Department of the Interior and Local Government

Form 1. LGU Profile

LGPMS Profiling
CY 2019

Local Governance Performance Management System – DATA COLLECTION AND CERTIFICATION FORM
Form 1. LGU Profile

City/Municipality of : __________________________________ Region :

Province : __________________________________

INSTRUCTIONS: PLEASE READ BEFORE PROCEEDING TO THE ITEMS.

For the LGU-LGPMS Team:
(1) To be completed and certified by the LGU-LGPMS Team. (2) The data or information should be based on the current situation of the
year under review i.e., as of July 31, 2019; except for select indicators with specific reference year e.g., financial data based on CY 2017
records. (3) Members of the LGU-LGPMS Team are to affix their respective signatures on the Certification Page.

I. Basic Information II. Ecosystems

Please tick available condition(s)

Income Class __________________
☐ Agricultural
☐ Coastal Marine
Population (CY 2015) __________________
☐ Forest
☐ Freshwater
No. of Households (CY 2015) __________________
☐ Urban

Land Area (in sq.km) __________________

Website __________________

III. Hazards IV. Economic Activity

Please indicate the type of hazard the LGU is exposed to. Rank the present economic activities present in the
LGU with “1” being the most dominant. Put N/A if the
☐ Typhoon activity is not present in the locale.

☐ Earthquake
Agriculture
☐ Landslide
Commercial and service centers
☐ Flood
Fisheries
☐ Storm surge
Industrial
☐ Others. Please specify:
Mining
__________________________________

V. Financial Summary CY 2017

LGU Income Resource Allocation and Utilization

IRA share PhP __________________ Personal services
expenditure ratio __________ %
Locally-sourced Total expenditure per
revenues PhP __________________ capita __________ %
Other revenues PhP __________________
Debt service ratio __________ %
Total PhP __________________

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 Department of the Interior and Local Government
Form 1. LGU Profile
LGPMS Profiling
CY 2019

Financial Summary CY 2017 VI. LGU-owned Economic Enterprise

(continuation)

Revenue Generation Please tick present enterprise

Cost-to-collect revenue
Real property tax
accomplishment rate
Locally-sourced revenue
to Total Income
Locally-sourced
revenue per capita
Regular revenue to
Total Income
PhP __________________
☐ Museum
☐ Public cemetery
__________ % ☐ Public market
☐ Public park
__________ % ☐ Slaughterhouse
☐ Transport terminals
PhP __________________ ☐ Others. Please specify:
________________________________
__________ %

VII. Local Special Bodies, Committees and Other Councils

Please indicate whether the following local entities are organized in the LGU. If organized, specify the
year of constitution; otherwise, write “NA”

Organized? Year
Yes No
Local health board ☐ ☐ ____________
Local school board ☐ ☐ ____________
Local council for the protection of children ☐ ☐ ____________
Local nutrition committee ☐ ☐ ____________
Local drinking water quality monitoring committee ☐ ☐ ____________

VIII. Legislative Profile and Support to Operations

Year last updated

☐ Code of general ordinances ____________
☐ Revenue code ____________
☐ Market code ____________
☐ Health and sanitation code ____________
☐ Environmental code ____________
☐ Freedom of Information ordinance or EO ____________
☐ Manual of Operations ____________
Human Resource Management and
☐ Development Plan ____________
☐ Capacity Development Agenda ____________

IX. Housing and Basic Utilities

HH w/ access to piped-
No. of Informal Settlers __________ HH in water (Level III) __________ %
Households (HH) w/ HH w/ access to
access to electricity __________ % sanitary toilets __________ %

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 Department of the Interior and Local Government
Form 1. LGU Profile
LGPMS Profiling
CY 2019

X. Appointed/Designated Local Officials/Employees

Please tick Department Head position present in the LGU, and indicate if incumbent Head seats in plantilla
(permanent) position as well as year s/he was appointed.

Plantilla Year
Position Appointed
(tick if Yes)
☐ Secretary to the Sanggunian ☐ _________
☐ Treasurer ☐ _________
☐ Assessor ☐ _________
☐ Accountant ☐ _________
☐ Budget Officer ☐ _________
☐ Planning and Development Officer ☐ _________
☐ Engineer ☐ _________
☐ Health Officer ☐ _________
☐ Civil Registrar ☐ _________
☐ Administrator ☐ _________
☐ Legal Officer ☐ _________
☐ Agriculturist ☐ _________
☐ Social Welfare and Development Officer ☐ _________
☐ Environmental and Natural Resources Officer ☐ _________
☐ Architect ☐ _________
☐ Information Officer ☐ _________
☐ Cooperatives Officer ☐ _________
☐ Population Officer ☐ _________
☐ Veterinarian ☐ _________
☐ General Services Officer ☐ _________
☐ Tourism Officer ☐ _________

XI. Personnel Complement

Please indicate total number of:

