MODALITY APPLICATION FORM

INDIVIDUAL ENTERPRISE

I. BASIC INFORMATION OF THE SLPI

Name of PARTICIPANT: NIL PAMS

Name of SLPI:

II. BASIC INFORMATION OF THE PROJECT

Title of Microenterprise Project: SARI-SARI STORE

Amount Requested (SCF): Php 15,000.00

Location of Microenterprise: Pk. Palmera, Brgy. Mabua, Tandag City,

Surigao del Sur

III. RATIONALE OF THE PROPOSED SEED CAPITAL FUND

The walk-in client asked for financial assistance from the office for Sari-sari store.
[Provide justification on the link/ usability of the proposed SCF to the Microenterprise Project of the SLP participant]

IV. BUSINESS PROFITABILITY ASSESSMENT

A. TARGET MARKET (Merkado)
Mark your answer with a (✔) (Punan ng tsek (✔) ang kahon ng iyong napiling sagot)

Question Yes No
Is there a demand and market for the products and/or services to be
produced / developed? (Mayroon bang pangangailangan at mamimili o /
tiyak na tatangkilik sa inyong produkto o serbisyo?)
Is the location of the microenterprise accessible? (Malapit ba ang lugar /
na pagtatayuan ng negosyo sa mga mamimili?)
Is there an identified consumer to regularly purchase from the
microenterprise? (Mayroon bang tukoy na konsumer na regular na /
tatangkilik sa inyong produkto o serbisyo?)
Are there effective distribution channels to the market? (Mayroon na
bang epektibong paraan ng distribusyon ng mga produkto o serbisyo sa /
merkado?)
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Relatives, Friends, Neighbour and nearest Purok in our

Target Market: Barangays

B. MICROENTERPRISE MANAGEMENT (pamamahala ng negosyo)

a) Raw Materials (Mga kinakailangang sangkap)

Raw Material Quantity Unit Unit Frequency of Total Cost

(sangkap/materyal (Bilang) (Yunit) Price Production – no. (Kabuuang
es) (a) (b) (c) (Halaga of days, months, halaga o
o presyo quarters, etc. presyo), (f)
ng (Dalas ng (f)= [(b)] x
bawat paggawa) (d) x (e)]
unit) (e)
(d)
Rice 2 sack 2,000.00 weekly 4,000.00
Noodles 5 dozen 96.00 480.00
Canned Goods 20 dozen 250.00 5,000.00
Coffee 3 dozen 120.00 360.00
Sugar 5 kg 90.00 450.00
Detergent soap 16 dozen 85.00 1,360.00
Milk Powder 5 dozen 150.00 750.00
Bath Soap 5 dozen 240.00 1,200.00
Shampoo 5 dozen 80.00 400.00
Seasoning 5 dozen 60.00 300.00
Biscuits 10 pack 70.00 700.00
Grand Total 15,000.00

b) Manpower available and labor required (Mga tauhan at mga kinakailangang

manggagawa)

Name of Workers in the Microenterprise Specific Task in the Daily

(Pangalan ng lahat ng magtatrabaho sa Microenterprise Wage/Salary
negosyo) (Gawain/trabaho sa (Arawang sweldo)
negosyo)
NIL PAMS Tindera/Cashier 50.00

Total daily wage (Kabuuang arawang suweldo) 50.00

Total wage based on production or business (Total daily wage x no. of days based on the
cycle (Kabuuang suweldo base sa siglo ng production cycle) 50 x 30 days=1,500.00
produksyon)

c) Tools and Equipment (Mga kinakailangang kagamitan)

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DSWD | PROMOTIVE SERVICES DIVISION | FIELD OFFICE CARAGA| SUSTAINABLE LIVELIHOOD PROGRAM
 DSWD-SLP-GF-003 | REV 01 | 14 NOV 2022

