2SsW! & PROMOTIVE SERVICES DIVISION DSWD 7 eK Sinaia ivelinod Program fanart Meerut FIELD OFFICE CARAGA FOR CHECK TURN-OVER 2023 CHECKL Province: AGUSAN DEL NORT! Municipality: TUBAY Barangay: SANTA ANA Fund Source: SLP REGULAR 2023 In Charged PDO: ROXANE D, VELARDE No. | Required Documents \complied?- 1 SLPA Grant Acknowledgement Receipt -2 copies 7 2. [Signed Disbursement Voucher (DV)-2 copies 7 3 Photocopy of Check 7 4. Picture during Check Turnover 7 5 Photocopy of deposit sip le | 6 Photocopy of Passbook refiecting the deposited amount. Z wr? | 7 Authorization Letter from SLPA/Individual 2 “| |_8 Received copy of Certificate of Accreditation (CSO) | 9. Pictures of posting of CSO Certificates in conspicuous places al 10 CSO Tumover (Data Privacy Consent) y |_11 Client satisfaction measurement form | Z PAGE Loft Palms Siret, Bazan Cy, Paiippines B00 gos gh Tel Nos: (085) 303-8620 DSWD Field Office Care Webnite: ip wwFs wD PRO! “IVE SERVICES DIVISION DSWD ds Susie inte Progam eet tt i em yw FIELD OFFICE CARAGA SLPA GRANT ACKNOWLEDGEMENT RECEIPT Ako si ARCE B. MALINAO, Pangulo ng SANTA ANA CATALYST FOR CHANGE ~ SLP ASSOCIATION na may SLPA ID No: ay pinapatunayan ang pagtanggap ng aming SLPA ng halagang Php 450,000.00 mula sa DSWD para sa aming mga proyekto na isinumite noong para sa mga sumusunod na mga modality ng SLP: Modality ‘Amount SCF Php 450,000.00 MD-STF Php CBLAF Php TOTAL Php 450,000.00 Bilang kasapi ng SANTA ANA CATALYST FOR CHANGE ~ SLP ASSOCIATION, ako at ang mga opisyales at mga miyembro ay taos-pusong tinatanggap ang katapat na tungkulin 0 responsibilidad ng aming natanggap na_pinansyal na tulong mula sa DSWD-SLP gaya ng mga sumusunod: 1. Tamang pag-gamit ng pera na naayon sa nakasaad sa aprubadong Mungkahing Proyekto at Modality Application Form; 2. Pagsumite ng “GRANT UTILIZATION REPORT" at mga kaukulang dokumento bilang patunay sa paggamit ng mga perang natanggap mula sa DSWD-SLP. Bilang Presidente ng SANTA ANA CATALYST FOR CHANGE ~ SLP ASSOCIATION ay sinisiguro ko na bantayan ang mga nakasaad sa CBL na alinsunod sa mga alituntunin ng SLPA at DSWD-SLP. Bilang pagtanggap sa mga responsibilidad para sa perang natanggap mula sa DSWD-SLP, ako at ang tatlumpu na mga saksi ay aming nilalagdaan ang dokumentomg ito ngayong ika- sa buwan ng Oktobre taong 2023. —— NO | POSISYON TINANGGAP NI PRESIDENTE | | 2._| SINAKSIHAN NI VICE PRESIDENT | da 10] 19 [2S 3._| SINAKSIHAN NI SECRETARY JANICE LAWUSAIN | eafe> | 4 ‘SINAKSIHAN NI TREASURER IVY MAL. ABREA | PAGE 10f3 NE Ilia Garp Els Beet as yn @RpGi PRO IVE SERVICES DIVISION DSWD OBE ym _oeemcnme @ FIELD OFFICE CARAGA [= | | | sonst NIAUDITOR | anced E. RESULLAR loiq}es a | SINAKSIHAN NI CHAIRMAN ON ma Wofiales |__| MEMBERSHIP COMMITTEE EMMA R: GALGO ae |_| SINAKSIHAN