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1
Republic of the Philippines
Department of Labor and Employment
REGIONAL OFFICE No. _ _
Number of
Number of
Employees
Name and Address Services Personnel Description of the
Nature of Covered in each
of Oient/Principal Provided to Assigned to each Phase of the
Business Phase of the
Clients/Principa I client Contract Contract
Male Female Male Female
UNDERTAKING:
Of ---~~~~-------~
name of company
after having been duly sworn to in accordance with law, do
Doc. No.
Page No.
Book No.
Series of
Note: All contracts entered into after this registration shall be reported to the DOLE Regional Office on or before the 1r:f'
day of the month immediately following the date of entry into contract.