NOT FOR SALE

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT
RKS Form 5 of
______________________________________ Page 1 of 3
2020
Region-PO/FO-Year-Month-Count
(ex. NCR-MFO-2020-05-001) Certificate Number: AJA15-0048

Instructions:
1. Accomplish this form when filing a notice of: a) Flexible Work Arrangement/Alternative Work Scheme; b) Temporary Closure;
c) Retrenchment or Reduction of Workforce; or d) Permanent Closure.
2. The report is considered as duly filed when the complete list of workers affected is made part of the submission. Fields with
asterisks(*) should be accomplished by the company representative.
3. This form should be submitted to the DOLE Provincial/Field Office as soon as possible in the case of adoption of flexible work
arrangement or temporary closure.
4. For establishments that will retrench or permanently close, the form should be submitted 30 days prior to the effectivity of
termination.
5. Page 1 should contain general information about the establishment and the number of workers affected.
6. Page 3 should enumerate the names of workers affected, their addresses and contact numbers, and other information stated therein.
7. Total number of workers listed should equal the total number of workers affected as reported in this page.
ESTABLISHMENT REPORT
□ FLEXIBLE WORK ARRANGEMENT (FWA) / ALTERNATIVE WORK SCHEME (AWS)
□ TEMPORARY CLOSURE
□ RETRENCHMENT/REDUCTION OF WORKFORCE
□ PERMANENT CLOSURE
Date of Filing (mm-dd-yyyy): 0 7 - 0 2 - 2 0 2 0
A. ESTABLISHMENT INFORMATION
*Name of Establishment: TRAVEL SCENE INC.

*Floor/Bldg/No/Street/Subdivision : 3F PACIFIC PLACE BUILDING,539 ARQUIZA COR J. BOCOBO STREET

*Barangay/City/Municipality : BARANGAY 667, ERMITA MANILA
Geo Code :
Kind of Business/Economic : TRAVEL AGENCY
Activity/Principal Product:
PSIC Code :
*Company TIN : 000-149-793-000
*Company SSS Number : 03-8785259-9
*Number of Workers Male : 3 Managerial Employees : 0
Female : 11 Supervisory : 0
Total : 14 Rank-and-File : 14
Total : 14

B. SUMMARY OF AFFECTED EMPLOYEES DUE TO

B.1 Flexible Work Arrangement / Alternative Work Scheme*
Period of Adoption of FWA / AWS Type of FWA/AWS to Primary Reason
No. of Workers be Implemented ofAdoption of FWA/AWS
Covered/Affected Start End (Use code below, select only (Use code below, select only
(mm/dd/yyyy) (mm/dd/yyyy)
one) one)
7 07/01/2020 12/31/2020 OTH OTH
There is partial closure of the
business and those employees
There is government regulation,
belonging to the unit that will
as well as financial losses in the
operate and who voluntarily
company.
agreed to the FWA shall have
reduced workdays per week.

Codes for Types of FWAs/AWS

TOE - Transfer of employees to another branch or outlet of the same ROW - Rotation of workers
employer FCL - Forced leave
AOE - Assignment of employees to other function or position in the BTS - Broken-time schedule
same or other branch or outlet of the same employer CWW - Compressed Work Week
RWD - Reduction of workdays per week TWA - Telecommuting Work Arrangement
RWH - Reduction of workhours per day OTH - Others (please specify)
JR - Job rotation alternately providing employees with work within There is partial closure of the business and those employees
the workweek or within the month belonging to the unit that will operate and who voluntarily
agreed to the FWA shall have reduced workdays per week.

