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  • FRANKLIN SMITH - PDD-2022-0004 - Pre-Deployment Declaration Form

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    Jo Hn
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    1) The document is a pre-deployment declaration signed by a Filipino worker being deployed by Staffhouse International Resources Corporation to an unspecified destination country as an employee of a also unnamed employer. 2) The worker declares that they did not pay any placement, processing, or other fees to the agency for their recruitment and deployment. 3) The worker agrees to honor the terms of their employment contract, including completing the full contract duration abroad and being willing to work in different locations as needed by the employer.

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    FRANKLIN SMITH - PDD-2022-0004_Pre-Deployment Declaration Form

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    1) The document is a pre-deployment declaration signed by a Filipino worker being deployed by Staffhouse International Resources Corporation to an unspecified destination country as an employee of a also unnamed employer. 2) The worker declares that they did not pay any placement, processing, or other fees to the agency for their recruitment and deployment. 3) The worker agrees to honor the terms of their employment contract, including completing the full contract duration abroad and being willing to work in different locations as needed by the employer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    281 views2 pages

    FRANKLIN SMITH - PDD-2022-0004 - Pre-Deployment Declaration Form

    Uploaded by

    Jo Hn
    1) The document is a pre-deployment declaration signed by a Filipino worker being deployed by Staffhouse International Resources Corporation to an unspecified destination country as an employee of a also unnamed employer. 2) The worker declares that they did not pay any placement, processing, or other fees to the agency for their recruitment and deployment. 3) The worker agrees to honor the terms of their employment contract, including completing the full contract duration abroad and being willing to work in different locations as needed by the employer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 2

    PRE- DEPLOYMENT DECLARATION

    I, ____________________________________________, Filipino, of legal age, single/married,


    and a resident of ___________________________________________________________, do
    hereby affix my signature as evidence of my declaration to wit:

    1. That I was hired by my employer, ___________________________________________,


    as a _____________________________ for deployment to _____________________;

    2. That I did not pay any placement fee, processing fee or any fee for that matter, to
    Staffhouse International Resources Corporation (also known as “agency”) in
    connection with my recruitment and deployment;

    3. That I am fully aware that my agency has provided me with the Mandatory Insurance as
    required by the DMW / POEA as mandated by RA 10022;

    3.1. That the said insurance was paid by the agency and/or the employer, and will
    not be deducted from my salary nor will be recovered from me through any
    means whatsoever;

    4. That in consideration of the time, effort and resources spent by my employer in hiring me
    and getting me to the designated country, I hereby agree to honor and adhere to all the
    stipulations in the employment contract;

    4.1. That I am aware that upon completion of the first phase, the second phase is
    the completion of the contract duration of the Employment Contract as a
    Regular Employee;

    4.2. That I am aware that my primary work location may vary from time to time
    according to the business needs of my employer, and that I am willing to be
    assigned to any of my employer’s work locations anywhere in the destination
    country;

    5. That I agree to continuously work for the company for the duration of the employment
    contract upon arrival to the destination country;

    5.1. That I am aware that if I fail to complete the contract term with my employer
    upon arrival to the destination country without any acceptable basis and due
    process, I am aware that I am required to shoulder the cost of the return ticket
    to the Philippines, in accordance with the Employment Contract, and the
    corresponding costs to cover the processing and documentation fees.

    PRE-DEPLOYMENT DECLARATION
    PDD-2022-0004-01 (09-2022)
    AUTHOR: MICHELLE D. MOROTA
    Page 1 of 2
    6. That I am aware that I should update my agency of my employment status in my
    destination country.

    7. That I fully understand and agree to all the contents hereof.

    _______________________________
    SIGNATURE OVER PRINTED NAME / DATE

    WITNESS:

    _______________________________
    SIGNATURE OVER PRINTED NAME / DATE

    ACKNOWLEDGEMENT

    REPUBLIC OF THE PHILIPPINES )


    CITY OF ___________) S.S.

    BEFORE ME, a Notary Public for the City of _______________,this ___ day of
    ___________________, 202__, personally came and appeared the following:

    Name Passport/ID No. Date/Place Issued

    ______________________ ______________________ ________________________

    known to me and to me known to be the same persons who executed this Agreement and who
    acknowledged to me that the same is their own free and voluntary act and deed as well as the
    corporation they represent.

    WITNESS MY HAND AND NOTARIAL SEAL the date and place already written below.

    NOTARY PUBLIC

    Doc. No.: _______


    Page No.:________
    Book No. : _______
    Series of 202__.
     

    PRE-DEPLOYMENT DECLARATION
    PDD-2022-0004-01 (09-2022)
    AUTHOR: MICHELLE D. MOROTA
    Page 2 of 2

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