FM.POEA{'4.8F.{'8.

D philippine Overseas Employment Administration

Effstlver April ,, 209 Pre-Employment Service Office- landbased Center

CHECKTISTOF REQUIREMENTS FOR EVATUATION OF DIRECTHIRE APPTICATION

HOUSEHOTD SERVICE woRKERs (HsWs}

{All documentsto be submitted must be in dupticotes)
WORKER
EMPLOYER
WORKSITE
POStTtON

DOCUMENTARY REQUTREMENTS
PHASE 1

TIME RECEIVED:
Remarks

tr Passport with vaiidity period oi not iess tiran sir (ei momhs
I

Vatid Work Visa, Entry/Work permit (whichever ls applicable per coLntry).

E] lf vlsa assurance or guarantee ls Issued by employer, the same shoutd be
noted/acknowledged by the Government or lmmlgratton Offfce in the
iobsite

Employment Coniract:
E] _ Origlnal copy of Employrnent Conffact or Offer of Employment
_ Verlfled by the phtltpplnes Overceas tabor Offfce (POLO)
Authentlcated by the Phllippine Embassy/€onsulate for countrles wlth no polo

tr -
FOIO Endorsemert Letter addressed to the Adminlstrator seeking
exemption from the ban on direa-hlring

E] Additional country-speciflc requirements:

a. canada- r.abor Market oplnlon (LMo), Labor Market rmpact Ass€ssment (tMlA) for
and Canadian Letter and'Emptoier,s tertlflcate of Reglsbatlon from ECON '
(Provlnce of Saskatcheuran Executfue Councll) or Saskatcheriran tmmlgratlon
Nomlnee Program (SlNp) approval are requircd fom workers to Saskatchelvan
ln lleu of lMO
b. USA- LaborCondltlon Application and Notice ofAction
c. Middle EastandAftlcancountries-Contingencyplanissued bytheemployer

E] TESDA Natlonal Certfficate il (NC-tt) for Domestlc Workers

tr Notarlzed statemem on how the workers secured hls/her employment wlth attached
photocopy of employey's passport/tD and contact detaits

TIME CLOSED:

PHASE 2

TIME RECEIVED:

tl E-Registration Account

tl Compllance Form (!l necessary)

tl Valld Medlcal Certlfl€ate from DoH-accredlted medlcal cllnlc authorlzed to conduct medical enm lor oFWs

E Pre-Employment Orlentation Semlnar Certifi cate (PEOS)

E PrsDeparture Orlentatlon Semlnar (PDOS) Cenmcate issued by OWWA

tl Comprehensfue he,Departule Educatton program (CpDEp) Certificate by OWWA

E] PoEA clearance (for employers under section lzrtd of the poEA Revlsed Rules & Regulations)

tr Certificate of lnsurance coyerage Govering at teast the beneflts provlded

Under Sectlon 37-A of RA 8042 as amended;
/ Repatrlation of Remalns/Moral Remains/n case of Death

TIME CTOSED:

ACTION TAXEN:
Returned due to incomplete documents
_ Others

RECEIVING OFFICER:
RECEIVED BY:

PRINTEO NAME & SIGNATURE

PRINTED NAME & SIGNATURE

qUEUE NO.