Name of Project: TUPAD OSEC-FMS Form No.

4
DOLE Regional Office: XI
Province: DAVAO DEL SUR
Municipality: DAVAO CITY
District: BUNAWAN

LIST OF BENEFICIARIES

1 Type of ID Civil
7
Dependent (Name of
Birthdate 2 E-payment/Bank 5 Relationship to
No. Name of Beneficiary Address (e.g. SSS, ID Number Contact No. Sex 6 Age Beneficiary of the Micro-
(YYYY/MM/DD) Account No. Status Dependent Interested for
Voter's ID) Type of 4 insurance Holder) Skills Training If Yes, Indicate skills training
(indicate the type of 3 Occupation (Y - Yes 9

Extension account and no. as Beneficiary N - No)

needed
Last Name First Name Middle Name Barangay City/Municipality Province District applicable)
Name

DAVAO DEL BUNAWA

1 ABELGAS ELSA GINATILAN MUDIANG DAVAO CITY OSCA 18-31126 F
SUR N

2 ABIS DIONISIO SEBIDO 11/6/1956 PANACAN OSCA 16-34551 M

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

3 ALFAR ADELINA DUBLAS MUDIANG DAVAO CITY OSCA 83836 F
SUR N

DAVAO DEL BUNAWA

4 ALGABRE MELITON ALBON MUDIANG DAVAO CITY OSCA 16-22281 M
SUR N

DAVAO DEL BUNAWA

5 ANDAYA ROSITA BASALO MUDIANG DAVAO CITY OSCA 54200 F
SUR N

DAVAO DEL BUNAWA

6 ANDAYA RUDOLFO SASA MUDIANG DAVAO CITY OSCA 16-17039 M
SUR N

DAVAO DEL BUNAWA

7 ANDAYA LAURENCE SASA SR MUDIANG DAVAO CITY OSCA F
SUR N

DAVAO DEL BUNAWA

8 APOLINARES MARIANITA TAYAWAN ILANG DAVAO CITY OSCA 77714 F
SUR N

9 PANACAN M
DAVAO DEL BUNAWA
ATUEL VIRGINIA ABRAHAN DAVAO CITY SUR N

DAVAO DEL BUNAWA

10 BETONIO ELIZABETH MUDIANG DAVAO CITY OSCA 10404 F
SUR N

DAVAO DEL BUNAWA

11 BUENA JUANITA JAPAY MUDIANG DAVAO CITY OSCA 7208 F
SUR N

DAVAO DEL BUNAWA

12 BUENA RAMY PECOLERA MUDIANG DAVAO CITY OSCA M
SUR N

DAVAO DEL BUNAWA

13 CABALLES BELEN MONDELO SAN ISIDRO DAVAO CITY 83589
SUR N

DAVAO DEL BUNAWA

14 CABALLES CELSO OBESO SAN ISIDRO DAVAO CITY 19-02665
SUR N

DAVAO DEL BUNAWA

15 CATAMORA DANILO PATRICIO ILANG DAVAO CITY OSCA M
SUR N

DAVAO DEL BUNAWA

16 CAYMO ADELAIDA MANAPOL SAN ISIDRO DAVAO CITY 645
SUR N

DAVAO DEL BUNAWA

17 CELOCIA JOVITO MENERIA ILANG DAVAO CITY OSCA M
SUR N
18 COSEP RICHARD DELOS REYES 5/31/1858 PANACAN OSCA 18-16797 M
DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

