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    Fish R Form

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    libertygavarra1
    This document is an application for municipal fisherfolk registration in the province of Bulacan, Philippines. It collects personal information such as name, address, contact details, livelihood details, and organization membership. The applicant certifies that the information provided is true and correct. Municipal authorities review and approve the application.

    Copyright:

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

    Fish R Form

    Uploaded by

    libertygavarra1
    53 views1 page
    This document is an application for municipal fisherfolk registration in the province of Bulacan, Philippines. It collects personal information such as name, address, contact details, livelihood details, and organization membership. The applicant certifies that the information provided is true and correct. Municipal authorities review and approve the application.

    Original Title

    Fish-R-Form (1)

    Copyright

    © © All Rights Reserved

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    This document is an application for municipal fisherfolk registration in the province of Bulacan, Philippines. It collects personal information such as name, address, contact details, livelihood details, and organization membership. The applicant certifies that the information provided is true and correct. Municipal authorities review and approve the application.

    Copyright:

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

    Fish R Form

    Uploaded by

    libertygavarra1
    This document is an application for municipal fisherfolk registration in the province of Bulacan, Philippines. It collects personal information such as name, address, contact details, livelihood details, and organization membership. The applicant certifies that the information provided is true and correct. Municipal authorities review and approve the application.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    You are on page 1of 1

    Republic of the Philippines

    Attach Province of Bulacan


    Logo Here City of MALOLOS
    Attach Photo Here
    (1 1/2 " x 1 1/2 ")
    Photo should be
    APPLICATION FOR MUNICIPAL FISHERFOLK REGISTRATION aquired during the last
    six (6) months
    Registration No.: New Registration
    Registration Date: Updating
    1. PERSONAL INFORMATION
    Complete Name
    Mr Ms Mrs
    Salutation Last Name First Name Middle Name Appellation (Sr, Jr, III)
    Address

    Street Barangay City/Municipality Province Postal Code


    Contact No. Date of Birth Place of Birth Resident of the Municipality since
    (Cell Phone, Telephone) (Municipality, Province) (indicate the year)

    (M M - D D - Y Y Y Y
    Gender Civil Status Nationality Religion
    Single
    Legally Seperated Filipino
    Male
    ___Widowed ___Others (pls. specify)
    ___Married
    Female No. of Children On Number of Household Members
    Educational Background No. of male No. of female

    Elementary Vocational Post- Graduate No. of in-school No. of out of school

    High School College Others (pls. specify) No of employed No of unemployed

    Other Source of Income (farming) Income Value Php


    Household Monthly Income
    (fishing/ farm laboring)
    Php Other Source of Income (non-farming) Income Value Php

    Person to notify in case of emergency Contact No.(Cell Phone, Telephone)


    Relationship
    (First name, Last Name)
    Address (Barangay, Municipality)
    With Voter's Yes , ID No. CCT/4Ps Yes IP Yes SAAD Area Yes
    ID Benficiary
    No No No No

    2. LIVELIHOOD
    Main source of Income Livelihood Description (gears/species/type)
    Capture Fishing Fish Vending
    ___Aquaculture ___Fish Processing
    __Mariculture ___Others (pls. specify)
    3. ORGANIZATION
    Name of Organization Member Since Position/Official Designation

    4. CERTIFICATION THUMBMARK
    I have personally reviewed the information on this application and I certify under
    penalty of perjury that to the best of my knowledge and belief the information on this
    application is true and correct, and that I understand this information is subject to public
    disclosure.

    (Signature over printed name of Applicant) Date Accomplished


    Left Right

    5. FOR AUTHORIZED PERSONNEL ONLY


    Reviewed by: Certified Correct by: Approved by:

    (Signature over printed name) (Signature over printed name) (Signature over printed name)

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