USER ENROLMENT FORM v2

* all fields are required

* Do not directly edit here. Download this sheet first, fill-up necessary fields, and submit to your BTr field office

USER INFORMATION

Email Address cyrusjameschavez7@gmail.com xsoliven@gmail.com

First Name Cyrus James e.g.: Ian

Middle Name Francisco e.g.: Santos

Last Name Chavez e.g.: Soliven

Position Title SK Chairperson e.g.: Computer Programmer II

ACCESS RIGHTS

Usergroup N/A if LGU/NGA/GOCC/GFI:

System Role N/A

ORGANIZATION

Department N/A e.g.: Department of Transportation

Agency (Whole Name) (Acronym) N/A e.g.: Land Transportation Office (LTO)

Operating Unit N/A e.g. : Manila Office

LOCATION

Region R4B e.g. : NCR

Province/District Palawan e.g. : District 1

City/Municipality Aborlan e.g. : Manila

Signatories

Signature of the User

Fullname of User Cyrus James F. Chavez

Position of User SK Chairperson

Date Filed (mm/dd/yyyy) January 7, 2024

Signature of Head of Agency

Fullname of Head of Agency Renato T. Ondam

Designation of Head of Agency Barangay Captain

this part is to be filled up by the BTr admin

generated username Palawan Palawan palawan

date created (mm/dd/yyyy) Chavez Chavez chavez

Signature of User Admin

Fullname of User Admin
Designated BTr office R4B - Palawan

- if you are applying as NGA/LGU/GOCC/GFI user, please submit the accomplished form to your designated BTr field office.
 USER ENROLMENT FORM v1
* all fields are required
* Do not directly edit here. Download this sheet first, fill-up necessary fields, and submit to your BTr field office

USER INFORMATION
Email Address xsoliven@gmail.com xsoliven@gmail.com
First Name Ian Hero e.g.: Ian
Middle Name Santos e.g.: Santos
Last Name Soliven e.g.: Soliven
Position Title Computer Programmer II e.g.: Computer Programmer II

ACCESS RIGHTS
Usergroup LGU/NGA/GOCC/GFI if LGU/NGA/GOCC/GFI: NGA
System Role Admin

ORGANIZATION
Department Department of Transportation e.g.: Department of Transportation
Agency (Whole Name) (Acronym) Land Tranportation Office LTO e.g.: Land Transportation Office (LTO)
Operating Unit Manila Office e.g. : Manila Office

LOCATION
Region NCR e.g. : NCR
Province/District District 1 e.g. : District 1
City/Municipality Manila e.g. : Manila

Signatories

Signature of the User (affix signature here)

Fullname of User Ian Hero Santos Soliven
Position of User Computer Programmer II
Date Filed (mm/dd/yyyy) July 1, 2024

Signature of Head of Agency (affix signature here)

Fullname of Head of Agency Edgar Galvante
Designation of Head of Agency Chief

this part is for the BTr system admin

generated username issoliven_ncr_district1_nga_ad District1 District1 district1

date created (mm/dd/yyyy) Soliven Soliven soliven

Signature of User Admin

Fullname of User Admin
Designated BTr office NCR - District 1

- if you are applying as BTR admin, please submit the accomplished form to issoliven@treasury.gov.ph
- if you are applying as NGA/LGU/GOCC/GFI user, please submit the accomplished form to your designated BTr field office.