Unit
Total Cost
Price Life Span of Production Depreciation
Tool/ Quantit Unit (kabuuang
(halaga o tools/equipment Cycle (in Cost
Equipment y (yunit halaga o
presyo ng (divide by 365 days/
(kagamitan) (bilang) ) presyo)
bawat isa) days) months/years) (h) =
(a) (b) (c)
(d) (e) = [(b) x (d)] (f) (g) [(e)/(f)] x (g)

Store 1 unit 2500 2500 5 years weekly 10.42

Grand Total 10.42

d) Other Expenses (Iba pang gastusin)

Frequency of Payment –
Regular Operational Expense Total Cost
daily, monthly, quarterly
(regular na pinagkakagastusan) (kabuuang halaga o presyo)
(Dalas ng pagbayad)
Work space rent
(Upa sa gawaan ng N/A
produkto/opisina)
Electricity (kuryente) 300.00 75.00
Water (tubig) N/A
Transportation cost (Pamasahe) 100.00/once a week 100.00
Permit to operate 1,200 Annually 25.00
Miscellaneous expenses 100.00 100.00
Grand Total 300.00

e) Gross sales per production cycle (Pangunahing kita mula sa puhunan para sa mga
sangkap)
Sale Price per unit
Total Sales
Product Quantity Unit (halaga ng
(kabuuang halaga ng
(produkto) (bilang) (yunit) pagbenta kada
pagbenta)
(a) (b) (c) piraso)
[(e)= (b) x (d)]
(d)
Rice 2 sack 2,400.00 4,800.00
Noodles 5 dozen 115.20 576.00
Canned Goods 20 dozen 300.00 6,000.00
Coffee 3 dozen 144.00 432.00
Sugar 5 kg 108.00 540.00
Detergent soap 16 dozen 102.00 1,632.00
Milk Powder 5 dozen 180.00 900.00
Bath Soap 5 dozen 288.00 1,4400.00
Shampoo 5 dozen 96.00 480.00
Seasoning 5 dozen 72.00 360.00
Biscuits 10 pack 84.00 840.00
Gross Sales 18,000.00

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DSWD | PROMOTIVE SERVICES DIVISION | FIELD OFFICE CARAGA| SUSTAINABLE LIVELIHOOD PROGRAM
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f) Net profit per production cycle (Kabuuang kikitain sa bawat paggawa ng produkto
o serbisyo)
ITEMS COST
Gross Sales (inaasahang kita para sa isang
18,000.00
“production cycle”)
Less: Raw materials 15,000.00
Gross Profit 3,000.00
Less:
Manpower available and labor required 350.00
Depreciation Cost 10.42
Other Expenses 300.00
Total Operating Expense 660.42
Gross profit after operating expense 2,339.58

g) Schedule for the Use of the SCF (Plano sa Paggastos ng SCF)

Expenses Amount Schedule of Utilization

[Raw materials, manpower (Halaga) (Kailan gagastusin, hal. 1
requirement, etc.] buwan matapos matanggap
(Pagkakagastusan) ang SCF, etc.)
Rice 4,000.00 December 15, 2022
Noodles 480.00 December 15, 2022
Canned Goods 5,000.00 December 15, 2022
Coffee 360.00 December 15, 2022
Sugar 450.00 December 15, 2022
Detergent soap 1,360.00 December 15, 2022
Milk Powder 750.00 December 15, 2022
Bath Soap 1,200.00 December 15, 2022
Shampoo 400.00 December 15, 2022
Seasoning 300.00 December 15, 2022
Biscuits 700.00 December 15, 2022

November 29,
Prepared by:
NIL PAMS 2022
(Inihanda ni)
Signature over Printed Name of SLPI Date:

Approved by:
(Inabrubahan MONINA A. TANJAY
ni) Signature over Printed Name of Provincial Coordinator Date:

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DSWD | PROMOTIVE SERVICES DIVISION | FIELD OFFICE CARAGA| SUSTAINABLE LIVELIHOOD PROGRAM