19 DAGATAN ESTELITA DUMAGUIT SAN ISIDRO DAVAO CITY 26955
SUR N

20 DAMICOG MARGARITA PEROLINO 7/20/1950 PANACAN OSCA 75841 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

21 DAYANG ADELINA MEDENA SAN ISIDRO DAVAO CITY 15-8404
SUR N

DAVAO DEL BUNAWA

22 DAYANG RUBUSTIANO SANCHEZ SAN ISIDRO DAVAO CITY 88842
SUR N

DAVAO DEL BUNAWA

23 DEJON CECILIA D ILANG DAVAO CITY OSCA 13-007519 F
SUR N

24 DELA CRUZ GERALDA BALUAT 9/9/1955 PANACAN OSCA 16-000281 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

25 DELACRUZ EUGENIA TAYAWAN ILANG DAVAO CITY OSCA 2323 F
SUR N

DAVAO DEL BUNAWA

26 DELMO APOLONIO PASUMAYA MUDIANG DAVAO CITY OSCA 16-29999 M
SUR N

DAVAO DEL BUNAWA

27 DESTINADO RAQUEZA LAGUNA ILANG DAVAO CITY OSCA 33789 F
SUR N

DAVAO DEL BUNAWA

28 DETROS GLORIA TERINGTERING ILANG DAVAO CITY OSCA 15-004033 F
SUR N

DAVAO DEL BUNAWA

29 DIAPUES ELYSITO CAGASAN PANACAN DAVAO CITY OSCA 12-100202 M
SUR N

DAVAO DEL BUNAWA

30 DIAPUES NESTOR CAGASAN PANACAN DAVAO CITY OSCA 18-12543 M
SUR N

31 DIOSO MERCEDES MORENO 7/21/1950 PANACAN OSCA 12-004916 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

32 DORMIDO CATALINA TALINGTING SAN ISIDRO DAVAO CITY 35068
SUR N

DAVAO DEL BUNAWA

33 ESCUDERO BENJAMIN ADORABLE MUDIANG DAVAO CITY OSCA 17-000031 M
SUR N

DAVAO DEL BUNAWA

34 GALDO MEDINA CASTANEDA ILANG DAVAO CITY OSCA 18-43781 F
SUR N

DAVAO DEL BUNAWA

35 GASCO PATROCINIA L MUDIANG DAVAO CITY OSCA 15-4453 F
SUR N

36 GEMOYA TERESITA SABALA PANACAN F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

37 GEMOYA ROSALINO PANONCIA 1/30/1959 PANACAN OSCA 19-15510 M 63

DAVAO DEL BUNAWA
DAVAO CITY SUR N
 DAVAO DEL BUNAWA
38 GRAPE CELSO GAPOL SAN ISIDRO DAVAO CITY 18-43308
SUR N

DAVAO DEL BUNAWA

39 HAIDEN ANTONIO SAUMANG SAN ISIDRO DAVAO CITY 94675
SUR N

DAVAO DEL BUNAWA

40 IDPALINA ROBERTO MENDOZA MUDIANG DAVAO CITY OSCA 91204 M
SUR N

DAVAO DEL BUNAWA

41 IÑIGO URSULA CAYMO SAN ISIDRO DAVAO CITY 16-374
SUR N

DAVAO DEL BUNAWA

42 JUEVESANO ELENA SABIJON ILANG DAVAO CITY OSCA 16-9337 F
SUR N

BUNAWA
43 LABORCE DONALD ABDIN 16-8713
DAVAO DEL N
SAN ISIDRO DAVAO CITY SUR

DAVAO DEL BUNAWA

44 MABASO GREGORIO PALOMAR JR ILANG DAVAO CITY OSCA 44625 M
SUR N

DAVAO DEL BUNAWA

45 MABASO MINDANITA SABEJON ILANG DAVAO CITY OSCA 43477 F
SUR N

DAVAO DEL BUNAWA

46 MANTIBING GERONIMO PAYAN SAN ISIDRO DAVAO CITY 17-04070
SUR N

DAVAO DEL BUNAWA

47 MANTIBING TERESITA TEDERA SAN ISIDRO DAVAO CITY 16-183559
SUR N

DAVAO DEL BUNAWA

48 MANTIBING RODOLFO VISTAL SAN ISIDRO DAVAO CITY 16-2905
SUR N

DAVAO DEL BUNAWA

