Form No.

Kasambahay Masterlist

EDUCATIONAL ATTAINMENT NATURE OF WORK EMPLOYMENT

1.Elem Under Grad ARRANGEMENT
SALARY
2.Elem Grad
.
1.Gen Household
MEMBERSHIP(write Y for Yes and
3.HS under grad. All around 1.Live-in N for no
Registra Civil 4. HS Grad 2.Yaya NAME OF EMPOYER’S
3.Cook 1.1,500.00-1,999.00
tion Control Sex Age Status 5. Col Under grad
4.gardener
2.Live-out EMPLOYER COMPLERTE ADDRESS
No. 6.Col grad.
NAME OF KASAMBAHAY 7.Vocational 5.Laundry Person 2.2,000.00-2,499.00
6. Others
3.2,500.00-4,999.00

4.5,000.00 n above SSS Pag- Philhealt

Ibig h
Family First Name Middle Name

Prepared and Submitted by: NOTED BY:

NIDA L. BIBANGCO, RONIE A. BALANDANG

Kasambahay Desk Officer Punong Barangay