NOT FOR SALE

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT
RKS Form 5 of
2020 Page 1 of 3
Region-PO/FO-Year-Month-Count
(ex. NCR-MFO-2020-05-001) Certificate Number: AJA15-0048

Instructions:
1. Accomplish this form when filing a notice of: a) Flexible Work Arrangement/Alternative Work Scheme; b) Temporary Closure;
c) Retrenchment or Reduction of Workforce; or d) Permanent Closure.
2. The report is considered as duly filed when the complete list of workers affected is made part of the submission. Fields with aster-
isks (*) should be accomplished by the company representative.
3. This form should be submitted to the DOLE Provincial/Field Office as soon as possible in the case of adoption of flexible work
arrangement or temporary closure.
4. For establishments that will retrench or permanently close, the form should be submitted 30 days prior to the effectivity of
termination.
5. Page 1 should contain general information about the establishment and the number of workers affected.
6. Page 3 should enumerate the names of workers affected, their addresses and contact numbers, and other information stated therein.
7. Total number of workers listed should equal the total number of workers affected as reported in this page.
ESTABLISHMENT REPORT
□ FLEXIBLE WORK ARRANGEMENT (FWA) / ALTERNATIVE WORK SCHEME (AWS)
□ TEMPORARY CLOSURE
□ RETRENCHMENT/REDUCTION OF WORKFORCE
⁄ PERMANENT CLOSURE
Date of Filing (mm-dd-yyyy): 11-26-2024 m m - d d - y y y y
A. ESTABLISHMENT INFORMATION
*Name of Establishment: MHM GLOBAL MANUFACTURING INC.

*Floor/Bldg/No/Street/Subdivision :6605 PUROK 6 PANGIL LIMBON ROAD

*Barangay/City/Municipality : PANGIL, AMADEO, CAVITE
Geo Code : 421021010
Kind of Business/Economic :
Activity/Principal Product: MANUFACTURING
PSIC Code : G
*Company TIN : 010-250-929
*Company SSS Number : 80-0072094-2-000
*Number of Workers Male : 7 Managerial Employees : 1
Female : 22 Supervisory : 1
Total : 29 Rank-and-File : 27
Total : 29

B. SUMMARY OF AFFECTED EMPLOYEES DUE TO

B.1 Flexible Work Arrangement / Alternative Work Scheme*
Period of Adoption of FWA / AWS Type of FWA/AWS to Primary Reason of
No. of Workers be Implemented Adoption of FWA/
Covered/Affected Start End (Use code below, select only AWS (Use code below, se-
(mm/dd/yyyy) (mm/dd/yyyy) one) lect only one)

Codes for Types of FWAs/AWS

TOE - Transfer of employees to another branch or outlet of the same ROW - Rotation of workers
employer FCL - Forced leave
AOE - Assignment of employees to other function or position in the BTS - Broken-time schedule
same or other branch or outlet of the same employer CWW - Compressed Work Week
RWD - Reduction of workdays per week TWA - Telecommuting Work Arrangement
RWH - Reduction of workhours per day OTH - Others (please specify)
JR - Job rotation alternately providing employees with work within
the workweek or within the month
PCE - Partial closure of establishment where some unit or departments
of the establishment are continued while other units or depart-
ment are closed

Codes for Primary Reason for Adoption of FWA/AWS:

Economic Reasons Non-Economic Reasons
CI - Competition from Imports LRM - Lack of raw materials INV - Inventory
CMM - Change in management/merger MR - Increase in minimum wage rate NMC - Natural or man-made calamity
FL - Financial losses PD - Peso depreciation PC - Project completion
GR - Government regulation UPP - Uncompetitive price of products RGM - Repair or general maintenance
HCP - High cost of production OTH - Others (please specify): WSO - Work stoppage order/ cease
and LC - Lack of capital desist order
LM - Lack of market/ slump in demand/ OTH - Others (please specify):
cancellation of orders
 NOT FOR SALE
Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOYMENT
RKS Form 5 of
2020 Page 2 of 3
Region-PO/FO-Year-Month-Count
(ex. NCR-MFO-2020-05-001) Certificate Number: AJA15-0048

B.2 Temporary Closure*

Period of Temporary Closure Primary Reason of
No. of Workers Cov-
Start End Temporary Closure
ered/Affected
(mm/dd/yyyy) (mm/dd/yyyy) (Use code below, select only
one)

B.3 Retrenchment/Reduction of Workforce*

No. of Workers Cov- Effectivity Date Primary Reason of Retrenchment
ered/Affected (mm/dd/yyyy) (Use code below, select only one)

B.4 Permanent Closure*

Effectivity Date of
No. of Workers Cov- Primary Reason of Permanent Clo-
Termination
ered/Affected (mm/dd/yyyy) sure
(Use code below, select only one)
12 12/31/2024 FL – Financial losses

Codes for Primary Reason Temporary Closure (B.2)/Retrenchment (B.3) / Permanent Closure (B.4):

Economic Reasons Non-Economic Reasons

CI - Competition from Imports MR - Increase in minimum wage rate AWOL - Absence without leave
CMM - Change in management/merger PD - Peso depreciation CCO - Commission of a crime or offense
FL - Financial losses R - Redundancy FWBT - Fraud or willful breach of trust
COE - Closure or cessation of operation of an RDS - Reorganization/downsizing GHN - Gross and habitual neglect of
duty
establishment not due to serious losses RPL - Retrenchment to prevent losses INV - Inventory
of financial reverses OTH - Others (please specify): IR - Impossible reinstatement
EDC - Employee suffering from a disease not NMC - Natural or man-made calamity
curable within the period of six (6) PC - Project completion
months RES - Resignation
GD - Government decision RET - Retirement
HCP - High cost of production RGM - Repair or general maintenance
LC - Lack of capital SMWD - Serious misconduct or willful
LRM - Lack of raw materials disobedience
LM - Lack of market/ slump in demand/ WSO - Work stoppage order/ cease
and cancellation of orders desist order
LSA - Lack of service assignment OTH - Others (please specify):
LSD - Installation of labor-saving devices
C. AGREEMENT ON ADOPTION OF FWA/AWS
This is to certify as to the following:
1. That I am the employees’ representative;
2. That the data provided in Item B.1 Summary of Affected Employees - Flexible Work Arrangement/Alternative
Work Scheme are accurate;
3. That a consultation with the workers was undertaken prior to the adoption of FWA; and
4. Attached is a copy of the Agreement.