PCE - Partial closure of establishment where some unit or departments

of the establishment are continued while other units or
department are closed

Codes for Primary Reason for Adoption of FWA/AWS:

Economic Reasons Non-Economic Reasons
CI - Competition from Imports LRM - Lack of raw materials INV - Inventory
CMM - Change in management/merger MR - Increase in minimum wage rate NMC - Natural or man-made calamity
FL - Financial losses PD - Peso depreciation PC - Project completion
GR - Government regulation UPP - Uncompetitive price of products RGM - Repair or general maintenance
HCP - High cost of production OTH - Others (please specify): WSO - Work stoppage order/ cease and
 NOT FOR SALE
LC - Lack of capital There is government regulation as well desist order
as financial losses in the company.
LM - Lack of market/slump in demand/ OTH - Others (please specify):
cancellationof orders

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT
RKS Form 5 of
______________________________________ Page 2 of 3
2020
Region-PO/FO-Year-Month-Count
(ex. NCR-MFO-2020-05-001) Certificate Number: AJA15-0048

B.2 Temporary Closure*

Period of Temporary Closure Primary Reason of
No. of Workers
Start End Temporary Closure
Covered/Affected
(mm/dd/yyyy) (mm/dd/yyyy) (Use code below, select only one)
4 07/02/2020 12/31/2020 OTH
There is partial closure of the business
due to government regulation as well as
financial losses in the company.
Moreover, the company is not back in
its regular course of operation. The
company is only processing refunds to
its clients whose trips and flights were
cancelled due to the ongoing pandemic
and travel restrictions being
implemented. No operation for profit.

B.3 Retrenchment/Reduction of Workforce*

No. of Workers Effectivity Date Primary Reason of Retrenchment
Covered/Affected (mm/dd/yyyy) (Use code below, select only one)
3 08/01/2020 FL

B.4 Permanent Closure*

Effectivity Date of
No. of Workers Primary Reason of Permanent Closure
Termination
Covered/Affected (Use code below, select only one)
(mm/dd/yyyy)

Codes for Primary Reason Temporary Closure (B.2)/Retrenchment (B.3) / Permanent Closure (B.4):

Economic Reasons Non-Economic Reasons

CI - Competition from Imports MR - Increase in minimum wage rate AWOL - Absence without leave
CMM - Change in management/merger PD - Peso depreciation CCO - Commission of a crime or offense
FL - Financial losses R - Redundancy FWBT - Fraud or willful breach of trust
COE - Closure or cessation of operation of an RDS - Reorganization/downsizing GHN - Gross and habitual neglect of duty
establishment not due to serious losses RPL - Retrenchment to prevent losses INV - Inventory
of financial reverses OTH - Others (please specify): IR - Impossible reinstatement
EDC - Employee suffering from a disease not There is partial closure of the business NMC - Natural or man-made calamity
due to government regulation as well
as financial losses in the company.
Moreover, the company is not back in
its regular course of operation. The
company is only processing refunds to
its clients whose trips and flights were
cancelled due to the ongoing
pandemic and travel restrictions being
implemented. No operation for profit.
curable within the period of six (6) PC - Project completion
months RES - Resignation
GD - Government decision RET - Retirement
HCP - High cost of production RGM - Repair or general maintenance
LC - Lack of capital SMWD - Serious misconduct or willful
LRM - Lack of raw materials disobedience
LM - Lack of market/slump in demand/ WSO - Work stoppage order/ cease and
Cancellation of orders desist order
LSA - Lack of service assignment OTH - Others (please specify):
LSD - Installation of labor-saving devices

C. AGREEMENT ON ADOPTION OF FWA/AWS

This is to certify as to the following:
1. That I am the employees’ representative;
2. That the data provided in Item B.1 Summary of Affected Employees - Flexible Work Arrangement/Alternative Work Scheme
 NOT FOR SALE
are accurate;
3. That a consultation with the workers was undertaken prior to the adoption of FWA; and
4. Attached is a copy of the Agreement.

Signature Over Printed Name of Employees’ Representative and Date

Designation: Mobile No.: Telephone No.: E-mail Address:

D. CERTIFICATION
This is to certify as to the accuracy of the data provided in this report.

Signature Over Printed Name of Owner or Company Representative and Date

Designation: Mobile No.: Telephone No.: E-mail Address:

 NOT FOR SALE

Republic of the Philippines Page 3 of 3

DEPARTMENT OF LABOR AND EMPLOYMENT
Intramuros, Manila

Certificate Number: AJA15-0048

LIST OF AFFECTED WORKERS
Instruction: If necessary, use additional sheets following the same format.