49 MARCHA RUBEN ESMALE MUDIANG DAVAO CITY OSCA 18-44152 M
SUR N

DAVAO DEL BUNAWA

50 MARTIN ROSITA ABREA 11/7/1952 ILANG DAVAO CITY OSCA 19-51032 F 70
SUR N

DAVAO DEL BUNAWA

51 MATUGAS ALFREDA TALINGTING SAN ISIDRO DAVAO CITY 18-30708
SUR N

DAVAO DEL BUNAWA

52 MEROSA PILIPINO RUSIAR ILANG DAVAO CITY OSCA 12-100145 M
SUR N

DAVAO DEL BUNAWA

53 MIER MYRNA BUENA MUDIANG DAVAO CITY OSCA 16-1140 F
SUR N

DAVAO DEL BUNAWA

54 MONSULLER ANGELINA CAYMO SAN ISIDRO DAVAO CITY 18-37666
SUR N

DAVAO DEL BUNAWA

55 MONTEHERMOSO MARFE CONCORDIA MUDIANG DAVAO CITY OSCA 16-33152 F
SUR N

DAVAO DEL BUNAWA

56 MONTEHERMOSO VICENTE CADAVAS MUDIANG DAVAO CITY OSCA 81541 M
SUR N

DAVAO DEL BUNAWA

57 MORALES FIDEL ADLAWAN ILANG DAVAO CITY OSCA 19-50172 M
SUR N
 DAVAO DEL BUNAWA
58 MORALES STEBAN ADLAWAN ILANG DAVAO CITY OSCA 19-26029 M
SUR N

DAVAO DEL BUNAWA

59 MOSQUERA MA. ALLAH DECLARADOR PANACAN DAVAO CITY OSCA 18-16804 M
SUR N

DAVAO DEL BUNAWA

60 NAVARRO DELIA ABONE ILANG DAVAO CITY OSCA F
SUR N

DAVAO DEL BUNAWA

61 PALMA NICOLAS LEGASPI JR SAN ISIDRO DAVAO CITY 51723
SUR N

DAVAO DEL BUNAWA

62 PALMA VIRGINIA LOQUINTE SAN ISIDRO DAVAO CITY 15-8403
SUR N

63 PALMAGIL LEONILA BALASABAS 10/17/1953 PANACAN OSCA 18-04860 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

64 PARALSO GREGORIO HILARIA SAN ISIDRO DAVAO CITY 36806
SUR N

DAVAO DEL BUNAWA

65 PAYLADO ANTONIO ADLAWAN MUDIANG DAVAO CITY OSCA 96885 M
SUR N

66 PLAZO MARIA MABEL GABAYAN 6/27/1961 PANACAN OSCA 19-40708 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

67 REYES MARTINIANA PANTILAG PANACAN F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

68 SAAVEDRA PRAXEDES SOLIJON ILANG DAVAO CITY OSCA 16-000157 M
SUR N

DAVAO DEL BUNAWA

69 SILVA CERILO RODA PANACAN DAVAO CITY OSCA 51314 M
SUR N

DAVAO DEL BUNAWA

70 SOLIVA EUTROPIO AMARILLE ILANG DAVAO CITY OSCA 16-10903 M
SUR N

DAVAO DEL BUNAWA

71 SUMANGIT TOMASA CATAG CATAG SAN ISIDRO DAVAO CITY 13165
SUR N

DAVAO DEL BUNAWA

72 TALINGTING RAUL HORTERA SR SAN ISIDRO DAVAO CITY 19-30212
SUR N

DAVAO DEL BUNAWA

73 TARAPAN ALEX LAMACAT SAN ISIDRO DAVAO CITY 84257
SUR N

74 TELEBRICO BEATRIZ MAKILING 2/18/1955 PANACAN OSCA 15-10283 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL
75 TORMES ISAGANI JUMUWAD 1/11/1959 TIBUNGCO DAVAO CITY BUNAWAN OSCA 19-07868 M 60
SUR

DAVAO DEL BUNAWA

76 TORMIS ANICITA GABATON SAN ISIDRO DAVAO CITY 11344
SUR N

DAVAO DEL BUNAWA

77 TORMIS ROLANDO PARDILLO SAN ISIDRO DAVAO CITY 15-16930
SUR N
 DAVAO DEL BUNAWA
78 TOYONGAN ANGELINA BANDAYANON MUDIANG DAVAO CITY OSCA 90637 F
SUR N

