Annex D

Profile of TUPAD Beneficiaries

Name of Project: TUPAD

DOLE Regional Office: MIMAROPA
Province: MARINDUQUE
Municipality:
Barangay:

Name of Beneficiary Project Location

Birthdate
Type of ID E-payment/Bank Average
No. Extension ID Number Contact No. Type of Beneficiary Occupation Sex Civil Status Age Dependent
First Name Middle Name Last Name Purok Barangay City/Municipality Province District (e.g. SSS, Voter's ID) Account No. Monthly Income
Name (YYYY/MM/DD)

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27
 28

29

30

Prepared and Certified true and Correct by:

(Signature over Printed Name)

Notes:
Birthdate: Year/Month/Day (YYYY/MM/DD)
Project Location: (Street No, Barangay, City/Municipality, Province, District)
Type of Beneficiaries: (a.) Underemployed/Self-employed, (b.) Minimum wage/below minimum wage earners that were displaced due to: temporary suspension of business operations, calamity/crisis situation i.e. earthquake, typhoon, volcanic eruption, global/national financial crisis, others (pls. specify), closure of company, retrenchment, (c.) Person with Disability (PWD), (d.) Indigenous People, (e.) Former rebels, (f.) Former Violent Extremist Groups
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);; Others (please specify)
• Others
Civil (please
Status: specify)
S for Single, M for Married, D for Divorced, SP for Separated, W for Widowed
Dependent: Name of the Beneficiary of micro-insurance policy holder.
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)
 Interested in
wagage
employment or Skills
self- training
employment? needed
(Y - Yes
N - No)