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Revised WCP Clearance Form

This document is a clearance form from the Department of Labor and Employment in the Philippines. It provides identifying information about a child, including name, address, date of birth, and education level. The form is then signed by authorized heads of several DOLE field offices to certify whether the child has any existing work permits or pending permit applications on record with those offices.

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Angelica Gallos - Madija
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90 views1 page

Revised WCP Clearance Form

This document is a clearance form from the Department of Labor and Employment in the Philippines. It provides identifying information about a child, including name, address, date of birth, and education level. The form is then signed by authorized heads of several DOLE field offices to certify whether the child has any existing work permits or pending permit applications on record with those offices.

Uploaded by

Angelica Gallos - Madija
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines WCP FORM NO.

4
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. _____

LOSS OF WORKING CHILD PERMIT CARD


CLEARANCE FORM

PART I: DATA OF CHILD


Child’s ID No.: _______________________
Name of Child: _________________________________________________________________________________________
(Last Name) (First Name) (Middle Name)

Home Address: _________________________________________________________ Contact Details: _________________


Date of Birth: ___________________________ Place of Birth: ______________________________________ Age: _____
Sex:  Male  Female Education:  Grade level (specify if applicable) __________________________

PART II: This is to certify that the above child:

 has record with this office: DOLE Field Office No. 1 __________
WCP No. ______________ issued on _______ Project ___________
 has no record with this office
 has pending WCP application with this office: ____________________________________
Project ____________ Date _____________ Location ___________ Name and Signature of Authorized Head
 has no pending WCP application with this office Date:
 has record with this office: DOLE Field Office No. 2 __________
WCP No. ______________ issued on _______ Project ___________
 has no record with this office
 has pending WCP application with this office: ____________________________________
Project ____________ Date _____________ Location ___________ Name and Signature of Authorized Head
 has no pending WCP application with this office Date:
 has record with this office: DOLE Field Office No. 3 __________
WCP No. ______________ issued on _______ Project ___________
 has no record with this office
 has pending WCP application with this office: ____________________________________
Project ____________ Date _____________ Location ___________ Name and Signature of Authorized Head
 has no pending WCP application with this office Date:
 has record with this office: DOLE Field Office No. 4 __________
WCP No. ______________ issued on _______ Project ___________
 has no record with this office
 has pending WCP application with this office: ____________________________________
Project ____________ Date _____________ Location ___________ Name and Signature of Authorized Head
 has no pending WCP application with this office Date:
 has record with this office: DOLE Field Office No. 5 __________
WCP No. ______________ issued on _______ Project ___________
 has no record with this office
 has pending WCP application with this office: ____________________________________
Project ____________ Date _____________ Location ___________ Name and Signature of Authorized Head
 has no pending WCP application with this office Date:
 has record with this office: DOLE Field Office No. 6 __________
WCP No. ______________ issued on _______ Project ___________
 has no record with this office
 has pending WCP application with this office: ____________________________________
Project ____________ Date _____________ Location ___________ Name and Signature of Authorized Head
 has no pending WCP application with this office Date:
 has record with this office: DOLE Field Office No. 7 __________
WCP No. ______________ issued on _______ Project ___________
 has no record with this office
 has pending WCP application with this office: ____________________________________
Project ____________ Date _____________ Location ___________ Name and Signature of Authorized Head
 has no pending WCP application with this office Date:

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