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Pea Applicationform

This document is an application for a license to operate a private employment agency (PEA) in the Philippines. It requests information such as the name and address of the agency, contact details, type of business organization, description of operations, management details, financial information, and an undertaking to adhere to ethical recruitment standards and not charge applicants fees. The applicant must sign and swear to the information before a notary public.

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133 views1 page

Pea Applicationform

This document is an application for a license to operate a private employment agency (PEA) in the Philippines. It requests information such as the name and address of the agency, contact details, type of business organization, description of operations, management details, financial information, and an undertaking to adhere to ethical recruitment standards and not charge applicants fees. The applicant must sign and swear to the information before a notary public.

Uploaded by

Chip
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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PM-NCR-03.02-F.

02
Department of Labor and Employment
REGIONAL OFFICE NO. X
APPLICATION FOR LICENSE
PRIVATE EMPLOYMENT AGENCY (PEA)

NAME OF AGENCY:
ADDRESS OF AGENCY:
TIN No. TEL. NOS. FAX NO.
TYPE OF BUSINESS ORGANIZATION: (please check)
( ) Sole Proprietorship ( ) Partnership ( ) Corporation
Date of Registration:_ Registration Number:
COMPREHENSIVE DESCRIPTION OF OPERATION:

MANAGEMENT: PRINCIPAL OFFICERS / MANAGING PARTNERS


NAME DESIGNATION ADDRESS

FINANCE:
Total Assets Bank Statement
Total Liabilities Date of Statement
Networth
Paid-in Capital
Date of Statement
UNDERTAKING:

That, I, , Filipino, of legal age,


(Name) (Position)
of , after having been duly sworn to in
(Company)
accordance with law, do hereby depose and say:
a. That our Company will not support or engage in acts involving illegal recruitment, trafficking in persons, violation
of Anti-Child Labor Laws or crimes involving moral turpitude or similar activities;
b. Ensure that DOLE Standard Recruitment are adhered to by the parties;
c. Not collect fees whatsoever from the applicants; and,
d. Assume full responsibility for all acts of its officers, employees and representatives in connection with recruitment
and placement activities.

In witness whereof, I have hereunto affixed my signature this day of , 20


in the City of .

(Affiant's Name and Signature)

SUBSCRIBED AND SWORN to before me this day of , 20


in , Affiant exhibited to me his/her Residence Certificate No.
issued at on .

Doc. No. NOTARY PUBLIC


Page No.
Book No.
Series of

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