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Records POEA

This document is a request form for verification or certification of an OFW's records from the Philippine Overseas Employment Administration (POEA). It contains the personal information of Leslie Iguál Sánchez who worked in Taiwan from 2014 to 2020 for agencies Grandplacement, MIP, and Firstchampion. The purpose of the request is for a new employment application. The form requires signatures to certify the record will only be used for the stated purpose and sections for POEA personnel to track the request.

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Leslie Igual - Sanchez
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207 views3 pages

Records POEA

This document is a request form for verification or certification of an OFW's records from the Philippine Overseas Employment Administration (POEA). It contains the personal information of Leslie Iguál Sánchez who worked in Taiwan from 2014 to 2020 for agencies Grandplacement, MIP, and Firstchampion. The purpose of the request is for a new employment application. The form requires signatures to certify the record will only be used for the stated purpose and sections for POEA personnel to track the request.

Uploaded by

Leslie Igual - Sanchez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FM-POEA-05-WP-02-F

Effective Date: December 17, 2018


SECURING OFW RECORD IS FREE OF CHARGE

Philippine Overseas Employment Administration


Administrative Branch
Central Records Division
Appointment Reference No. (ARN): 493052
Branch Office: POEA Ortigas
Appointment Date: July 01, 2022
Appointment Time: 10:00 AM
ONLINE REQUEST FOR VERIFICATION / CERTIFICATION OF OFW RECORDS
PERSONAL INFORMATION
SANCHEZ
LAST NAME (APELYIDO)

LESLIE
FIRST NAME (PANGALAN)

IGUAL
MIDDLE NAME (GITNANG APELYIDO)
(MAIDEN NAME FOR FEMALE - KUNG DALAGA PA UMALIS)

IGUAL
LAST NAME (APELYIDO )

LESLIE
FIRST NAME (PANGALAN)

ALTURA
MIDDLE NAME (GITNANG APELYIDO)

09709417140
CELLPHONE NUMBER

12/04/1990
BIRTHDATE (MONTH/DAY/YEAR)

TAIWAN
JOBSITE

GRANDPLACEMENT,MIP,FIRSTCHAMPION
AGENCY (AHENSYA NA NAGPA-ALIS)

2014 2020
YEAR OF RECORDS NEEDED

LB
WORKER CATEGORY

MODE OF DEPLOYMENT (PAANO NAKAALIS)


AGENCY HIRED DIRECT HIRED BALIK-MANGGAGAWA OTHERS

PURPOSE OF REQUEST (SAAN GAGAMITIN ANG KINUKUHANG RECORD)


:
PURPOSE OF REQUEST (SAAN GAGAMITIN ANG KINUKUHANG RECORD)
EMPLOYMENT
NEW APPLICATION

RETURNING TO SAME EMPLOYER


ASSISTANCE
BURIAL / INSURANCE

REPATRIATION
WHEREABOUTS
LEGAL (SUPPORT/COMPLAINT/CASE FILING)

REQUIREMENT
DFA

TESDA
OWWA PROGRAM

APPLICATION
VISA
REDUCED TRAVEL TAX (RTT)

LOAN

OTHERS
OTHERS

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.

LESLIE IGUAL SANCHEZ


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
PASSPORT | UMID | SSS | NBI | VOTERS ID PHILHEALTH | PAGIBIG | PRC | POSTAL ID | LTO MARRIAGE CONTRACT

BIRTH CERTIFICATE SPA / AUTHORIZATION LETTER REQUEST___________________________

OTHERS___________________________________

ACTION TAKEN (YEAR)


'03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17 '18 '19 '20 '21 '22 '23 '24 '25
'26
NUMBER OF RECORDS RETRIEVED / PRINTED
01 02 03 04 05 06 07 08 09 10 11 12 13 14 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

TIME
EVALUATED & VERIFIED BY

INITIAL
TIME
REVIEWED & APPROVED BY

INITIAL
TIME

TOTAL PCT: _______________ Within PCT More than PCT

RELEASING
RECEIVED / ACKNOWLEDGED BY

SIGNATURE
TIME
REMARKS: REASON IF TARGET PCT IS NOT ACHIEVED
Server Error Printer Error Photocopy ID / Requirements Others _________________________________

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


2022-06-30 21:29:39
:

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