APPENDICES
Absence Request Form
Employee Details:
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Name: _______________________________________
Position/Title: __________________________________
Employee ID No: __________________________________
Contact Information
○ Email Address: ___________________________
○ Contact Number: _________________________
Type of Absence Requested:
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Sick
● Injury
Absence
● Time Off Without Pay
Vacation
● Maternity/ Paternity
Bereavement
● Others
Date of Absence: _______________________________________
Reason for Absence:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
________________________________________
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Approved
Denied
Comments:
______________________________________________________________________________________
______________________________________________________________________________________
____________________
Employee Signature:
Signature: _________________________
Signature: _________________________
Date: ________________________
Date: _____________________________
Supervisor Signature:
Discrimination Complaint Report
Employee Details:
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Name: _______________________________________
Position/Title: __________________________________
Employee ID No: __________________________________
Contact Information
○ Email Address: ___________________________
○ Contact Number: _________________________
Nature of Discrimination/Harassment:
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● Gender
● Race
Age
● Religion
Color
● Medical Condition
Disability
● National Origin/ Ancestry
Date of Alleged Discrimination: _____________________________
Employee whom you believe has discriminated against you:__________________
Details of Alleged Incident:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_____________________________
Remedy Requested:
______________________________________________________________________________________
______________________________________________________________________________________
_________________________________________
The information provided above is true and correct to the best of my knowledge.
Employee Signature:
Signature: _________________________
Date: _____________________________
HR Supervisor Signature:
Signature: _________________________
Date: ________________________
Food Funding Request Form
Meeting Organizer: ___________________________
Date of Meeting: _____________________________
Meeting Time: _______________________________
Meeting Title/Agenda: __________________________________________________
Number of Attendees: _____________
Budget Requested: PHP _________________
Food Requirements:
Type of Food Needed:
● Snacks
● Beverages
● Lunch
● Others (please specify): _____________________
Specific Items Requested: [List specific food or beverage items if required]
______________________________________________________________________________
______________________________________________________________________________
____________________________________
Justification for Funding Request: Provide a brief explanation of why the funding is needed for this
meeting, considering the number of attendees and the purpose of the gathering.
_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________
Note: Please attach the meeting agenda document/s.
Incident Report Form
Employee Details:
● Name: _______________________________________
● Position/Title: __________________________________
● Contact Information
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○
Email Address: ___________________________
Contact Number: _________________________
Description of Incidents:
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Date: ________________________
Time: ______________________________
Location: ______________________________
Policy Notified:
● Yes
● No
● Incident Details (How the incident happened, factors leading to the event and what took place. Be
as specific as possible.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________
● Witness Details:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________
Confidentiality Statement:
I understand that the information provided in this report is confidential and will be used for the purpose of
investigating and resolving the reported incident. I affirm that the details provided are accurate to the best
of my knowledge.
Employee Signature:
Signature: _________________________
Date: _____________________________
Supervisor Signature:
Signature: _________________________
Date: _____________________________
Office Equipment Documents Log Book
Name Type of Document Related Equipment Date Submitted Signature
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Office Supply and Office Equipment Request Form
Employee Information:
● Name: ___________________________________________________________
● Job Title: _________________________________________________________
● Contact Information
○
○
Email Address: ______________________________________________
Phone Number: ______________________________________________
Request Details:
Item Description:
______________________________________________________________________________
__________________________________________________
Quantity Needed: ____________
Purpose:
______________________________________________________________________________
__________________________________________________
Urgency Level: (Please specify if the request is urgent)
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Low
Medium
High:
________________________________________________________________________
______________________________________________
Budget Information:
● Budget Allocation: _________________________________________________
Additional Notes/Comments:
_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________
Policy Development Form
Requester's Details:
● Name: _______________________________________
● Position/Title: __________________________________
● Contact Information
○ Email Address: ___________________________
○ Contact Number: _________________________
Policy Details:
● Type of Request
● New Policy
● Policy Change/Modification
● Policy Removal
● Title of Proposed Policy or Policy Change: ______________________________
● Description/Summary of the Proposed Policy or Change
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________
Objectives:
● Primary Objectives of the Proposed Policy/Change
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
● Secondary Objectives (if applicable):
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
Scope:
● Areas Covered by the Policy/Change:
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
● Specific Boundaries or Limitations of the Policy:
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
● Affected Departments or Stakeholders:
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
Intended Impact:
● Expected Impact on Operations/Processes:
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
● Anticipated Effect on Employees/Work Culture:
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
Alignment:
● Alignment with Organizational Goals/Mission:
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
● Relevance to Company Values:
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
Supporting Information:
● Research/Data Supporting the Need for the Policy/Change (if available):
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
● Similar Policies in Other Organizations (if known):
○ ___________________________________________________________
○ ___________________________________________________________
○ ___________________________________________________________
Additional Comments/Remarks:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________
Note: For a smooth request process, please attach all the relevant documents to the requested
policy development.