NI CHAIRMAN ON - | NOMINATION & ELECTION Ebi | Whales COMMITTEE ESTRELLA S.EDERIO | 8, | SINAKSIHAN NI BUSINESS OPERATIONS MANAGER |___JUVELYNE. CAJIGAS bales | SINAKSIHAN NI CHAIRMAN ON CANVASSING SUB-COMMITTEE © 10. | SINAKSIHAN NI MEMBER ON CANVASSING SUB-COMMITTEE 11. | SINAKSIHAN NI MEMBER ON I CANVASSING SUB-COMMITTEE ‘SINAKSIHAN NI CHAIRMAN ON 12. | REVIEW & RECOMMENDING SUB- wf/19] es COMMITTEE ___|__ VIRGINIA V. C! : ‘SINAKSIHAN NI MEMBER ON 13. | REVIEW & RECOMMENDING SUB- | Cu lo] 9/28 |__| COMMITTEE a) LORETO SINAKSIHAN Ni MEMBER ON 14, | REVIEW & RECOMMENDING SUB- | LLnyohan fo} | 2s COMMITTEE __LEONOR’A. LUYAHAN SINAKSIHAN NI CHAIRMAN ON | 15. | AUDIT / INSPECTION SUB- | COMMITTEE HANN, |AUDIA ‘SINAKSIHAN NI MEMBER ON 16. | AUDIT / INSPECTION SUB- COMMITTEE 17. | SINAKSIHAN NI MEMBER ON PURCHASING SUB-COMMITTEE 18, | SINAKSIHAN NI CHAIRMAN ON in Hf 19] 23 | PURCHASING SUB-COMMITTEE FEDERICOF.TUBAN | 19. | SINAKSIHAN NI MEMBER ON di | by} jes | PURCHASING SUB-COMMITTEE JOINE ROSE S.LLIDO | 20. | SINAKSIHAN NI MEMBER SA Cod by) (9/23 | | ASSOCIATION _ . _|___ESTRELLA C. LADAQ | SSS A is Cage Pes Set aan ay, Pg wa WdDSWD Owe y SINAKSIHAN NI MEMBER SA ASSOCIATION PRO. ‘Sustainable Livelihood Program FIELD OFFICE CARAGA paeileet MURRO SINAKSIHAN NI MEMBER SA ASSOCIATION nose aac ‘SINAKSIHAN NI MEMBER SA ASSOCIATION = SINAKSIHAN NI MEMBER SA ASSOCIATION Ri: Cadet RUBY D. GADOT i ants G. AVILA 25, 26, SINAKSIHAN NI MEMBER SA ASSOCIATION SINAKSIHAN NI MEMBER SA ASSOCIATION MELINDA M. BIGCAS - | MAL LovetiA R. CALAMBA 27. | 28. 29, SINAKSIHAN NI MEMBER SA | SINAKSIHAN NI MEMBER SA. ASSOCIATION SINAKSIHAN NI MEMBER SA ASSOCIATION CINDY Z. PIZARRO | 30. | 31. SINAKSIHAN NI MEMBER SA ASSOCIATION PAGE 3 0f3 Palma Suoet Butuan City, Piippnes 8600 Tel Nor (O85) 303-8620| DSWD 4 PRO!__IVE SERVICES DIVISION DSWD cha Suse Lee Pea eet ota teen nme ee FIELD OFFICE CARAGA, SLPA GRANT ACKNOWLEDGEMENT RECEIPT Ako si ARCE B. MALINAO, Pangulo ng SANTA ANA CATALYST FOR CHANGE — SLP ASSOCIATION na may SLPA ID No: ay pinapatunayan ang pagtanggap ng aming SLPA ng halagang Php 450,000.00 mula sa DSWD para sa aming mga proyekto na isinumite noong para sa mga sumusunod na mga modality ng SLP: Modality ‘Amount SCF Php 450,000.00 MD-STF Php CBLAF Php TOTAL Php 450,000.00 Bilang kasaping SANTA ANA CATALYST FOR CHANGE ~ SLP ASSOCIATION, ako at ang mga opisyales at mga miyembro ay taos-pusong tinatanggap ang katapat na tungkulin o responsibilidad ng aming natanggap na_pinansyal na tulong mula sa DSWD-SLP gaya ng mga sumusunod: 1. Tamang pag-gamit ng pera na naayon sa nakasaad sa aprubadong Mungkahing Proyekto at Modality Application Form; 2. Pagsumite ng “GRANT UTILIZATION REPORT’ at mga kaukulang dokumento bilang patunay sa paggamit