Ergfdfydtjghvjkl
NOT FOR SALE
Kindly print 2 copies
Processing Office : Appointment Date: Appointment Time:
CENTRAL OFFICE July 09, 2013 9:00 AM
BALIK-MANGGAGAWA INFORMATION SHEET
PERSONAL DATA
GAURANO
Last Name Passport No.: Birthdate: XX3988018 15/04/1977
EDGARDO
First Name
MAYOR
Middle Name Name Ext. (e.g. Jr., III)
Gender: Civil Status:
X Male Single X Married
Female Widow/er Separated
DD / MM / YYYY Place of Birth: MORONG RIZAL
Address in the Philippines:
0427 CERVO BILIBIRAN BINANGONAN, RIZAL PHILLIPINES
Lot No. Block No. Phase No. House No. Street Name Subdivision
BINANGONAN
City/Municipality
RIZAL
Province ZIP Code
Telephone/Cellphone No.: 09206217858 SSS Number: 33-2382205-6 Philhealth Number.: Mothers Complete Maiden Name: AMADA MAYOR GAURANO Name of Spouse (for married): RAQUEL FRANSISCO GAURANO
Email Address: Pag-IBIG RTN/MID:
ehdgar_77@yahoo.com
CONTRACT PARTICULARS OF OFW Name of Company / Employer: WOONGNAM ENG. CONST. Address of Employer: KOREA Tel.No./Fax No.: 8223327711 Contract Duration: 12 Months July 11, 2013 Salary / Currency: 174 / KUWAIT DINAR July 08, 2012 Jobsite / Country of Destination: KUWAIT Position of OFW: WELDER Date of Return to the Philippines. : Date of last deployment from the Philippines:
LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS
Children (20 years old and below) - Registered Birth Certificate; Non-Member Spouse - Registered Marriage Certificate; Parents (60 years old and above) - Senior Citizens Card and Registered Birth Certificate of Member (OFW)
Complete Name
Sex
Relationship of OFW to Dependent/s SON SON SON
Date of Birth
EDRICK F GAURANO EDRIAN F GAURANO JUNE IVAN F GAURANO
MALE MALE MALE
08/02/1996 09/13/1998 06/15/2001
I hereby certify that the above statements are true and correct and that the above-named dependents have not been declared by my spouse/brother/sister.
EDGARDO MAYOR GAURANO
TRANSACTION NUMBER:
137407721577 - 21511
Kindly print 2 copies
Processing Office : Appointment Date: Appointment Time:
CENTRAL OFFICE July 09, 2013 9:00 AM
BALIK-MANGGAGAWA INFORMATION SHEET
PERSONAL DATA
GAURANO
Last Name Passport No.: Birthdate: XX3988018 15/04/1977
EDGARDO
First Name
MAYOR
Middle Name Name Ext. (e.g. Jr., III)
Gender: Civil Status:
X Male Single X Married
Female Widow/er Separated
DD / MM / YYYY Place of Birth: MORONG RIZAL
Address in the Philippines:
0427 CERVO BILIBIRAN BINANGONAN, RIZAL PHILLIPINES
Lot No. Block No. Phase No. House No. Street Name Subdivision
BINANGONAN
City/Municipality
RIZAL
Province ZIP Code
Telephone/Cellphone No.: 09206217858 SSS Number: 33-2382205-6 Philhealth Number.: Mothers Complete Maiden Name: AMADA MAYOR GAURANO Name of Spouse (for married): RAQUEL FRANSISCO GAURANO
Email Address: Pag-IBIG RTN/MID:
ehdgar_77@yahoo.com
CONTRACT PARTICULARS OF OFW Name of Company / Employer: WOONGNAM ENG. CONST. Address of Employer: KOREA Tel.No./Fax No.: 8223327711 Contract Duration: 12 Months July 11, 2013 Salary / Currency: 174 / KUWAIT DINAR July 08, 2012 Jobsite / Country of Destination: KUWAIT Position of OFW: WELDER Date of Return to the Philippines. : Date of last deployment from the Philippines:
LEGAL BENEFICIARIES / QUALIFIED DEPENDENTS
Children (20 years old and below) - Registered Birth Certificate; Non-Member Spouse - Registered Marriage Certificate; Parents (60 years old and above) - Senior Citizens Card and Registered Birth Certificate of Member (OFW)
Complete Name
Sex
Relationship of OFW to Dependent/s SON SON SON
Date of Birth
EDRICK F GAURANO EDRIAN F GAURANO JUNE IVAN F GAURANO
MALE MALE MALE
08/02/1996 09/13/1998 06/15/2001
I hereby certify that the above statements are true and correct and that the above-named dependents have not been declared by my spouse/brother/sister.
EDGARDO MAYOR GAURANO
TRANSACTION NUMBER:
137407721577 - 21511