Purchase Order
PO Number: __________
Date: ________________
Supplier Information:
● Supplier Name: ___________________________________________________
● Address: ________________________________________________________
● Contact
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Email Address: ______________________________________________
Phone Number: ______________________________________________
Company Information:
● Company Name: __________________________________________________
● Address: ________________________________________________________
● Contact:
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Email Address: ______________________________________________
Phone Number: ______________________________________________
Item
Item Description
Quantity
Unit Price
Additional Details:
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Total Cost: _______________________________________________________
Delivery Address: _________________________________________________
Delivery Date: ____________________________________________________
Payment Terms: ___________________________________________________
Total Price
Terms and Conditions:
1. All items listed in this purchase order must adhere to the specifications provided.
2. Payment will be processed in accordance with the agreed-upon payment terms.
3. Any changes or modifications to this order must be mutually agreed upon by both parties in
writing.
Authorized Signature:
___________________
Authorized Signatory Name: ____________________________________
Title: _______________________________
Date: ______________________________
ROUTINE MAINTENANCE SCHEDULE AND CHECKLIST
Areas and Operations
Frequency
J
F
M A
M J
A
S O N
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E
A
P
A U U U
E C O
N
B
R
R
Y N L G P T V
FURNITURE AND FIXTURES
1. Wood Furniture - apply furniture
Monthly
oil or polish occasionally
2. Inspect Hardware - Check
Monthly
screws, bolts, and hinges
regularly. Tighten if needed.
3. Fabric Upholstery - Use fabric
Monthly
protectors to guard against stains.
4. Metal Fixtures - use appropriate
Monthly
metal cleaners to maintain shine
and prevent tarnishing.
STORE INTERIOR & EXTERIOR
1. Doors - wash, check weather
stripping, re-paint as needed
2. Windows - wash, repair if needed
Monthly
3. Signage - inspect, clean, repair if
needed
4. Lighting - clean fixtures, change
bulb if needed
5. Stairs- clean
Annually
Daily
Monthly
Daily
6. Foundation - monitor for
Monthly
cracking, confirm no pests
OFFICE INTERIOR & EXTERIOR
1. Windows - wash, repair if needed
Daily
2. Lighting - clean fixtures, change
bulb if needed
3. Floors - professionally clean
common areas
4. Walls - Wash off hand prints
Monthly
5. Unit appliances- clean interior
and exterior, vacuum under and
behind
Daily
Daily
Monthly
STORE EQUIPMENT
1. Inspect cooking equipment and
food preparation surfaces and
Daily
J
D
E
C
2.
3.
4.
5.
tools for cleanliness and
functionality.
Ensure cleanliness of the
Daily
production area and service
counters.
Check floor surfaces for spills or
Daily
hazards.
Check lighting and fixtures for
Monthly
any issues.
Inspect to detect the presence of
Daily
any potential gas leaks.
OFFICE EQUIPMENTS
1. Check computers and other
equipment for proper
functioning.
2. Ensure desk areas are organized
and free from clutter.
3. Check lighting and fixtures for
any issues.
4. Test and ensure proper
functioning of
telecommunication systems.
5. Review and update office
security measures.
Daily
Daily
Daily
Daily
Monthly
Remarks: (Note incidents to which particular attention should be focused)
Signed and checked by:
Signed and monitored by:
Report Form: Misuse or Missing Office Supply
and/or Office Equipment
Employee Information:
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Name: __________________________________
Department: _____________________________
Position: ________________________________
Date of Report: ___________________________
Description of Incident:
Type of Incident: (Check all that apply)
● Misuse of Office Supplies
● Overuse of Office Supplies
● Missing Office Supplies
Description: Please provide a detailed description of the incident, including specific
details such as:
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Items involved: ______________________________________________
Date and time observed: _______________________________________
Location: ___________________________________________________
Individuals involved (if known): __________________________________
Evidence (if available): Attach any relevant evidence, such as photographs, documents, or
additional notes that support the incident report.
Action Taken (if any):
Actions Previously Taken
If this incident has been previously reported or addressed, briefly describe the actions
taken or steps already initiated.
________________________________________________________________________
________________________________________________________
Requested Action
What action do you recommend or request to address this incident?
________________________________________________________________________
________________________________________________________
Confidentiality Statement:
I understand that the information provided in this report is confidential and will be used for the
purpose of investigating and resolving the reported incident. I affirm that the details provided are
accurate to the best of my knowledge.
Employee Signature:
Signature: _________________________
Date: _____________________________
Sickness Leave Form
Employee Details:
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●
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Name: _______________________________________
Position/Title: __________________________________
Employee ID No: __________________________________
Contact Information
○ Email Address: ___________________________
○ Contact Number: _________________________
Reason for Sickness Leave:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________
● Approved
● Denied
Reason for Denied:
________________________________________________________________________
________________________________________________________________________
________________________________________________
Employee Signature:
Signature: _________________________
Date: _____________________________
Supervisor Signature:
Signature: _________________________
Date: _________________