1/18/2019 Records | POEA

FM-POEA-05-WP-02-F SECURING OFW RECORD IS FREE OF CHARGE

Effective Date: December 17, 2018
Appointment Reference No. (ARN):
Philippine Overseas Employment Administration
Administrative Branch
Central Records Division
6787
Branch Office: POEA Ortigas Office
Appointment Date: February 01, 2019
Appointment Time: 2:00 PM

ONLINE REQUEST FOR VERIFICATION / CERTIFICATION OF OFW RECORDS

PERSONAL INFORMATION
ESQUILLO DANIEL MR FURIO
LAST NAME (APELYIDO) FIRST NAME (PANGALAN) MIDDLE NAME (GITNANG APELYIDO)
(MAIDEN NAME FOR FEMALE - KUNG DALAGA PA UMALIS)
LAST NAME (APELYIDO ) FIRST NAME (PANGALAN) MIDDLE NAME (GITNANG APELYIDO)

09493444140 01/27/1979 AFRICA

CELLPHONE NUMBER BIRTHDATE (MONTH/DAY/YEAR) JOBSITE

INTER ASIA OUTSOURCE 2007 2019 LB

AGENCY (AHENSYA NA NAGPA-ALIS) YEAR OF RECORDS NEEDED WORKER CATEGORY

MODE OF DEPLOYMENT (PAANO NAKAALIS)

AGENCY HIRED DIRECT HIRED BALIK-MANGGAGAWA OTHERS
PURPOSE OF REQUEST (SAAN GAGAMITIN ANG KINUKUHANG RECORD)
EMPLOYMENT ASSISTANCE REQUIREMENT APPLICATION OTHERS
NEW APPLICATION BURIAL / INSURANCE DFA VISA OTHERS
RETURNING TO REPATRIATION TESDA REDUCED TRAVEL TAX (RTT)
SAME EMPLOYER
WHEREABOUTS OWWA PROGRAM LOAN
LEGAL
(SUPPORT/COMPLAINT/CASE
FILING)

FOR THE AUTHORIZED REPRESENTATIVE (Ang kumukuha ng Record ay HINDI MISMONG OFW)
LAST NAME (APELYIDO) FIRST NAME (PANGALAN) MIDDLE NAME (GITNANG APELYIDO)
RELATIONSHIP TO OFW
SPOUSE (ASAWA) SIBLING (KAPATID) PARENT (MAGULANG) CHILD (ANAK) RELATIVE (KAMAG-ANAK) 

This is to certify that the OFW record/s being requested shall be used ONLY for the purpose stated above.

DANIEL FURIO ESQUILLO MR

SIGNATURE OVER PRINTED NAME
(Please do not forget to sign before submiting)
(See second page for Guide, Requirements & Procedures)

<<<<<<<<<< DO NOT FILL OUT THIS PORTION: FOR POEA - CRD PERSONNEL ONLY >>>>>>>>>>

DOCUMENTS PRESENTED ACTION TAKEN (YEAR)

PASSPORT | UMID | SSS | NBI | VOTERS ID '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14
PHILHEALTH | PAGIBIG | PRC | POSTAL ID | LTO MARRIAGE CONTRACT '15 '16 '17 '18 '19 '20 '21 '22 '23 '24 '25 '26
BIRTH CERTIFICATE SPA / AUTHORIZATION NUMBER OF RECORDS RETRIEVED / PRINTED
LETTER REQUEST___________________________ 01 02 03 04 05 06 07 08 09 10 11 12 13 14
OTHERS___________________________________ 15 16 17 18 19 20 21 22 23 24 25 26
OFW RECORD RELEASED
PRINT-OUT (25 Mins.) DIGITAL IMAGE (30 Mins.) CERTIFIED COPY (8 Hrs.) CERTIFICATE OF NO RECORD (25 Mins.)

ENDORSED / WRITTEN REQUEST (15 Days)

RECEIVED EVALUATED & VERIFIED BY REVIEWED & APPROVED BY RELEASING

RECEIVED / ACKNOWLEDGED BY

TIME INITIAL TIME INITIAL TIME

SIGNATURE TIME
TOTAL PCT: _______________ Within PCT More than PCT

REMARKS: REASON IF TARGET PCT IS NOT ACHIEVED

Server Error Printer Error Photocopy ID / Requirements Others _________________________________

FOR EDITING / ENCODING: ICT BRANCH LANDBASED CENTER OTHERS: ___________________________________

2019-01-18 17:46:54

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