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    OFW Infosheet PDF

    Uploaded by

    Wounded Heart
    1. This document contains personal information about an overseas Filipino worker (OFW), including their name, address, birthdate, passport number, education level, spouse/beneficiary details, and contract particulars with their employer overseas such as job position, salary, and duration. 2. It also includes membership details for OWWA and PhilHealth/Medicare, as well as allotment information for who the OFW designates to receive a portion of their salary. 3. There is a section for the OFW to provide details of any dependents who may benefit from their PhilHealth coverage, such as children, parents, and unemployed spouse.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    OFW Infosheet PDF

    Uploaded by

    Wounded Heart
    117 views1 page
    1. This document contains personal information about an overseas Filipino worker (OFW), including their name, address, birthdate, passport number, education level, spouse/beneficiary details, and contract particulars with their employer overseas such as job position, salary, and duration. 2. It also includes membership details for OWWA and PhilHealth/Medicare, as well as allotment information for who the OFW designates to receive a portion of their salary. 3. There is a section for the OFW to provide details of any dependents who may benefit from their PhilHealth coverage, such as children, parents, and unemployed spouse.

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    OFW infosheet.pdf

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    1. This document contains personal information about an overseas Filipino worker (OFW), including their name, address, birthdate, passport number, education level, spouse/beneficiary details, and contract particulars with their employer overseas such as job position, salary, and duration. 2. It also includes membership details for OWWA and PhilHealth/Medicare, as well as allotment information for who the OFW designates to receive a portion of their salary. 3. There is a section for the OFW to provide details of any dependents who may benefit from their PhilHealth coverage, such as children, parents, and unemployed spouse.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    117 views1 page

    OFW Infosheet PDF

    Uploaded by

    Wounded Heart
    1. This document contains personal information about an overseas Filipino worker (OFW), including their name, address, birthdate, passport number, education level, spouse/beneficiary details, and contract particulars with their employer overseas such as job position, salary, and duration. 2. It also includes membership details for OWWA and PhilHealth/Medicare, as well as allotment information for who the OFW designates to receive a portion of their salary. 3. There is a section for the OFW to provide details of any dependents who may benefit from their PhilHealth coverage, such as children, parents, and unemployed spouse.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    LASTEST PAYMENT: DO NOT WRITE ON THIS SPACE

    DATE: ______ (For POEA, OWWA, Philhealth Use Only)

    1. OWWA CG No: __________________________


    MEMBERSHIP: _________________ RFP No: __________________________
    PHILIPPINE OVERSEAS EMPLOYMENT ADMINISTRATION Assessment No: ____________________
    2. PHILHEALTH/ Assessed Amount :
    OVERSEAS WORKERS WELFARE ADMINISTRATION
    MEDICARE: ___________________ POEA: _________________________
    PHILIPPINE HEALTH INSURANCE CORPORATION
    OWWA: _________________________
    PHILHEALTH: ___________________
    OFW E-Card / ID No:

    FM-POEA O2-GP-07
    Effectivity date : April 8, 2005

    OFW INFORMATION SHEET

    PERSONAL DATA Change/s (if any)

    Name _________________________________ _______________________________ ______________________________ ___________________________________


    Family Name (Apelyido) First Name (Pangalan) Middle Name (G. Apelyido) ___________________________________
    Address in the Phils (Tirahan): _________________________________________________________________________ ___________________________________
    __________________________________
    Birth date: ____ / ____ / _____ Sex: M F Civil Status: Single Widowed __________________________________
    MM DD YYYY __________________________________
    Married Separated __________________________________
    Passport No: ___________________________ Highest Educational Attainment: __________________________ __________________________________
    Name of Spouse (if married): ______________________________________ Mothers Full Maiden Name: _____________________________________________

    Legal Beneficiaries (Mga tatanggap ng benepisyo sa OWWA) :


    Name Relationship Address
    ________________________________________________________ ________________________ ________________________________________________________
    ________________________________________________________ ________________________ ________________________________________________________
    ________________________________________________________ ________________________ ________________________________________________________

    ALLOTTEE (Itinalaga na padadalhan ng bahagi ng sahod ng OFW):

    __________________________________________________________________ ________________________________________________________________________

    CONTRACT PARTICULARS OF OFW Change/s (if any)


    Name of Principal / Company / Employer: ________________________________________________________________ _________________________________
    Address: ______________________________________________________________________________________________ _________________________________
    Jobsite/Country of Destination: _____________________________________ Tel No: ______________________ _________________________________
    Position of OFW: ___________________________________ Fax No / Email address: ______________________ _________________________________
    Contract Duration ___________ months Monthly Salary: ___________________ Currency: _____________ _________________________________
    Last date of arrival of vacationing worker in the Phils: _________________________________________________ _________________________________
    Date of scheduled departure / Return of OFW to the jobsite: ___________________________________________ _________________________________
    Name of Agency (if applicable): _______________________________________________________________________________________________________________

    ___________________________________ __________________________________
    Signature of Worker / Approval of Authorized Agency
    Thumbmark Representative ( if agency-hired)

    --------------------------------------------------------------------------------------------------------------------------------------------------------------------------
    (To be filled in by OFW for PHILHEALTH RECORD)
    Name of Worker: _____________________________________________________________________________________________________________
    Family Name (Apelyido) First Name (Pangalan) Middle Name (G. Apelyido)
    Address in the Philippines (Tirahan) :_____________________________________________________________ Tel No: ______________
    Date of Birth: _____ / _____ / ________ Birthplace: ____________________________________________
    MM DD YYYY
    Sex: M F Civil Status: Single Married Widowed Separated

    Dependents (Mga makikinabang):


    20 years old and below for child/ren, 60 years old and above for parents, and Unemployed spouse.

    Name of Children/Parent/Spouse Sex Relationship of OFW Date of Birth


    to dependent/s (mm/dd/yyyy)
    _______________________________________________________________ ______ _____________________ __________________
    _______________________________________________________________ ______ _____________________ __________________
    _______________________________________________________________ ______ _____________________ __________________
    _______________________________________________________________ ______ _____________________ __________________
    _______________________________________________________________ ______ _____________________ __________________
    _______________________________________________________________ ______ _____________________ __________________
    _______________________________________________________________ ______ _____________________ __________________
    I hereby certify that the above statements are true and correct. (Ako ay nagpapatunay na ang nasa itaas na pahayag ay totoo at tama).

    _________________________________
    Signature of Worker

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