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Application For Registration of Worker'S Association (Was)

This document is an application for registration of a worker's association (WA) with the Department of Labor and Employment in Region XII. It requests information about the applicant association such as its name, address, president's name and contact information, date organized, places of operation, number and occupation of members. The president of the association must sign and have the application notarized to attest to the truth of the information provided. The purpose is to officially register the WA with the proper government authority.

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August One
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2K views1 page

Application For Registration of Worker'S Association (Was)

This document is an application for registration of a worker's association (WA) with the Department of Labor and Employment in Region XII. It requests information about the applicant association such as its name, address, president's name and contact information, date organized, places of operation, number and occupation of members. The president of the association must sign and have the application notarized to attest to the truth of the information provided. The purpose is to officially register the WA with the proper government authority.

Uploaded by

August One
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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BLR Form No.

4, Series 2016

Republic of the Philippines


DEPARTMENT OF LABOR AND EMPLOYMENT
XII
Regional Office No. ____

APPLICATION FOR REGISTRATION OF WORKER’S ASSOCIATION (WAs)


PART I. INFORMATION ABOUT THE REPORTING ORGANIZATION Date Accomplished (mm/dd/yyyy)
To be accomplished by the applicant. Supply all required information. Misrepresentation, false statement or fraud in this
application or any supporting document is a ground for denial or cancellation of registration.

Name of Applicant Association Contact Nos.


E-mail: ________________________________
Landline No: ___________________________
Address
Mobile No:_____________________________

Name of President Contact Nos.


(First Name) (M.I.) (Last Name)
E-mail: ________________________________
Landline No: ___________________________
Address
Mobile No:_____________________________

Gender
Padding

Date of CBL Ratification (mm/dd/yyyy)


Date Organized (mm/dd/yyyy)

Place/s of Operation No. of Association Members


Male
Female
TOTAL

Occupation of Members. Please check appropriate category.


Agricultural Workers (  Farmers  Fisher folk  Artisans  Cottage  Others __________________ )
Small Transport Workers (Drivers: Jeepney FX  Tricycle Pedicab )
Home-based / Homeworkers
 Small Construction Workers
 Vendors (  Market  Sidewalk  Ambulant )
 Small-scale Miners
 Others / Own-Account, Please specify ____________________________________________________________
padding

I attest to the truth of the foregoing.

________________________________________________
President
(Signature over printed name)

Subscribed and sworn to before me at ___________________________________________________, Philippines,


this _______ day of _________________ 20 _______ with I.D. No. _________________________________________
issuedby ___________________________________________________ on _________________________________.

NOTARY PUBLIC

Doc. No. __________


Page No. __________
Book No. __________
Series of __________

Padding

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