Scribd
Upload
119 views2 pages

Tupad Template

The document outlines the TUPAD Program, which provides assistance to displaced, underemployed, or self-employed workers affected by the COVID-19 pandemic. It includes a list of beneficiaries with their personal details, civil status, and occupations, along with a certification that they have not received other forms of cash assistance. The document emphasizes the types of beneficiaries eligible for the program and the various circumstances leading to their displacement.

Uploaded by

banimohaymin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
119 views2 pages

Tupad Template

The document outlines the TUPAD Program, which provides assistance to displaced, underemployed, or self-employed workers affected by the COVID-19 pandemic. It includes a list of beneficiaries with their personal details, civil status, and occupations, along with a certification that they have not received other forms of cash assistance. The document emphasizes the types of beneficiaries eligible for the program and the various circumstances leading to their displacement.

Uploaded by

banimohaymin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd

Name of Project: TUPAD Program OSEC-FMS Form No.

4
Regional Office: National Capital Region
Province:
Municipality/City:
Barangay:

LIST OF BENEFICIARIES

Name of TUPAD Beneficiary Birthdate Compelete Address E-Payment/Bank Interested


Sex Civil Status If Yes, indicate
Type of I.D. (e.g. SSS, Voter's Account No. (indicate Type of Dependent (Name of Beneficiary of the Micro-Insurance for Skills
No. Extension Birth Birth Birth I.D. No. Contact No. Occupation (Male/Female (Single/Maried Age skills training
First Name Middle Name Last Name Barangay Municipality Province District ID) the type of account and Beneficiary Holder) Training (Y-
Name Month Day Year ) ) needed
no. as applicable Yes / N-No)
Juan Antonio Dela Cruz Jr. August 20 1975 Poblacion Minglanilla Cebu 1st SSS 6064100 09150113558 Underemployed Vendor Female M 47 Maria J. Dela Cruz Y Welding
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50

I hereby certify that the above lis of beneficiaries are displaced workers, underemployed or self-employed workers who have lost their livelihood or whose earnings were affected by the COVID-19 pandemic.

Further, I certify that they, or any member of their families, were verified to have not received cash assistance from the COVID Adjustment Measures Program (CAMP), Abot Kamay Ang Pagtulong (AKAP) for OFWs, DSWD under the Assistance to Individuals in Crisis Situations (AICS) and the Enhance
Pantawid Pamilyang Pilipino Program (4Ps), DA's Cash assistance for rice farmers, DOF's Small Business Wage Subsidy Program.

Prepared and Certified True and Correct by:


LGU or Authorized Representative (signature over printed name)

Note:

TYPE OF BENEFICIARIES: Underemployed / Self-Employed


Minimum wage/below minimum wage earners that were displaced due to:
(a) temporary suspension of business operations
(b) calamity/crisis situation (please specify): COVID-19 pandemic, earthquate, typhoon (please specify), volcanic eruption (please specify), global/national financial crisis, others
(c) closure of campan, retrenchment
PWDs, Senior Citizens, Former rebels, Former Violent Extremist Groups, Indigeneous People

OCCUPATIONS: Transport workers, Vendors, Crop Growers (please specify, i.e tobacco farmer), Homebased Worker (please spcify, i.e sewer), Fisherfolks, Livestock/Poultry Raiser, Small Transport Drivers, Laborer (please specify), Barangay Tanod, Barangay Health Workers, Others (please specify)

CIVIL STATUS: S for single, M for married

DEPENDENT: Name of the Beneficiary Micro-Insurance policy Holder

You might also like