPINES

PROVINCE OF ZAMBALES PROVINCE OF ZAMBALES

MUNICIPALITY OF SUBIC MUNICIPALITY OF SUBIC

NAME: MERLY O. GARCIA NAME: RUBY D. DANCEL

POSITION: BRGY. RECORD KEEPER POSITION: VAWC DESK OFFICER
ADDRESS: STO. TOMAS SUBIC, ZAMB. ADDRESS: STO. TOMAS SUBIC, ZAMB.
DOB: JULY 17, 1992 DOB: NOVEMBER 14, 1973

HON. JAYSAR M. LEONARDO HON. JAYSAR M. LEONARDO

BARANGAY CAPTAIN BARANGAY CAPTAIN

REPUBLIC OF THE PHILIPPINES REPUBLIC OF THE PHILIPPINES

PROVINCE OF ZAMBALES PROVINCE OF ZAMBALES
MUNICIPALITY OF SUBIC MUNICIPALITY OF SUBIC

NAME: PATRICIO T. ALMORO NAME: MARITES O. SUMALA

POSITION: DESK OFFICER POSITION: DESK OFFICER
ADDRESS: STO. TOMAS SUBIC, ZAMB. ADDRESS: STO. TOMAS SUBIC, ZAMB.
DOB: JANUARY 26, 1962 DOB: JANUARY 8, 1969

HON. JAYSAR M. LEONARDO HON. JAYSAR M. LEONARDO

BARANGAY CAPTAIN BARANGAY CAPTAIN
 PERSONAL INFORMATION PERSONAL INFORMATION

CIVIL STATUS: CIVIL STATUS:

GENDER: GENDER:
RELIGION: RELIGION:
ADDRESS: ADDRESS:
CONTACT NO.: CONTACT NO.:
TIN ID NO.: TIN ID NO.:

IN CASE OF LOSS, PLS. RETURN TO IN CASE OF LOSS, PLS. RETURN TO

BARANGAY STO. TOMAS SUBIC, ZAMBALES BARANGAY STO. TOMAS SUBIC, ZAMBALES

__________________________ __________________________
Employee’s Signature Employee’s Signature

PERSONAL INFORMATION PERSONAL INFORMATION

CIVIL STATUS: CIVIL STATUS:

GENDER: GENDER:
RELIGION: RELIGION:
ADDRESS: ADDRESS:
CONTACT NO.: CONTACT NO.:
TIN ID NO.: TIN ID NO.:

IN CASE OF LOSS, PLS. RETURN TO IN CASE OF LOSS, PLS. RETURN TO

BARANGAY STO. TOMAS SUBIC, ZAMBALES BARANGAY STO. TOMAS SUBIC, ZAMBALES

__________________________ __________________________
Employee’s Signature Employee’s Signature