Signature Over Printed Name of Employees’ Representative and Date

Designation: Mobile No.: Telephone No.: E-mail Address:

D. CERTIFICATION
This is to certify as to the accuracy of the data provided in this report.

ROMEO J. MARTIN JR. / 11/26/2024

Signature Over Printed Name of Owner or Company Representative and
Date
Designation: Mobile No.: Telephone No.: E-mail Address:
GENERAL MANAGER 0917-866-0749 (046) 890 9853 [email protected]
NOT FOR SALE
 NOT FOR
SALE
Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOY-
MENT
Intramuros, Manila Page 3 of 3

LIST OF AFFECTED WORKERS

Certificate Number: AJA15-0048
Instruction: If necessary, use additional sheets following the same format.

CONSENT NOTICE: By accomplishing this form, you agree that the information submitted shall be used solely for purposes of monitoring and planning. We may likewise
disclose your personal information to the extent that we are required to do so by the Data Privacy Act of 2012. As a general rule, we may only keep your information until
such time that we have attained the purpose by which we collect them. Under the foregoing circumstances and to the extent permissible by applicable law, you agree not
to take any action against the DOLE for the disclosure and retention of your information.

Name of Worker* Home Address* Employ- Monthly Salary (in Peso)*

ment Adopted
Birth- Se Contact Email Ad- 28,001
No. Last Name First Name Middle Ho City/ Designa- Status* 4,000- 10,001- 16,0 22,001- Work
day* x* Street Brgy. Province No* dress* and
Name use Munici- tion* (regular, 10,000 16,000 01- 28,000
above Ar-
(dd/ (F/ Nu pality 22,0
contrac- range-
mm/ M) m- 00
ber tual, ment*
yyyy)
etc.)
1 COGTONG JIRECHO PAZ 10/10/2001 M NA PUROK 4 PANGIL AMADEO CAVITE 0955-173- jirechocogtong54 PRODUC- REGULAR 10,955.00
5960 [email protected] TION/
WARE-
HOUSE
2 DERECHO REINALENE PRESTO 12/06/2000 F 6004 PUROK 6 PANGIL AMADEO CAVITE 0985-770- derechoreinalene ADMIN AS- REGULAR 11,679.65
3510 @gmail.com SITANT
3 ESPARTINEZ MARISSA ARTISTA 01/04/1982 F 6009A PUROK 6 PANGIL AMADEO CAVITE 0912-669- espartinezmarissa PRODUC- REGULAR 10,955.00
8914 [email protected] TION STAFF
4 EYAYA NORLITA PREPEÑA 29/08/1976 F 6010A PUROK 6 PANGIL
AMADEO CAVITE 0916-100- eyaya.norlita@g PRODUC- REGULAR 10,955.00
3140 mail.com TION STAFF
5 GARBULO LEONILSON DATARIO 11/04/1968 M NA NA MAGSAYSAY LOPEZ QUEZON 0955-3156- nelsongarbulo@g GUARD REGULAR 13,416.68
944 mail.com
6 HAWAK EVA ARTISTA 27/12/1979 F 6010A PUROK 6 PANGIL AMADEO CAVITE 0962-840- evawak27@gmail PRODUC- REGULAR 10,955.00
7276 .com TION STAFF
7 MANZANO RONNIE COGTONG 03/12/1998 M NA PUROK 4 PANGIL AMADEO CAVITE 0994-382- lheysoaladin@gm PRODUC- REGULAR 10,955.00
2990 ail.com TION STAFF
8 PRESTO MAYETH BE- 01/10/1976 F NA PUROK 6 PANGIL AMADEO CAVITE 0905-328- mayethpresto@g PRODUC- REGULAR 10,955.00
LANDREZ 2426 mail.com TION STAFF
9 QUINES LAURENCE ENCISO 06/03/1986 M NA LAND- PARIAN CITY OF LAGUNA 0905-647- laurencemarvin.q R&D AND REGULAR 40,510.91
MARVIN MARK CALAMB 8874 [email protected] QA MAN-
SUBD. A AGER
10 RAMOS MARIANE CABILES 07/05/1981 F NA PUROK 6 PANGIL AMADEO CAVITE 0905-841- marianeramos050 PRODUC- REGULAR 10,955.00
 7402 [email protected] TION STAFF
11 TABOR MECAELA CAÑELAS 07/03/2001 F NA PUROK 6 PANGIL AMADEO CAVITE 0997-300- mecaela.ct@gmai QUALITY REGULAR 11,679.65
2471 l.com ASSUR-
ANCE AS-
SISTANT
12 VALLEGA LIEZL CAÑELAS 19/05/1983 F NA PUROK 6 PANGIL AMADEO CAVITE 0994-728- liezlvallega19@g PRODUC- REGULAR 10,955.00
8187 mail.com TION STAFF

*Mandatory fields to be accomplished by the company representative