ng mga perang natanggap mula sa DSWD-SLP: Bilang Presidente ng SANTA ANA CATALYST FOR CHANGE ~ SLP ASSOCIATION ay sinisiguro ko na bantayan ang mga nakasaad sa CBL na alinsunod sa mga alituntunin ng SLPA at DSWD-SLP. Bilang pagtanggap sa mga responsibilidad para sa perang natanggap mula sa DSWD-SLP, ako at ang tatlumpu na mga saksi ay aming nilalagdaan ang dokumentomg ito ngayong ika- ‘sa buwan ng Oktobre taong 2023. NO POSISYON PANGALAN AT LAGDA PETSA | | bfia/2s | 1._| TINANGGAP NI PRESIDENTE ARCE B. MALINAO 7 2._| SINAKSIHAN NI VICE PRESIDENT at . MANZON SINAKSIHAN NI SECRETARY | JANI Chit | A SINAKSIHAN NI TREASURER | IVY MAEL. ABREA | Jibs | PAGE 10f3, ‘DSWD Field Office Caraga, Palma Sweet, Butuan Cay, Pippanes 8600 Website: ip /vm sion gov ph Tel Now: (85) 303-8620pswo 2x PRO. Sustainable Livelihood Program FIELD OFFICE CARAGA SINAKSIHAN NI AUDITOR 6. | SINAKSIHAN NI CHAIRMAN ON MEMBERSHIP COMMITTEE ‘SINAKSIHAN NI CHAIRMAN ON NOMINATION & ELECTION COMMITTEE 8, | SINAKSIHAN NI BUSINESS | OPERATIONS MANAGER 9. | SINAKSIHAN NI CHAIRMAN ON CANVASSING SUB-COMMITTEE SINAKSIHAN NI MEMBER ON CANVASSING SUB-COMMITTEE Zs ESTRELLAS.EDERIO Be | IVE SERVICES DIVISION | |__ARCELITA E. RESULLA\ EMMA R. aatso bales b/19]25 | JUVELYNE. CAJIGAS _ pfales efits | lf 2% RESIEL 0. SOTERI al ! be/tq | 25 14. | SINAKSIHAN NI MEMBER ON CANVASSING SUB-COMMITTEE 12, | COMMITTEE REVIEW & RECOMMENDING SUB- | be) ta)2> w/a [23 | SINAKSIHAN NI MEMBER ON 13. | REVIEW & RECOMMENDING SUB- COMMITTEE | SINAKSIHAN NI MEMBER ON REVIEW & RECOMMENDING SUB- COMMITTEE 14. t VIRGINIA V. CUSTODIO EDI tet RETO E bnschan pono’ LUYAHAN | pin) bo] ta) 25 ‘SINAKSIHAN NI CHAIRMAN ON AUDIT / INSPECTION SUB- | COMMITTEE 15. 7 oe [7 SINAKSIHAN NI MEMBER ON AUDIT / INSPECTION SUB- _| COMMITTEE b/ta]as CHERYL(D. MONTES | SINAKSIHAN NI MEMBER ON PURCHASING SUB-COMMITTEE _ tal2s LTERR. CATACTE a] ne SINAKSIHAN NI CHAIRMAN ON ___| PURCHASING SUB-COMMITTEE 19. | SINAKSIHAN NI MEMBER ON PURCHASING SUB-COMMITTEE 20. | SINAKSIHAN NI MEMBER SA | | ASSOCIATION PAGE? DSWD Feld Om ‘Website: hip oh vache F. TUBAN | i. pia [2 |___ JOINE ROSE S. LLIDO ni) ESTRELLA C. LADAO weft | 29 of 3 Palma Suec, Bunun City Phipps B00 Tel Nos: (085) 303-8620 — pliales | Oepswo 2m PRO! s IVE SERVICES DIVISION felihood Program FIELD OFFICE CARAGA 21 SINAKSIHAN NI MEMBER SA cnet MURRO ASSOCIATION whales 22. SINAKSIHAN NI MEMBER SA | ASSOCIATION | noses’ dacio He | 23. | SINAKSIHAN NI MEMBER SA | (L.Gadet Iefia] 29 ASSOCIATION _ RUBY D. GADOT he 24, | SINAKSIHAN NI MEMBER SA ge 19 |" | ASSOCIATION — RITGHEL G. AVILA "yf ! | 25. | SINAKSIHAN NI MEMBER SA | mB | pollafas ___| ASSOCIATION _ MELII |. BIGCAS Z 26. | SINAKSIHAN NI MEMBER SA of na ASSOCIATION MA. LOVELZA R. CALAMBA (9/1942 127, | SINAKSIHAN