Elective positions __________________ Police officers __________________
Permanent appointive Firemen
positions __________________ __________________
Permanent employees Doctors
__________________ __________________
Contractual employees Midwife
__________________ __________________
Job order and/or contract Nurses
of services __________________ __________________
Barangay health
workers __________________

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 Department of the Interior and Local Government
Form 1. LGU Profile
LGPMS Profiling
CY 2019

XII. LGU-managed Facilities XIII. LGU Service Vehicles

Please indicate total no. of facilities managed by the Please indicate total no. of vehicle of
LGU the LGU
Drug rehabilitation centers _________
Fire truck _____________
Health center/hospitals _________ Ambulance _____________
Museum _________ Service vehicle _____________
Motorcycle _____________
Parks _________
Garbage truck _____________
Pre-school _________ Patrol car _____________
Reading center/library _________
Residential care facility _________
Socio-cultural center _________
Sports facility _________
Vocational/ technical school
_________

XIV. Other sectoral profiles

A. Senior citizens’ welfare

1. The LGU has an Office of Senior Citizen’s Affairs (OSCA) ☐ Yes
☐ No
If yes:
1.1 OSCA is headed by (indicate position title of OSCA Head): ______________________________
1.2 OSCA Head is appointed in (indicate year): ______________
B. Youth development
1. The LGU has a Local Youth Development Office (LYDO) ☐ Yes
☐ No
If yes:
1.1 LYDO is headed by (indicate position title of LYDO Head):
_______________________________________
1.2 LYDO Head is appointed in (indicate year): ______________
2. There is a Sanggunian-approved local youth development plan ☐ Yes
☐ No
If yes:
2.1 Plan was approved in (indicate date): _______________________________________
C. Climate Change Expenditure Tagging
1. Climate change expenditures are identified in the CY 2019 Annual ☐ Yes
Investment Programs (AIP) ☐ No
2. Identified climate change expenditures in AIP are tagged using ☐ Yes
the prescribed AIP Form ☐ No
D. Project Monitoring
1. The LGU has a local project monitoring committee ☐ Yes
☐ No
If yes:
1.1 Project Monitoring Reports are submitted to the local ☐ Monthly
development council: ☐ Quarterly
☐ Semi-annual
☐ Annual
☐ No submission

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 Department of the Interior and Local Government
Form 1. LGU Profile
LGPMS Profiling
CY 2019

F. Pantawid Pamilyang Pilipino Program (4Ps) [This portion is for cities and municipalities only]
1. There is a City/Municipal Advisory Committee that oversees ☐ Yes
implementation of 4Ps in the LGU ☐ No
2. The LGU designated a Focal Person who serves as a DSWD-Link in ☐ Yes
the implementation of the Program ☐ No
E. Agriculture and Fisheries
1. The LGU organized an Agriculture and Fishery Council ☐ Yes
☐ No
If yes:
1.1 Indicate year the Council was organized: ______________
2. The LGU has an agriculture office ☐ Yes
☐ No
If yes:
2.1 Indicate name of the Office:
_____________________________________________
2.2 The Office has an agricultural engineering division/ section ☐ Yes
which serves as the planning, coordinating, regulating and ☐ No
implementing body of the LGU to oversee infrastructure
requirements for modernization of agriculture and fisheries

XV. Awards and Recognitions

Enumerate local governance-related awards and recognitions received by the LGU since CY 2017, both national
and international. Note: Please do not include the following: a) personal awards, and b) regional awards.

Award title Year conferred Award-giving body Nat’l Int’l

_________________________________________ ____________ _________________________________ ☐ ☐
_________________________________________ ____________ _________________________________ ☐ ☐
_________________________________________ ____________ _________________________________ ☐ ☐
_________________________________________ ____________ _________________________________ ☐ ☐
_________________________________________ ____________ _________________________________ ☐ ☐

XVI. LGU Description

Please provide a brief description of the local government that highlights its governance thrusts and how these are
translated in programs and commitments. The LGU can also feature what it is known for (e.g., products, destinations
and taglines). Description MUST NOT EXCEED 70 words. In case the LGU passed 2019 SGLG, this description may be
used during the awarding ceremony.

_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________

XVII. LCE Profile

Name of Governor or Mayor _________________________________________

Term of Office (1st, 2nd or 3rd) _________________________________________
Party Affiliation _________________________________________
Telephone No. _________________________________________
Fax No. _________________________________________
E-mail address _________________________________________

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 Department of the Interior and Local Government
Form 1. LGU Profile
LGPMS Profiling
CY 2019

City/Municipality of : __________________________________ Region :

Province : __________________________________

Date: ________________________________

C E R T I F I C A T I O N P A G E

We, the members of the LGU-LGPMS Team, hereby confirm the answers provided in
Form 1. LGU Profile CY 2019.

We assume the responsibility in providing credible and realistic data.

SIGNED:
(Note: Place your signature above printed name. Indicate your position)

__________________________________________ __________________________________________

__________________________________________ __________________________________________

__________________________________________ __________________________________________

__________________________________________ __________________________________________

__________________________________________ __________________________________________

__________________________________________ __________________________________________