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    Municipality of - Application For Municipal Fisherfolk Registration

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    MAO LGU-CLAVER
    This document is an application form for municipal fisherfolk registration that collects personal information such as name, address, contact details, livelihood, and organization membership. It requires the applicant to certify that the information provided is true and requests review and approval signatures from authorized personnel. The form is used to register or renew registration for municipal fisherfolk.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Municipality of - Application For Municipal Fisherfolk Registration

    Uploaded by

    MAO LGU-CLAVER
    181 views1 page
    This document is an application form for municipal fisherfolk registration that collects personal information such as name, address, contact details, livelihood, and organization membership. It requires the applicant to certify that the information provided is true and requests review and approval signatures from authorized personnel. The form is used to register or renew registration for municipal fisherfolk.

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    This document is an application form for municipal fisherfolk registration that collects personal information such as name, address, contact details, livelihood, and organization membership. It requires the applicant to certify that the information provided is true and requests review and approval signatures from authorized personnel. The form is used to register or renew registration for municipal fisherfolk.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    181 views1 page

    Municipality of - Application For Municipal Fisherfolk Registration

    Uploaded by

    MAO LGU-CLAVER
    This document is an application form for municipal fisherfolk registration that collects personal information such as name, address, contact details, livelihood, and organization membership. It requires the applicant to certify that the information provided is true and requests review and approval signatures from authorized personnel. The form is used to register or renew registration for municipal fisherfolk.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Republic of the Philippines

    Region VIII
    ______________________ Attach Photo Here
    Municipality of _________ (1 ½ x 1 ½”)

    Photo should be taken


    APPLICATION FOR MUNICIPAL FISHERFOLK REGISTRATION within the last six (6)
    months
    Registration No.: New Registration
    Registration Date: Renewal
    1. PERSONAL INFORMATION

    Complete Name
    Mr Ms Mrs

    Salutation Last Name First Name Middle Name Appellation (Sr. Jr, III)
    Address

    Street/Barangay City/Municipality Province


    Contact No. (Cell Phone, Telephone) Resident of the Municipality since
    (indicate the year)

    Age Date of Birth Place of Birth (Municipality, Province)

    (M M – D D – Y Y Y Y )

    Gender Civil Status No. of Children


    Male Female Single Legally Separated
    Married Widowed
    Nationality Educational Background
    Filipino Elementary Vocational Post-Graduate
    Others (pls. specify) ________________ High School College Others (pls. specify)
    ___________
    Person to notify in case of emergency: Relationship: Contact No. (Cell Phone, Telephone)
    (First Name, Last Name)
    Address: (Barangay, Municipality, Province)

    2. LIVELIHOOD
    Main Source of Income: Other Sources of Income:
    Capture Fishing (specify gear used) __________________________ Capture Fishing (specify gear used) ____________________
    Aquaculture (specify culture method used)______________________ Aquaculture (specify culture method used)________________
    Fish Vending Fish Vending
    Gleaning Gleaning
    Fish Processing Fish Processing
    Others (pls. specify) _______________________ Others (pls. specify) _______________________
    3. ORGANIZATION
    Name of Organization Member Since Position/Official Designation

    4. CERTIFICATION THUMBARK
    I have personally reviewed the information on this application and I certify under penalty
    of perjury that to the best of my knowledge and belief the information on this application is true
    and correct, and that I understand this information is subject to public disclosure.

    ___________________________ __________________
    (Signature over printed name of Applicant) Date Accomplished
    5. FOR AUTHORIZED PERSONNEL ONLY
    Reviewed by: Certified correct by: Approved by:

    _______________________ _______________________ _______________________


    (Signature over printed name) (Signature over printed name) Municipal Mayor
    (Signature over printed name)

    MFRS FORM V.2.2| OCT 2012 DA-BFAR|WWW.BFAR.DA.GOV.PH

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