NI MEMBER SA phalz ASSOCIATION _ CINDY Z, PIZARRO ! a) 28. | SINAKSIHAN NI MEMBER SA 1s 19) I |” | ASSOCIATION DAI IGA yy | fice 29, | SINAKSIHAN NI MEMBER SA |__| ASSOCIATION MARY GRACE T. LADAO wnat: 25 | | 30. | SINAKSIHAN NI MEMBER SA | fu. tee bres | ASSOCIATION |___ RECEN B. yTAC | th 31. | SINAKSIHAN NI MSWD OFFICER | MA.EV REGIS h)eels PAGE 30f3, DSWD Field Ofioe Carp, ‘Wetit: ip 0 ds moh ima Stet, Huta Cay, Philipps 8000 0 Tol Non: O83) 308Appendix 32 Department of Social Welfare and Development [Fund Cluster = DISBURSEMENT VOUCHER DV No. : 23-02 (2419 Mos Check JCommercial Check Jothers (Please specify) [ARCIE B MALINAO AND IVY MAE L ABREA AND JANICE] TIN/Employee No. FORS/BURS No. IL HUSAIN FAO STA ANA CATALYST FOR CHANGE SLP initiator: Brgy. Santa Ana, Particulars Responsibility | _MFO/PAP, Provision of Seed Capital Fund (SCF) to SANTA ANA CATALYST FOR ICHANGE - SLP ASSOCIATION for Hog Raising project at Bray. Sant: JAna, Tubay, Agusan del Norte under SLP GAA 2023 "7 Certified: Expenses/Cash Advance necessary, lawfuland nog fed under my direct supervision fB._[ Accounting Entry: 7 Account Title UACS Code Sulasi dies offen 291YAA oD (070 4o 4000] [D- [Approved for Payment Cash available Sypféct to Authority to Debit Account (when applicable) Supporting documents complete and amount claimed Printed Name: GRETCHEN f. ESCAIA | Printed | ‘Accounfant iy Head, Accounting Unit/authorized Resfesentative Date 7 Date :._[Receipt of Pay check ADA an cs “Ne rumor eee Coe we Printed Name: ARIE B- MAUWAD— ACTO Position Position Signature(002026-9003-83 y Tessunen or werourroes MUM 0001206401 Be ‘Sia, — 40 -16 273 mero mecca ONE yp ye “ARCIE B MALINAO AND IVY MAE L ABREA AND JANICE | HUSAIN FAO STA AIBA CATALYST “Member: PDIC™ PAY TO THE ORDER OF 459,000.00" i 1 pesos : PSS sg RR RET TSN PGE cg vs oc ay RU TTT OSR i LANDBANK UAN BRANCH Woe Woe WOMTILLA give con P ouRcoS st e0TUaN etry Asusaw Get RoRTe eu — eS "000 § 20640 b 30035"00 soeok 2036900353" O00SLP PROVE AGHA MUNICIPALITY OF TUBAY 723500 Sata oxo NNO POLCHECK a at & LANDBANK Se “TrannaraeTESOD. OD z30cT23 WLCLO seonesosee450,000.00 #884 F99687450, 509.07 ZEBY 2000123 UPOPBK ‘Seasaasssssssesey 09 sesssessss450, 500.00 2EfV , 0 n 2Bewo PRON... IVE SERVICES DIVISION DSWD PEARAGA Sustainable Liveinod Program Seen een et FIELD OFFICE CARAGA AUTHORIZATION LETTER TO COLLECT THE CHECK October 18, 2023 To: MARI-FLOR A. DOLLAGA-LIBANG Regional Director DSWO Field Office Caraga Butuan City, Agusan del Norte To whom it may concern: Greetings! |, , hereby authorized Mr. RENANTE G ABENDANIO and/or RPMO designated staff to claim the SLP Association Check in the CASH UNIT Section of DSWD FO Caraga for Check Turnover in the Cabadbaran, Agusan del Norte Thank you for your