Annex 2:

Case Transfer Summary

Note: This form shall be accomplished by the C/ML who after data gathering has found out that
the NAS has transferred to another area covered by another C/ML. This shall be endorsed to the
RPMO, SWO III and C/ML from the area where the NAS has relocated. The NAS case shall be
engaged under BBE initiative and results shall be indicated in the Case Progress Report (Annex
3), which shall be periodically forwarded to the C/ML from the NAS area of origin, for updating
and continuous monitoring.

Completed by:

Location:
Date:
Objectives:

A. Child Information
Name: Present Address:

B. Present Guardian/ Companion of the minor

Relationship Est.
Civil
with HH Monthly Contact
Status
Name Age Sex Head Occupation Income Information

Reason for transfer to other location as stated by the client:

Is the client attending school in present location? Yes No

Provide the following information:

a.) Name of school of the child

b.) Grade/ Secondary level

c.) Teacher’s name; contact information

d.) Describe the school attendance and performance of the child

Present condition of the client:

 Establish if there are urgent risks or issues that need to be addressed.

 Status of living condition (owner of the house/location where client stays, physical set-up,
 where does he/she sleeps, arrangement on expenses)

 If not schooling but working, where? Nature of work? Income? Any risk/exploitation
issues?

 If both schooling and working, how does he/she juggle his/her time? Any issues or
concerns?

 Who are his/her support system? Does he/she have communication with parents and/or
siblings?

Client’s impression on his/her present condition:

 How do you see your present situation now? (Pangungumusta)

 What assistance/help do you need?

Worker’s observations/ Impressions:

 Important: Observable physical appearance, life skills

Recommendations:

Name: Date:

Title/ position: Area Assignment:

Endorsed to: