VAC Form 3

MONITORING OF INCIDENCE ON VIOLENCE AGAINST CHILDREN (VAC) DURING THE COVID-19 PANDEMIC
Jovellar, Albay
For the month of ________________________________2023

VAC VICTIMS GENDER AGE TYPE OF VIOLENCE

(1) (2) (3) (4)

Barangay 18 Y.O. and

Psycholo-
(iii) above with
Physical Sexual gical/
Total No. of Male Female 0-4 Y.O. 5-9 Y.O. 10-14 Y.O 15-17 Y.O. physical or Neglect
Abuse Abuse Emotional
VAC Victims (2a) (2b) (3a) (3b) (3c) (3d) mental (4d)
(4a) (4b) Abuse
disability
(4c)
(3e)

MABINI 0 0 0 0 0 0 0 0 0 0 0 0

PERPETRATORS ACTION TAKEN BY THE BARANGAY/BCPC

(5) (6)

Others
Immediate Others Referred for Referred for (ex:
Other Close Acquainta Stranger/ Local Law Referred to Referred to Referred to
Family (ex: Medical Legal Referred to
Relative/s nce/s s Official/s Enforcer/s LSWDO PNP NBI
Member/s Guardian) Treatment Assistance NGOs,
(5b) (5c) (5d) (5e) (5f) (6a) (6b) (6c)
(5a) (5g) (6d) (6e) FBOs)
(6f)

0 0 0 0 0 0 0 0 0 0 0 0 0

Prepared by: Submitted by:

(In Charge) Punong Barangay

VAW Form 3

MONITORING OF INCIDENCE ON VIOLENCE AGAINST WOMEN (VAW) DURING

THE COVID-19 PANDEMIC
Jovellar, Albay
For the month of ________________ 2023

VAW
TYPES OF VIOLENCE ACTIONS TAKEN BY THE BARANGAY
VICTIMS
(2) (3)
(1)
Barangay
(iii) Psycholo-
Physical Sexual gical/ Economic Referred to Referred to
Total No. of Issued BPO
Abuse Abuse Emotional Abuse LSWDO PNP
VAW Victims (3a)
(2a) (2b) Abuse (2d) (3b) (3c)
(2c)

MABINI 0 0 0 0 0 0 0 0

ACTIONS TAKEN BY THE BARANGAY

(3)

Others
Referred for Referred for (ex:
Referred to Referred to
Medical Legal Referred to
NBI Court
Treatment Assistance NGOs,
(3d) (3g)
(3e) (3f) FBOs)
(3h)

0 0 0 0 0

Prepared by: Submitted by:

(In - Charge) Punong Barangay

VAC Form 3

MONITORING OF INCIDENCE ON VIOLENCE AGAINST CHILDREN (VAC) DURING THE COVID-19 PANDEMIC
Jovellar, Albay
For the _______ Quarter 2023
BARANGAY __________________

VAC VICTIMS GENDER AGE TYPE OF VIOLENCE

(1) (2) (3) (4)

18 Y.O. and
MONTH Psycholo-
above with
Physical Sexual gical/
Total No. of Male Female 0-4 Y.O. 5-9 Y.O. 10-14 Y.O 15-17 Y.O. physical or Neglect
Abuse Abuse Emotional
VAC Victims (2a) (2b) (3a) (3b) (3c) (3d) mental (4d)
(4a) (4b) Abuse
disability
(4c)
(3e)

JULY

AUGUST

SEPTEMBER

TOTAL

PERPETRATORS ACTION TAKEN BY THE BARANGAY/BCPC

(5) (6)

MONTH Others
Immediate Other Others Referred for Referred
Acquaint Local Law Referred to Referred to Referred to (ex: Referred
Family Close Stranger/s (ex: Medical for Legal
ance/s Official/s Enforcer/s LSWDO PNP NBI to NGOs,
Member/s Relative/s (5d) Guardian) Treatment Assistance
(5c) (5e) (5f) (6a) (6b) (6c) FBOs)
(5a) (5b) (5g) (6d) (6e)
(6f)

JULY

AUGUST

SEPTEMBER

TOTAL

Prepared by: Submitted by:

In Charge Punong Barangay

VAW Form 3

MONITORING OF INCIDENCE ON VIOLENCE AGAINST WOMEN (VAW) DURING

THE COVID-19 PANDEMIC
Jovellar, Albay
For the ________ QUARTER 2023
BARANGAY ____________________

VAW
TYPES OF VIOLENCE ACTIONS TAKEN BY THE BARANGAY
VICTIMS
(2) (3)
(1)

MONTH Psycholo-
Physical Sexual gical/ Economic Referred to Referred to
Total No. of Issued BPO
Abuse Abuse Emotional Abuse LSWDO PNP
VAW Victims (3a)
(2a) (2b) Abuse (2d) (3b) (3c)
(2c)
JULY
AUGUST
SEPTEMBER
TOTAL

ACTIONS TAKEN BY THE BARANGAY

(3)

Others
MONTH Referred for Referred for (ex:
Referred to Referred to
Medical Legal Referred to
NBI Court
Treatment Assistance NGOs,
(3d) (3g)
(3e) (3f) FBOs)
(3h)

JULY
AUGUST
SEPTEMBER

TOTAL

Prepared by: Submitted by:

In Charge Punong Barangay