KR Form 2

KASAMBAHAY MASTERLIST
Quarterly Report
For the Period __________________, 20_____

Region:
Province:
City/Municipality:
Barangay:

Educational
Nature of Work Salary Membership
Attainment
1. Elem Undergrad 1. Gen. Househelp (Write Y for Yes, and N for No)
Registration
Home Civil 2. Elem Grad (all around); Employer's Complete
Control Name of Kasambahay Sex Age Name of Employer
Address Status 3. HS Undergrad 2. Yaya Address
Number
4. HS Grad 3. Cook
5. Coll. Undergrad 4. Gardener
6. Coll. Grad 5. Laundry person
SSS Pag-IBIG Phil-Health
7. Vocational 6. Others

Prepared and submitted by:

Date: _____________________ _______________________________

(Signature over Printed Name)

Position / Designation
KR Form 3
MONTHLY BARANGAY CONSOLIDATED KASAMBAHAY REPORT
For the Month of __________________, 20_____

Barangay:
Mun./City:
Province:
Region:

NO. OF KASAMBAHAY: (2)

EDUCATIONAL ATTAINMENT (d)
SEX (a) AGE (b) CIVIL STATUS (c)
TOTAL NO. OF ELEMENTARY HIGH SCHOOL COLLEGE
REGISTERED
KASAMBAHAY
(1)

Prepared and submitted by:

Date: _____________________ _______________________________

(Signature over Printed Name)

Position / Designation