79 UDTOHAN VICENTA DAGOHOY 10/12/1955 PANACAN OSCA 15-10283 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N

DAVAO DEL BUNAWA

80 VALDEZ WINRY SALVA MUDIANG DAVAO CITY OSCA 58711 M
SUR N

DAVAO DEL BUNAWA

81 VASQUEZ ALLAN BERMESO ILANG DAVAO CITY OSCA 19-04449 M
SUR N

DAVAO DEL BUNAWA

82 VERANO ENGRACIA AMPER ILANG DAVAO CITY OSCA 12-005557 F
SUR N

83 VILLANUEVA ERENIA PINANONGAN 6/28/1955 PANACAN OSCA 19-13571 F

DAVAO DEL BUNAWA
DAVAO CITY SUR N
I hereby certify that the above list of beneficiaries are displaced workers, underemployed or self-employed workers that have lost their livelihood or whose earnings were affected by the COVID-19 pandemic.

Further, I certify that they or any member of their families were verified to have not received cash assistance from the DOLE’s TUPAD #BKBK and TUPAD as post COVID intervention, COVID Adjustment Measures Program (CAMP), Abot Kamay Ang Pagtulong (AKAP) for OFWs, DSWD under the Assistance to Individuals in Crisis Situation (AICS) and the Enhanced Pantawid
Pamilyang Pilipino Program (4Ps), DA's cash assistance for rice farmers, and DOF's Small Business Wage Subsidy Program.

Prepared and Certified true and Correct by:

BLGU Representative
Signature over Printed Name

Notes:
*Only the gray portion of this form should be submitted to concerned agencies, i.e DSWD for data matching/validation.
1 – Birthdate: Year/Month/Day (YYYY/MM/DD)
2 – Address: (Street No, Barangay, City/Municipality, Province, District)
3 –Type of Beneficiaries:
• Underemployed/Self-employed
• Minimum wage/below minimum wage earners that were displaced due to:
a. temporary suspension of business operations
b. calamity/crisis situation (please specify): COVID 19 pandemic, Earthquake, Typhoon (please specify), Volcanic eruption (please specify), Global/National financial
crisis, others
4 - Occupation - Transport workers, Vendors, Crop growers (please specify, i.e tobacco farmer), Homebased worker (please specify, i.e sewer), Fisherfolks, Livestock/Poultry Raiser, Small transport drivers, Laborer (please specify), Barangay Tanod, Barangay Health Workers
• Others (please specify)
5 – Sex: F for female, M for Male
6 – Civil Status: S for single, M for married
7 – Dependent: Name of the Beneficiary of micro-insurance policy holder.
8 - Trainings: Agriculture crops production, Aquaculture, Automotive, Construction, Welding, Information and Communication Technology,Electrical and electronics, Furniture making, Garments and textiles, Food Processing, Cooking, Housekeeping, Tourism, Customer Services

Note: Statement of Informed Consent

I understand the purpose of this profiling activity. I voluntarily and willfully give my consent to be part of this undertaking. I certify that the information that I will give are true and correct and that any misrepresentation and falsification of information may void their application to TUPAD. I authorize the use, processing and sharing of my personal data for the purpose that is intended for without
prejudice to my rights stated in the Data Privacy Act of 2012.
Name of Project: TUPAD OSEC-FMS Form No. 4
DOLE Regional Office: XI
Province: DAVAO DEL SUR
Municipality: DAVAO CITY
District: BUNAWAN

LIST OF BENEFICIARIES

1 Type of ID Civil
7
Dependent (Name of
Birthdate 2 E-payment/Bank 5 Relationship to
No. Name of Beneficiary Address (e.g. SSS, ID Number Contact No. Sex 6 Age Beneficiary of the Micro-
(YYYY/MM/DD) Account No. Status Dependent Interested for
Voter's ID) Type of 4 insurance Holder) Skills Training If Yes, Indicate skills training
(indicate the type of 3 Occupation (Y - Yes 9

