USER ENROLMENT FORM v1

* all fields are required

* Do not directly edit here. Download this sheet first, fill-up necessary fields, and submit to your BTr field office

USER INFORMATION
Email Address [email protected]
First Name e.g.: Ian
Middle Name e.g.: Santos
Last Name e.g.: Soliven
Position Title e.g.: Computer Programmer II

ACCESS RIGHTS
Usergroup if LGU/NGA/GOCC/GFI:
System Role

ORGANIZATION
Department e.g.: Department of Transportation
Agency (Whole Name) (Acronym) e.g.: Land Transportation Office (LTO)
Operating Unit e.g. : Manila Office

LOCATION
Region e.g. : NCR
Province/District e.g. : District 1
City/Municipality e.g. : Manila

Signatories

Signature of the User

Fullname of User
Position of User
Date Filed (mm/dd/yyyy) May 21, 2021

Signature of Head of Agency

Fullname of Head of Agency
Designation of Head of Agency

this part is to be filled up by the BTr admin

generated username
date created (mm/dd/yyyy)

Signature of User Admin

Fullname of User Admin
Designated BTr office -

- if you are applying as BTr admin, please submit the accomplished form to [email protected]
- if you are applying as NGA/LGU/GOCC/GFI user, please submit the accomplished form to your designated BTr field office.
[email protected]
e.g.: Ian
e.g.: Santos
e.g.: Soliven
e.g.: Computer Programmer II

e.g.: Department of Transportation

e.g.: Land Transportation Office (LTO)
e.g. : Manila Office

e.g. : NCR
e.g. : District 1
e.g. : Manila
 USER ENROLMENT FORM v1
* all fields are required
* Do not directly edit here. Download this sheet first, fill-up necessary fields, and submit to your BTr field office

USER INFORMATION
Email Address [email protected] [email protected]
First Name Sheila Mae e.g.: Ian
Middle Name Tubelleza e.g.: Santos
Last Name Cabarles e.g.: Soliven
Position Title TROO IV e.g.: Computer Programmer II

ACCESS RIGHTS
Usergroup LGU/NGA/GOCC/GFI if LGU/NGA/GOCC/GFI: NGA
System Role Admin

ORGANIZATION
Department Department of Finance e.g.: Department of Transportation
Agency (Whole Name) (Acronym) Bureau of the Treasury BTr e.g.: Land Transportation Office (LTO)
Operating Unit Jordan e.g. : Manila Office

LOCATION
Region R6 e.g. : NCR
Province/District Guimaras e.g. : District 1
City/Municipality Jordan e.g. : Manila

Signatories

Signature of the User (affix signature here)

Fullname of User Sheila Mae Tubelleza Cabarles
Position of User TROO IV
Date Filed (mm/dd/yyyy) May 21, 2021

Signature of Head of Agency (affix signature here)

Fullname of Head of Agency CHERYL J. PALILEO
Designation of Head of Agency CTROO I / OIC

this part is for the BTr system admin

generated username stcabarles_r6_guimaras_nga_ad

date created (mm/dd/yyyy)

Signature of User Admin

Fullname of User Admin
Designated BTr office R6 - Guimaras

- if you are applying as BTR admin, please submit the accomplished form to [email protected]
- if you are applying as NGA/LGU/GOCC/GFI user, please submit the accomplished form to your designated BTr field office.
[email protected]
e.g.: Ian
e.g.: Santos
e.g.: Soliven
e.g.: Computer Programmer II

e.g.: Department of Transportation

e.g.: Land Transportation Office (LTO)
e.g. : Manila Office

e.g. : NCR
e.g. : District 1
e.g. : Manila

Guimaras Guimaras guimaras

Cabarles Cabarles cabarles
 USER ENROLMENT FORM v1
* all fields are required
* Do not directly edit here. Download this sheet first, fill-up necessary fields, and submit to your BTr field office

USER INFORMATION
Email Address [email protected] [email protected]
First Name Joji Marie e.g.: Ian
Middle Name Castro e.g.: Santos
Last Name Palec e.g.: Soliven
Position Title Accountant I e.g.: Computer Programmer II

ACCESS RIGHTS
Usergroup LGU/NGA/GOCC/GFI if LGU/NGA/GOCC/GFI:
System Role Admin

ORGANIZATION
Department Department of Education e.g.: Department of Transportation
Agency (Whole Name) (Acronym) Passi National High School PNHS e.g.: Land Transportation Office (LTO)
Operating Unit Passi e.g. : Manila Office

LOCATION
Region R6 e.g. : NCR
Province/District Iloilo e.g. : District 1
City/Municipality Passi e.g. : Manila

Signatories

Signature of the User (affix signature here) Do not fill up - auto generated
Fullname of User JOJI MARIE C. PALEC when user info is filled up
Position of User Accountant I
Date Filed (mm/dd/yyyy) May 21, 2021

Signature of Head of Agency (affix signature here)

Fullname of Head of Agency REY P. DEATRAS Fill up
Designation of Head of Agency Principal IV

this part is for the BTr system admin

generated username jcpalec_r6_iloilo__ad

date created (mm/dd/yyyy)

Signature of User Admin

Fullname of User Admin
Designated BTr office R6 - Iloilo

- if you are applying as BTR admin, please submit the accomplished form to [email protected]
- if you are applying as NGA/LGU/GOCC/GFI user, please submit the accomplished form to your designated BTr field office.
[email protected]
e.g.: Ian
e.g.: Santos
e.g.: Soliven
e.g.: Computer Programmer II

e.g.: Department of Transportation

e.g.: Land Transportation Office (LTO)
e.g. : Manila Office

e.g. : NCR
e.g. : District 1
e.g. : Manila

Do not fill up - auto generated

when user info is filled up

Iloilo Iloilo iloilo

Palec Palec palec
 USER ENROLMENT FORM v1
* all fields are required
* Do not directly edit here. Download this sheet first, fill-up necessary fields, and submit to your BTr field office

USER INFORMATION
Email Address [email protected] [email protected]
First Name Ian Hero e.g.: Ian
Middle Name Santos e.g.: Santos
Last Name Soliven e.g.: Soliven
Position Title Computer Programmer II e.g.: Computer Programmer II

ACCESS RIGHTS
Usergroup LGU/NGA/GOCC/GFI if LGU/NGA/GOCC/GFI: NGA
System Role Admin

ORGANIZATION
Department Department of Transportation e.g.: Department of Transportation
Agency (Whole Name) (Acronym) Land Tranportation Office LTO e.g.: Land Transportation Office (LTO)
Operating Unit Manila Office e.g. : Manila Office

LOCATION
Region NCR e.g. : NCR
Province/District District 1 e.g. : District 1
City/Municipality Manila e.g. : Manila

Signatories

Signature of the User (affix signature here)

Fullname of User Ian Hero Santos Soliven
Position of User Computer Programmer II
Date Filed (mm/dd/yyyy) May 21, 2021

Signature of Head of Agency (affix signature here)

Fullname of Head of Agency Edgar Galvante
Designation of Head of Agency Chief

this part is for the BTr system admin

generated username issoliven_ncr_district1_nga_ad District1 District1 district1

date created (mm/dd/yyyy) Soliven Soliven soliven

Signature of User Admin

Fullname of User Admin
Designated BTr office NCR - District 1

- if you are applying as BTR admin, please submit the accomplished form to [email protected]
- if you are applying as NGA/LGU/GOCC/GFI user, please submit the accomplished form to your designated BTr field office.