BALIK-MANGGAGAWA INFORMATION SHEET

Appointment Date: August 07, 2019 09:00 AM

Processing Site: Region 6 (Iloilo)

PERSONAL DATA

DEOCAMPO JUAN SILVESTRE

Last Name First Name Name Ext. (e.g. Jr.,III) Middle Name

P8461147A August 01, 1970 Dingle, Iloilo MALE MARRIED

Passport Birth Date Birth Place Sex Civil Status

N/A Sta. Clara Oton ILOILO

Home Address in the Philippines

SSS Pag-IBIG RTN/MID

09207453625 deocampojuan@gmail.com
Telephone/Cellphone No. E-mail Address

Mother's Full Maiden Name:

Silvestre Amparo Sabig
Last Name First Name Middle Name

Name of Spouse (If married)

Deocampo Anabelle Sabio
Last Name First Name Middle Name

CONTRACT PARTICULARS OF OFW

Extrastaff Company
Name of Company/Employer

23 Tropicana Drive Mount Roskill, Aukland AUSTRALIA

Address of Employer Country

-/- 900.00 NZD

Tel. No./Fax No./E-Mail Address Salary / Currency

Carpenter 24 months
Position Contract Duration

July 23, 2018 August 23, 2019

Last Deployment Date Last Arrival Date

LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS

Complete Name Sex Relationship of OFW to Dependent/s Date of Birth

Anabelle Sabio Deocampo FEMALE WIFE January 19, 1974

I hereby certify that the above statements are true and correct.

Control Number: D2515228148

LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS
Worker's Signature Over Printed Name