KR Form 4

MONTHLY CONSOLIDATED KASAMBAHAY

MONTHLY CONSOLIDATED R
KASAMBAHAY REPORT
As of __________________________

Municipality/City : Province: Page of Pages

NO. OF KASAMBAHAY BY: (3)

TOTAL NO. SEX AGE EDUCATIONAL ATTAINMENT (d) WORK INFORMATION (e)
BARANGAY OF (a) (b) CIVIL STATUS (c) HIGH SCHOOL
(1) ELEMENTARY COLLEGE (d.3) NATURE OF WORK (e.l) SALARY (e.2)
REGISTERED (d.2)
KASAMBAHA below SEPARATE UNDER UNDER UNDER HOUSEH GARDE LAUNDRY 1,500 2,000 2,500 5,000 and
F M 18-30 31-45 and above S M w GRAD GRAD GRAD YAYA COOK OTHERS
18 D GRAD GRAD GRAD ELP NER PERSON PI,999 P2,499 p4,999 above

1 Urbiztondo 300 150 150 25 150 75 50 200 100 125 50 75 25 20 5 100 25 50 125 180 100 20
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL

Prepared by: Submitted by:

PESO Staff Head, PESO

KR Form 3
MONTHLY BARANGAY CONSOLIDATED KASAMBAHAY REPORT
For the month of _________________________________

Barangay
Mun.City:
Province
Region

NO. OF KASAMBAHAY BY: (2)

EDUCATIONAL ATTAINMENT (d) WORK INFORMATION (e)

SEX (a) AGE CIVIL STATUS (c)
TOTAL NO. OF ELEMENTARY HIGH SCHOOL COLLEGE NATURE OF WORK SALARY
REGISTERED
KASAMBAHAY (1)

46 and SEPARATE UNDER UNDER UNDER HOUSEHEL LAUNDRY Php 1,500- Php 2,000- Php Php 5,000
F M below 18 18-30 31-45 above s M W D GRAD GRAD GRAD GRAD GRAD GRAD PER YAYA COOK GARDENER PERSON OTHERS I,999 2,499 2,500- and above
4,999

Prepared by: Prepared by:

Kasambahay Desk Officer Punong Barangay

KR Form 2
KASAMBAHAY MASTERLIST
Quarterly Report
For the Period July - September 30, 2013
Barangay
Mun.City:
Province
Region

Educational Nature of Employm

Attainment Work ent Salary Membership

I -Gen.
I. Elem househeip Arrangem 1 PI, 500 -
Undergrad ent P1.999 (Write Y for Yes, and N for No)
(all around);

I - Live-in 2.
2. Elem. Grad 2 •Yaya 2 - Live P2,OOO-
out P2.499
Registration Civil
Name of Kasambahay Home Address Sex Age Name of Employer Employer's Complete
Control Number Status 3. HS 3. P2500 -
3 • Cook P4,999
Undergrad
4. P5,ooo
and
4. HS Grad 4 - Gardener
above

5. Coll. 5 - Laundry
Undergrad person
6. coll. Grad 6 - Others
Phil-
7. Vocational SSS Pag-lBlG
Health
5 Leon Guinto St.,
2013-0001 Santos Ana Martinez 2 Zamora St., San Jose S 25 1 2 3 N Juan dela Cruz
Ermita,

Prepared and submitted by:

(Signature over Printed Name)

Position / Designation
Prepared by: Prepared by:

Kasambahay Desk Officer Punong Barang

Punong Barangay
KR Form 5
CONSOLIDATED KASAMBAHAY REPORT
As of _________________

Mun/City
Province:
Region:

TOTAL NO. OF BARANGAYS

NO. BARANGAYS WITH REGISTERES KASAMBAHAYTOTAL NO. OF KASAMBAHAY

Submitted
Prepared by:
by:

________________________ ________________________
MLGOO/CLGOO/CITY DIRECTOR
Prepared by:
KR Form 3
MONTHLY BARANGAY CONSOLIDATED KASAMBAHAY REPORT
For the month of _________________________________

Barangay
Mun.City:
Province
Region

NO. OF KASAMBAHAY BY: (2)

EDUCATIONAL ATTAINMENT (d) WORK INFORMATION (e)

NAME OF KASAMBAHAY SEX (a) AGE CIVIL STATUS (c)
ELEMENTARY HIGH SCHOOL COLLEGE NATURE OF WORK SALARY

F M below 18 18-30 31-45 46 and s M W SEPARATED UNDER GRAD UNDER GRAD UNDER GRAD HOUSEHEL YAYA COOK GARDENER LAUNDRY OTHERS Php 1,500- Php 2,000- Php 2,500- Php 5,000
above GRAD GRAD GRAD PER PERSON I,999 2,499 4,999 and above
SURNAME FIRST NAME MIDDLE NAME

Prepared by: Prepared by:

Kasambahay Desk Officer Punong Barangay