FORM 2

KASAMBAHAY MASTERLIST
Quarterly Report
For the Period _______________________

Province:
City/Municipality:
Barangay:
Educa Employm Membership (Write Y for Yes, and Employer's
Registration Name of Kasambahay Home Civil tional Nature of ent Name of
Sex Age Salary N for No) Complete
Control Number Address Status Attain Work Arrangem Employer Address
ment ent
Last Name First Name Middle Name SSS Pag-IBIG Phil-Health

Date:
________________________________ Prepared and Submitted by:
__________________________________
(Signature over Printed Name)
_________________________________
Position/Designation
 MONTHLY BARANGAY CONSOLIDATED KASAMBAHAY REPORT
For the month of _____________________________

Barangay: ____________________________________
Municipality/City: ____________________________________
Province: ____________________________________

EDUCATIONAL ATTAINMENT (d) WORK INFORMATION (e)

TOTAL NO. OF SEX (a) AGE (b) CIVIL STATUS (c)
REGISTERED
KASAMBAHAY
(1)
ELEMENTARY (d.1) HIGH SCHOOL (d.2) COLLEGE (d.3) NATURE OF WORK (e.1) SALARY (e.2)
GEN. Php Php Php Php 5,000
15 to 46 and SEPARATE UNDERGR UNDERGR UNDERGR GARDENE LAUNDRY
F M 18-30 31-45 S M W GRAD GRAD GRAD HOUSEHE YAYA COOK OTHERS 1,000- 2,000- 2,500- and
below 18 above D AD AD AD R PERSON
LP 1,999 2,499 4,999 above

Prepared by: Submitted by:

__________________________________ _________________________________
Kasambahay Desk Officer Punong Barangay
 FORM 4
MONTHLY CONSOLIDATED KASAMBAHAY REPORT
AS OF _____________________________________________

MUNICIPALITY/CITY: PROVINCE:

NO. OF KASAMBAHAY BY: (3)

EDUCATIONAL ATTAINMENT (d) WORK INFORMATION (e)

TOTAL NO. OF
BARANGAY REGISTERED SEX (a) AGE (b) CIVIL STATUS (c)
KASAMBAHAY
ELEMENTARY (d.1) HIGH SCHOOL (d.2) COLLEGE (d.3)
NATURE OF WORK (e.1) SALARY (e.2)

GEN. Php Php Php Php 5,000

F M 15 to 18-30 31-45 46 and S M W SEPARA UNDERGR GRAD UNDERGR GRAD UNDERGR GRAD YAYA COOK GARDENE LAUNDRY OTHERS
HOUSEHE 1,000- 2,000- 2,500- and
below 18 above TED AD AD AD LP R PERSON 1,999 2,499 4,999 above

1
2
3
4
5

TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Prepared by: Submitted by:

______________________________________________ ___________________________________________________
PESO Staff Head, PESO
 FORM 5
BARANGAY CONSOLIDATED KASAMBAHAY REPORT
As of _____________________________________

Municipality/City: ____________________________________
Province: ____________________________________

NO. OF BARANGAYS WITH REGISTERED

TOTAL NO. OF BARANGAYS KASAMBAHAY TOTAL NO. OF KASAMBAHAY

Prepared by: Submitted by:

___________________________________ ____________________________________
MLGOO/CLGOO/CITY DIRECTOR
 FORM 6
BARANGAY CONSOLIDATED KASAMBAHAY REPORT
As of _____________________________________

Province: ____________________________________

NO. OF BARANGAYS WITH TOTAL NUMBER OF

CITY/MUNICIPALITY NO. OF BARANGAYS
REGISTERED KASAMBAHAY KASAMBAHAY
1
2
3
4
5
6
7
8
9
10
TOTAL 0 0 0

Prepared by: Submitted by:

___________________________ ____________________________
Provincial Director