consideration. ‘Yours sincerely, ARCIEB| MALINAO PRESIDENT Santa Ana Catalyst for Change SLP Association PAGE Loft DSWD Ficld Office Caraga, R Palme Stet, Butuan Cry, Philippines B00 ‘Website: itp "Tel Nos: (085) 303-8620Republic of the Philippines DSWD Department of Social Welfare and Development DSWD-CSO ACRN NO. B2023-A034 Certificate of Accreditation is hereby issued to SANTA ANA CATALYST FOR CHANGE -SLP ASSOCIATION with address at Purok 5, Brgy. Santa Ana, Tubay, Agusan del Norte operating at CARAGA REGION for having satisfactorily met the requirements for a legitimate Civil Society Organization pursuant to Section 75 (Fund Transfer to Civil Society Organizations) of the General Appropriations Act of 2023 and DSWD Memorandum Circular No. 26 series of 2020 entitled “Guidelines in the Accreditation of Civil Society Organizations (CSOs) Organized by the Sustainable Livelihood Program as beneficiaries using DSWD Funds". ‘This accreditation covers the: Hog Raising (Project) This Certificate of Accreditation shall be valid for three (3) years unless sooner revoked. Issued this 26th day of September 2023 in Butuan City, Philippines. |? 2 ale MARL-FLOR A. Wllncs. LIBANG vy) al ve? Regional Director, Region XIII Field Office Caraga oe we Department of Social Welfare and Development &S eo eee Jere, eo Sa i Re er ores ca 188151DSWD-GF-0104 | REV 00 | 22 SEP 2023 DATA PRIVACY CONSENT (FoR APPLICANT! DESIGNATED REPRESENTATIVE OF DSWD - REGULATORY SERVICES) In compliance with the Data Privacy Act (DPA) of 2012, and its Implementing Rules and Regulations (IRR) effective since September 8, 2016, | allow the Department of Social Welfare and Development (DSWD) to enter and store my personal data within the Department's authorized storage system and will only be accessed by the DSWD authorized personnel. The DSWD has instituted appropriate organizational, technical and physical security measures to ensure the protection of personal data Furthermore, the information collected and stored in the portal shall only be used for the following purposes: 1. Processing and reporting of documents related to the conduct of regulatory activities (\e., registration. licensing, accreditation of SWDAs and/or service providers), under certain conditions as required by law. 2. Announcements or promotions of programs, projects, and other activities organized by the Department and its partners. 