KR Form 2

KASAMBAHAY MASTERLIST
Quarterly Report
For the Period , 20

Region:
Province:
City/Municipality:
Barangay:

Educational
Nature of Work Salary Membership
Atainment
. Elem . Gen. (Write Y for Yes, and N for
Registration
Home Civil Undergrad Househelp No)
Control Name of Kasambahay Sex Age Name of Employer
Elem Grad (all around);
Address Status
Number HS Undergrad Yaya
HS Grad Cook
. Coll. . Gardener
Undergrad Laundry person SSSPag- IBIG Phil- Health
Coll. Grad Others
Vocational

Prepared and submitted by:

Date:
(Signature over Printed Name)

Position / Designation
Employer's Complete Address
KR Form 3

MONTHLY BARANGAY CONSOLIDATED KASAMBAHAY REPORT

For the Month of , 20

Region:
Province:
City/Municipality:
Barangay:

SEX

Educational Atainment
(a) Nature of Work Salary Membership
TOTAL NO. OF REGISTERED
Home Civil
KASAMBAHAY Address Sex Age Status 1. Elem Undergrad 1. Gen. Househelp (Write Y for Yes, and N for No)
(1) 2. Elem Grad (all around);
3. HS Undergrad 2. Yaya
4. HS Grad 3. Cook
5 . Coll. Undergrad 4 . Gardener
6. Coll. Grad 5. Laundry person
7. Vocational 6. Others SSS Pag-IBIG Phil-Health

Prepared and submitted by:

Date:

(Signature over Printed Name)

Position / Designation
Name of EmployerEmployer's Complete
Address