Scribd
Upload
659 views

Annex C.1 - Livelihood Project Status Form For Individual Project

This form collects information about livelihood assistance projects and their beneficiaries. It records the name, contact details, and type of beneficiary. It also notes the project details like location and nature. The form tracks the type and date of assistance provided, the project's current status and income, and number of jobs generated. It documents any licenses obtained. It asks about additional assistance received and issues/challenges. The interviewer signs off after administering the form.

Uploaded by

JessaMaeDelosReyes
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
659 views

Annex C.1 - Livelihood Project Status Form For Individual Project

This form collects information about livelihood assistance projects and their beneficiaries. It records the name, contact details, and type of beneficiary. It also notes the project details like location and nature. The form tracks the type and date of assistance provided, the project's current status and income, and number of jobs generated. It documents any licenses obtained. It asks about additional assistance received and issues/challenges. The interviewer signs off after administering the form.

Uploaded by

JessaMaeDelosReyes
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

LIVELIHOOD PROJECT STATUS FORM

(Individual)
Date: ________________
BENEFICIARY PROFILE:
Name: __________________________________________________ Contact No. ______________________
(Pangalan) Last Name First Name Middle Name

Type of Beneficiary (Uri ng Benepisyaryo): Farmers Fisherfolk PWD Senior Citizen


Others, pls. specify: __________________________________
Address: ______________________________________________________________________________________

PROJECT DETAILS:
Project Proponent: ________________________________________________________________________________
Address of Project/ Area of Operation: ________________________________________________________________
(Lugar ng Proyekto o Ginagalawan) ________________________________________________________________
Nature of Livelihood (Uri ng Kabuhayan): _________________________________________________________________
Type of Assistance (Klase ng Tulong): Formation Enhancement Restoration
Date Granted (Petsa Pinagkaloob): ____________________ Amount Granted (Halaga ng Pinagkaloob): _________________
Project Status (Estado ng Proyekto): Monthly Income ( Prior to receipt of assist.): _____________________
Operational (Buwanang Kita Bago Makakuha ng Tulong)
Operational but needs assistance Current Monthly Income: ________________
Not operational (Buwanang Kita Ngayon)
No. of Job Generated in the Project (Bilang ng Manggagawa Na-employ para sa Proyekto) : ______________
Licenses & Permits Acquired (Mga lisensya at permit na natamo):
Brgy. Clearance DTI Permit Mayor’s Permit Sanitary Permit BIR/TIN
Others: _______________________________________________________________________________________
A. Assistance acquired from other agencies/organizations
(Mga tulong na natanggap mula sa ibang mga ahensya/ organisasyon)

B. Issues / Challenges
(Mga balakid/problema sa implementasyon ng proyekto; Aspeto ng proyekto na kinakailangan ng tulong)

C. Recommendation/s / Remarks: (To be filled up by DOLE)

Administered by (Interviewer):

______________________________________
Annex “C.1”
(Signature over printed name)
Notes:
 Attach pictures of project and beneficiary/ies.
 Operational – projects that are continuously producing goods and rendering services with at least break-even return of
investments

You might also like