Scribd
Upload
96 views

FM-EW-038 - ACP Application Form

This document is an application form for an organization to become an Accredited Co-Partner (ACP) with the Department of Labor and Employment in the Philippines. The form requests information about the organization such as its name, type, address, registration details, affiliations, number of employees, and any previous grants received from the Department of Labor. The organization must also attach required documents like registration certificates, articles of incorporation, audited financial reports, and an affidavit stating there is no conflict of interest. The completed form will be reviewed and evaluated to determine if the organization qualifies for ACP status.

Uploaded by

Erica Paramio
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
96 views

FM-EW-038 - ACP Application Form

This document is an application form for an organization to become an Accredited Co-Partner (ACP) with the Department of Labor and Employment in the Philippines. The form requests information about the organization such as its name, type, address, registration details, affiliations, number of employees, and any previous grants received from the Department of Labor. The organization must also attach required documents like registration certificates, articles of incorporation, audited financial reports, and an affidavit stating there is no conflict of interest. The completed form will be reviewed and evaluated to determine if the organization qualifies for ACP status.

Uploaded by

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

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT


Regional Office No. IV-A

ACCREDITED CO-PARTNER (ACP) ACP FORM 1


APPLICATION FORM

Name of Organization: Type of Organization:


NGO Cooperative PO Union
Rural Workers Association Others ________ (pls. specify)
Registered Address: Registration No. and Date with DOLE/SEC/CDA:

Office Telephone No.: Taxpayer Identification Number (TIN)/VAT No.:


Affiliations with other organizations/s No. of Employees:
PREVIOUS GRANTS/ASSISTANCE RECEIVED FROM DOLE
Date Title Amount Duration Status

Other related information/request/intervention/s from DOLE:

Attached are the documents/requirements which I/We hereby attest to their veracity. Any false statement
would cause the automatic cancellation of the services/contract/grant and applicant shall refund amount received and/or
pay damages to DOLE and other sanctions in accordance with law.

I/We declare that the answers given above are true and correct.

Signature of Organization’s Representative Date

PROVINCIAL
TSSD Review
Checklist of Requirements: Assessment Remarks
and Validation
& Evaluation
Duly accomplished and signed application form (in 4 sets);
Certificate of Registration with the Securities and Exchange
Commission (SEC), or the Cooperative and Development Authority
(CDA), or Department of Labor and Employment (DOLE), as the case
maybe;
Authenticated copy of the latest Articles of Incorporation in the case
of a corporation, or the Articles of Cooperation in the case of
cooperative or Constitution and By-Laws in the case of
unions/associations, showing the original incorporators/organizers
and the Secretary’s Certificate for the incumbent officers, together
with the Certificate of Filing with SEC/Certificate of Approval by the
CDA;
Audited financial report for the past three (3) years preceding the date
of project implementation. For applicant which has been in operation
for less than 3 years, financial reports for the years in operation and
proof of previous implementation of similar projects;
List and/or photographs of similar projects previously completed, if
any, indicating the source funds for implementation; and
Sword affidavit of the secretary of the applicant organization/entity
that none of its incorporators, organizers, directors or officers is an
agent of or related by consanguinity or affinity up to the fourth civil
degree to the official of the agency authorized to process and/or
improve proposed Memorandum of Agreement, and release of funds.
NAME & SIGNATURE OF EVALUATOR

DATE

FM-EW-038 Effective 09/21/15

You might also like