3. Activities pertaining to establishing relations with DSWD stakeholders | understand that | am given certain rights under the Data Privacy Act, including the right to object to processing of my data, the right to access my data, the right to correct any inaccurate data, and the right to erasure or blocking of data. For more information on these rights, and for requests to review the Data, to withdraw consent to the use of the Data for any of the purpose stated above, and/or to correct or update the Data, | am to contact the Standards Bureau Data Privacy Compliance Officer at stb@dswd.gov ph. Signed this day of oclober” 2023 at ARCE B,|MALINAO. SLPA President PAGE Loft ‘DSWD Fed Oilice Caraga, R- Palin Soest, Hatuan Cry, Phiippnes 8000 ‘Webnit: ip wer dad. gor gh Tel Non: (O¥S) 308-8620 Re@DSWD wd CLIENT SATISFACTION! —\SUREMENT FORM 'DSWO-QUS-GF 2064] REV00| 8 OCT 2023 ‘CERTIFICATE OF INFORMED CONSENT usangoob kong ibinbigay ong aking pahintule pars s3 peggamit ng aking personal na impormasyon. Kinukumpimg-o na nabasa ko ang iinigay na |mpomnasyon, orabass na to sa akin. Nagkaroon ako ng pagkakataong magianong tungkol dto, at anumang mga ‘aking kasyahan. Navurawaan Ko na ang anumang Impormasyong nakolekia ay gogammlin lamang upang mapa panlpunan na inibigay ng OS. aaa ete Transaayon hyn) Pangan og Hye (Oa ana ana Ppfia/2o% RECIE @. MALINAD oF ‘aeran ing Ryete ‘ar te ‘iomemayan (Gener Pb) {thong may Kapanseran a Hrabutng ag sin penal chopra) a cr| EL kannts SUE ETE a eh ee eee — Terentia Assos Tah (Sargasso) Penge na Kawaningnagbiey na Satay 010792692. Sta. Ana, Tubray, Aqnion, oe} Wk} Roxane 0. VELAROE Pangan ng Taneiayon 0 Seeye: PANUTO: Lagyan ng sek (V) ane yong saget sa mga sumusunod na ktanungantungkol sa Clizen’s Charter (CC). te ay isang opsya na dokumento na hagialaman ng mga sels sa lang shaneyelopsina nq gobyemo, maka Mo ang ms Knakaangan na dokument, kaukulang ays, at pang abun 728 ng pogproseso, Gey Au engs cmrel my raptowen seventeen [Oo mpeg Go foes we | Se eng oem Ol fag cen eS SNe eco ovens | oe ope ees oleae oe = patoonourtintstnemewetengseiin, | Soehcaguedaneeanny, | renga | Eee: ee Seether tirocened a a spr iceeee + Felemiomy cong nits saranstang pave | 3 States > eee 2 iemcsrrecm acer | heres > oa secant remcce ms ruetaccs | 2 knaeee Seeaeeeet PANUTO ors SQD ayant (arg any na | ee te oe | ee Soman ry Ser [NTS ae | ae] GG OO® ° {5000 Nasyahan ko sa srasjon arg ratangap sa rapntaharg op 3604, Makar ng O98 me ig pg pr apne re ing Patton bay ea mparratyoe a z S602 to pay sme o ne aaa even tr | —. ‘5003, ng mga hacang an pagproeao acon na arg pagheyad ay mal at ‘rp ra 'SOD4, sds at mah akong rakahanep ng pamasyen Unga sang Sac Nar 'SQD6. Patera to a pata on apna saat, "walang paakaar Seng vorsatsyon 2 ‘S007. Mopalag kon iat rg mgs Kawa pina, fang Ska ako ay ‘inti rg bra} ont ne ia oy harden umalong 38a a ‘S008, Nabigay se ain ang knaatangang sarieyo mula opine, Salt ne mer riety sialwanag aba ig nays a ab. a sedback (Opsyonsl): Papuri, mungkshi,crektamo Upang mas mapagbut pa namin ang paghahalié ng aming mga serbisyo sa yo. aksyon dayen ila MARAMING SALAMAT!