FORM 2

KASAMBAHAY MASTERLIST
Quarterly Report
For the Period _______________________

Province:
City/Municipality:
Barangay:
Employm Membership (Write Y for Yes, and
Name of Kasambahay Employer's
Registration Home Civil Educational Nature of ent N for No) Name of
Sex Age Salary Complete
Control Number Address Status Attainment Work Arrangem Employer
Address
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)

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

15 to GEN. Php Php Php Php 5,000

46 and SEPARATE UNDERGR UNDERGR UNDERGR GARDENE LAUNDRY
F M below 18-30 31-45 S M W GRAD GRAD GRAD HOUSEH YAYA COOK OTHERS 1,000- 2,000- 2,500- and
above D AD AD AD R PERSON
18 ELP 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

15 to 46 and SEPARA 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 TED AD AD AD R PERSON
LP 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 TOTAL NO. OF KASAMBAHAY
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