Extension account and no. as Beneficiary N - No)

needed
Last Name First Name Middle Name Barangay City/Municipality Province District applicable)
Name

NATIONAL

DAVAO DEL BUNAWA

1 ALAS ESTRELLA EBARTE ILANG DAVAO CITY OSCA 50145 F
SUR N

DAVAO DEL BUNAWA

2 ABDUL ATAM HADJIBIL SAN ISIDRO DAVAO CITY 16-6288
SUR N

DAVAO DEL BUNAWA

3 GRAPE REMEDIOS SEBALA SAN ISIDRO DAVAO CITY 41227
SUR N

DAVAO DEL BUNAWA

4 MANAMPAD SYLVIA JALA IN SAN ISIDRO DAVAO CITY 84256
SUR N

DAVAO DEL BUNAWA

5 OLID NATIVIDAD SELGAS SAN ISIDRO DAVAO CITY 18-47733
SUR N

BUNAWA
6 SULTAN JAMAROL BELUSA SAN ISIDRO 19-07666
DAVAO DEL N
DAVAO CITY SUR

DAVAO DEL BUNAWA

7 TAPALLA TARILA PUGADA SAN ISIDRO DAVAO CITY 8100
SUR N

TEODORO MORAN

DAVAO DEL
8 CLENTO ELIZABETH LLAMERA 8/29/1959 TIBUNGCO DAVAO CITY BUNAWAN OSCA 19-17805 M 63
SUR

I hereby certify that the above list of beneficiaries are displaced workers, underemployed or self-employed workers that have lost their livelihood or whose earnings were affected by the COVID-19 pandemic.

Further, I certify that they or any member of their families were verified to have not received cash assistance from the DOLE’s TUPAD #BKBK and TUPAD as post COVID intervention, COVID Adjustment Measures Program (CAMP), Abot Kamay Ang Pagtulong (AKAP) for OFWs, DSWD under the Assistance to Individuals in Crisis Situation (AICS) and the Enhanced Pantawid
Pamilyang Pilipino Program (4Ps), DA's cash assistance for rice farmers, and DOF's Small Business Wage Subsidy Program.

Prepared and Certified true and Correct by:

BLGU Representative
Signature over Printed Name

Notes:
*Only the gray portion of this form should be submitted to concerned agencies, i.e DSWD for data matching/validation.
1 – Birthdate: Year/Month/Day (YYYY/MM/DD)
2 – Address: (Street No, Barangay, City/Municipality, Province, District)
3 –Type of Beneficiaries:
• Underemployed/Self-employed
• Minimum wage/below minimum wage earners that were displaced due to:
a. temporary suspension of business operations
b. calamity/crisis situation (please specify): COVID 19 pandemic, Earthquake, Typhoon (please specify), Volcanic eruption (please specify), Global/National financial
crisis, others
4 - Occupation - Transport workers, Vendors, Crop growers (please specify, i.e tobacco farmer), Homebased worker (please specify, i.e sewer), Fisherfolks, Livestock/Poultry Raiser, Small transport drivers, Laborer (please specify), Barangay Tanod, Barangay Health Workers
• Others (please specify)
5 – Sex: F for female, M for Male
6 – Civil Status: S for single, M for married
7 – Dependent: Name of the Beneficiary of micro-insurance policy holder.
8 - Trainings: Agriculture crops production, Aquaculture, Automotive, Construction, Welding, Information and Communication Technology,Electrical and electronics, Furniture making, Garments and textiles, Food Processing, Cooking, Housekeeping, Tourism, Customer Services

Note: Statement of Informed Consent

I understand the purpose of this profiling activity. I voluntarily and willfully give my consent to be part of this undertaking. I certify that the information that I will give are true and correct and that any misrepresentation and falsification of information may void their application to TUPAD. I authorize the use, processing and sharing of my personal data for the purpose that is intended for without
prejudice to my rights stated in the Data Privacy Act of 2012.