CONSENT NOTICE: By accomplishing this form, you agree that the information submitted shall be used solely for purposes of monitoring and planning. We may likewise disclose your personal
information to the extent that we are required to do so by the Data Privacy Act of 2012. As a general rule, we may only keep your information until such time that we have attained the purpose by
which we collect them. Under the foregoing circumstances and to the extent permissible by applicable law, you agree not to take any action against the DOLE for the disclosure and retention of your
information.

Employmen
t Status*
Contact Designation
Name of Worker* Home Address* Email Address* (regular,
No* *
Birthday* contractual,
No Sex* etc.)
(dd/mm/yyyy
. (F/M)
)
4,000-
Middle House City/
Last Name First Name Street Brgy. Province 10,00
Name Number Municipality
0

AZUCENA SARAH GREGORI 09/03/1995 F BLCK 3 PLUTO ST. SUNRISER CALOOCCAN 0965419437 [email protected] ACCOUNTING REGULAR 14,000.00
1 MAE O LOT 45 VILLAGE CITY 4 STAFF
LLANO
BAÑAS KIMBERLY BANGERO 13/06/1996 F 205E TRAMO ST. PASAY CITY 0909680179 [email protected] ACCOUNTING REGULAR 14,000.00
2
JOY 4 STAFF
CHING ALDRIDGE CHIONG 05/07/1974 M 470 E ALEGRIA ST. SAMPALOC 0942807057 [email protected] TICKETING REGULAR 14,000.00
3 CLIFTON COR KASAMA MANILA 4 STAFF
ST.
CRUZ ANABELLE HIZON 16/09/1977 F 2774 OLD STA. ANA 0916276341 [email protected] LIASON STAFF REGULAR 14,000.00
4 PANADEROS MANILA
ST.
FRANCISCO MELBA BASA 31/12/1975 F 205E TRAMO ST. PASAY CITY 0910725164 [email protected] ACCOUNTING REGULAR 14,000.00
5
5 STAFF
MANALON ELMERA MANIPOL 13/07/1980 F BLK 8 LOT STA. LUCIA NOVALICHES 0921247183 [email protected] RESERVATION REGULAR 15,000.00
4 VILLA QUEZON CITY 3 STAFF
6
HERMAN
O
 NOT FOR SALE
PAULINO NOEMEE LIM 21/05/1976 F 41 CAMIA ST. DE STA. LUCIA PASIG CITY 0942526238 [email protected] ACCOUNTING REGULAR 14,000.00
7
CASTRO SUBD. 0 STAFF
SALTING RODEL PATASIN 14/07/1974 M B24 L15 A.BONIFACIO BACOOR 0917548525 [email protected] RESERVATION REGULAR 15,000.00
ST. CAVITE 5 STAFF
8
CHERRYHOME
S SUBD.
SILVEDERIO PAT MAY CULANAG 05/03/1987 F O BLOCK AGULAN ST WEST MAKATI CITY 0910630373 [email protected] ACCOUNTING REGULAR 14,000.00
9
PEMBO 3 STAFF
CRISOLO SHIELA JOSE 06/04/1978 F 909 VALDEZ ST. 559 SAMPALOC 0928286234 [email protected] SALES & REGULAR 14,000.00
10
GRACE MANILA 2 MARKETING
REYES ROSIE MANRIQUE 16/01/1984 F 25E ROMANTIC ST. STA. ANA TAGUIG CITY 0998567310 [email protected] SALES & REGULAR 14,000.00
11
9 MARKETING
VALLESPIN ELCID CUTA 08/08/1992 M 8 GLADIOLA ST. PAMPLONA LAS PINAS 0906096508 [email protected] SALES & REGULAR 14,000.00
DOÑA 3 CITY 5 MARKETING
12
MANUELA
SUBD.
MANUEL CATHERIN RIGUER 31/03/1986 F 9204 MZM VILLARAMA ST. POBLACIO NORZAGARAY BULACA 0975364540 [email protected] INTERNAL REGULAR 15,000.00
13
E BLDG. N N 2 m AUDITOR
DAANAY DANICA SALIGUE 13/10/1997 F 1813 ROAD 9 FABIE STA. ANA 0915420988 [email protected] RESERVATION REGULAR 14,000.00
14
ESTATE MANILA 1 STAFF
15
16
fields to be accomplished by the company representative

*a