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    04 Rwa Application Form 2.0.

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    JC James
    This document is an application for registration of a worker's association called Samahan ng Mangiginga at Magsasaka ng Brgy. Pance. It provides details about the association such as its name, address, president and officers, date organized, number and occupations of members, and a certification by the president. The purpose is to officially register the association with the Department of Labor and Employment.

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    04 Rwa Application Form 2.0.

    Uploaded by

    JC James
    30 views1 page
    This document is an application for registration of a worker's association called Samahan ng Mangiginga at Magsasaka ng Brgy. Pance. It provides details about the association such as its name, address, president and officers, date organized, number and occupations of members, and a certification by the president. The purpose is to officially register the association with the Department of Labor and Employment.

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    This document is an application for registration of a worker's association called Samahan ng Mangiginga at Magsasaka ng Brgy. Pance. It provides details about the association such as its name, address, president and officers, date organized, number and occupations of members, and a certification by the president. The purpose is to officially register the association with the Department of Labor and Employment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    30 views1 page

    04 Rwa Application Form 2.0.

    Uploaded by

    JC James
    This document is an application for registration of a worker's association called Samahan ng Mangiginga at Magsasaka ng Brgy. Pance. It provides details about the association such as its name, address, president and officers, date organized, number and occupations of members, and a certification by the president. The purpose is to officially register the association with the Department of Labor and Employment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    BLR Form No.

    4, Series 2016
    Republic of the Philippines
    DEPARTMENT OF LABOR AND EMPLOYMENT
    Regional Office No. III

    APPLICATION FOR REGISTRATION OF WORKER’S ASSOCIATION (WAs)


    PART I. INFORMATION ABOUT THE REPORTING ORGANIZATION Date Accomplished (mm/dd/yyyy)
    To be accomplished by the applicant. Supply all required information. Misrepresentation, false statement or fraud in this
    application or any supporting document is a ground for denial or cancellation of registration.
    JULY 31, 2023

    Name of Applicant Association Contact Nos.


    SAMAHAN NG MANGINGISDA AT MAGSASAKA NG BRGY. PANCE
    E-mail: ________________________________

    BARANGAY PANCE, RAMOS, TARLAC Landline No: ___________________________

    Address Mobile No:


    09383785932___________________________

    Name of President Contact Nos.


    (First Name) (M.I.) (Last Name)
    CESARIO JR. M. ASIO E-mail: ________________________________

    Landline No: ___________________________


    BARANGAY PANCE, RAMOS, TARLAC
    Address Mobile No:
    09383785932___________________________
    Gender MALE
    Padding

    Date of CBL Ratification (mm/dd/yyyy)


    Date Organized (mm/dd/yyyy)
    JULY 20, 2023
    JULY 20, 2023
    No. of Association Members
    Place/s of Operation
    BARANGAY PANCE, RAMOS, TARLAC Male 26
    Female
    TOTAL 8
    34

    Occupation of Members. Please check appropriate category.


    Agricultural Workers ( / Farmers  / Fisher folk  Artisans  Cottage  Others __________________ ) Small
    Transport Workers (Drivers: Jeepney FX  Tricycle Pedicab )
    Home-based / Homeworkers
     Small Construction Workers
     Vendors (  Market  Sidewalk  Ambulant )  Small-scale Miners
     Others / Own-Account, Please specify ____________________________________________________________

    padding

    I attest to the truth of the foregoing.


    CESARIO M. ASIO JR.
    President
    (Signature over printed name)

    Subscribed and sworn to before me at _____________, Philippines, this _______ day of _________________ 20
    _______ with I.D. No. _________________________________________ issuedby
    ___________________________________________________ on _________________________________.

    NOTARY PUBLIC
    Doc. No. __________
    Page No. __________
    Book No. __________
    Series of __________

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