Form No. HRD 37
Aug 2023
Rev. 03
Form No. HRD 37
Aug 2023
Rev. 03
PROVINCIAL HUMAN RESOURCE MANAGEMENT OFFICE
REQUIREMENT SLIP FOR QUALIFIED APPLICANT
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TIN no. (xerox, 1 copy)
ATM (xerox)
Philhealth MDR. (xerox, 1 copy)
SSS- E1 or E4 (xerox, 1 copy)
Board results (xerox, 1 copy)
Civil Service Eligibility (Authenticated, 2 copies)
PRC license (xerox, 1 copy)
Diploma (Authenticated, 1 copy)
Transcript of Records (Authenticated, 1 copy)
Birth Certificate (xerox, 1 copy)
If Married:
Marriage Contract (xerox, 1 copy)
If With Children:
Children's Birth Certificate (xerox, 1 copy)
Cedula (1 copy, xerox only)
Medical (Orig. Certificate & Lab. Results)
PDS-(2 copies computerized) w/ Passport size picture
(w/ handwritten nametag and signature)
on the 4th page of PDS
Long WHITE, clean folder with plastic.
PROVINCIAL HUMAN RESOURCE MANAGEMENT OFFICE
REQUIREMENT SLIP FOR QUALIFIED APPLICANT
/
/
/
/
1
2
3
4
5
6
7
/
/
/
8
9
10
11
12
/
/
13
14
15
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/
16
TIN no. (xerox, 1 copy)
ATM (xerox)
Philhealth MDR. (xerox, 1 copy)
SSS- E1 or E4 (xerox, 1 copy)
Board results (xerox, 1 copy)
Civil Service Eligibility (Authenticated, 2 copies)
PRC license (xerox, 1 copy)
Diploma (Authenticated, 1 copy)
Transcript of Records (Authenticated, 1 copy)
Birth Certificate (xerox, 1 copy)
If Married:
Marriage Contract (xerox, 1 copy)
If With Children:
Children's Birth Certificate (xerox, 1 copy)
Cedula (1 copy, xerox only)
Medical (Orig. Certificate & Lab. Results)
PDS-(2 copies computerized) w/ Passport size picture
(w/ handwritten nametag and signature)
on the 4th page of PDS
Long WHITE, clean folder with plastic.
__/__/202_ (2-4 pm)
Required Date for the Submission of Requirements: ____________________
__/__/202_ (2-4 pm)
Required Date for the Submission of Requirements: ____________________
PROCEDURES ON FILING THE FOLLOWING REQUIREMENTS:
* For ATM, kindly proceed to LANDBANK Malolos Highway Branch and
complete the following requirements to process your application:
PROCEDURES ON FILING THE FOLLOWING REQUIREMENTS:
* For ATM, kindly proceed to LANDBANK Malolos Highway Branch and
complete the following requirements to process your application:
ATM REQUIREMENTS
1 Endorsement Letter
2 TIN (xerox)
3 2 pcs. -1 x1 picture
4 2 valid id's (xerox)
5 P100.00
Please photocopy the ATM & submit to PHRMO
* To process your SSS and PHILHEALTH, please prepare the following
requirements:
ATM REQUIREMENTS
1 Endorsement Letter
2 TIN (xerox)
3 2 pcs. -1 x1 picture
4 2 valid id's (xerox)
5 P100.00
Please photocopy the ATM & submit to PHRMO
* To process your SSS and PHILHEALTH, please prepare the following
requirements:
PHILHEALTH REQUIREMENTS (VISTA MALL Malolos Branch)
1
PMRF (completely filled-up)
2
Valid ID (xerox)
3
Birth Certificate (if single) (xerox)
Marriage Contract (if married)
Birth Certificate of Dependents
Please photocopy the MDR and submit to PHRMO
PHILHEALTH REQUIREMENTS (VISTA MALL Malolos Branch)
1
PMRF (completely filled-up)
2
Valid ID (xerox)
3
Birth Certificate (if single) (xerox)
Marriage Contract (if married)
Birth Certificate of Dependents
Please photocopy the MDR and submit to PHRMO
SSS REQUIREMENTS (CABANAS Malolos Branch)
1
SSS form (filled-up in 2 copies)
2
Valid ID (xerox)
3
Original copy birth certificate (if single)
Original copy marriage contract (if married)
Original copy birth certificate of beneficiaries
Please photocopy the SSS Form & submit to PHRMO
SSS REQUIREMENTS (CABANAS Malolos Branch)
1
SSS form (filled-up in 2 copies)
2
Valid ID (xerox)
3
Original copy birth certificate (if single)
Original copy marriage contract (if married)
Original copy birth certificate of beneficiaries
Please photocopy the SSS Form & submit to PHRMO
Additional Information:
Additional Information:
Person to Notify in case of emergency:
Name:_______________________________________
Contact No. : _________________________________
Employee's Data:
Religion : _____________________________________
Birthplace of Mother : ___________________________
Birthplace of Father : ___________________________
Remarks:
Date Received
(PHRMO): _____________
Evaluated by: ____________________
3rd Floor, Capitol Bldg., Antonio S. Bautista
Bulacan Provincial Capitol Compound, City of Malolos, Bulacan 3000
Telephone Nos.: +63 44 791 8145
Email Address: phrmo@bulacan.gov.ph
Person to Notify in case of emergency:
Name:_______________________________________
Contact No. : _________________________________
Employee's Data:
Religion : _____________________________________
Birthplace of Mother : ___________________________
Birthplace of Father : ___________________________
Remarks:
Date Received
(PHRMO): _____________
Evaluated by: ____________________
3rd Floor, Capitol Bldg., Antonio S. Bautista
Bulacan Provincial Capitol Compound, City of Malolos, Bulacan 3000
Telephone Nos.: +63 44 791 8145
Email Address: phrmo@bulacan.gov.ph