DOLE Telecommuting Report Form

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DOLE TWA Report Form (version 0 - as of 26 March 2019)

Republic of the Philippines


Department of Labor and Employment
Intramuros, Manila

REPORT ON THE ADOPTION OF TELECOMMUTING WORK ARRANGEMENT (TWA)

1. Name of establishment: 2. Address: 3. Contact details


3.1 Name of contact person and designation:

3.2 Telephone no.:

6. Nature of business: 7. Period of 5.1 Date start: 3.3 Mobile no.:


coverage on
the adoption
of TWA 5.2 Date end: 3.4 E-mail address:

9. Total no. of employees in the establishment: 10. Total no. of employees under TWA:

6.1 Male: 6.2 Female: 7.1 Male: 7.2 Female:


6.1.a 6.1.b 6.1.c 6.2.a 6.2.b 6.2.c 7.1.a 7.1.b 7.1.c 7.2.a 7.2.b 7.2.c
Solo Parent PWD Senior Solo Parent PWD Senior Citizen Solo Parent PWD Senior Citizen Solo Parent PWD Senior Citizen
Citizen

11. Implications 8.1 On employees:


of the
adopted
scheme
(describe 8.2 On employer:
briefly)

12. The scheme is agreed upon voluntarily by both parties, employer and employees.
9.1 Employer’s 9.1.a Signature: 9.2 Employee’s 9.2.a Signature:
representative representative

9.1.b Full name: 9.2.b Full name:

9.1.c Date: 9.2.c Date:

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