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  • SENA FORM 1 SeNA Application Form

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    Aid Bolanio
    222 vizualizări1 pagină
    The form includes sections for identifying information about the parties and their representatives, the nature of the dispute which includes options like money claims, unfair labor practices, and occupational safety issues, and the outcomes of the SENA process.

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    SENA FORM

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    The form includes sections for identifying information about the parties and their representatives, the nature of the dispute which includes options like money claims, unfair labor practices, and occupational safety issues, and the outcomes of the SENA process.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca DOCX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    222 vizualizări1 pagină

    SENA FORM 1 SeNA Application Form

    Încărcat de

    Aid Bolanio
    The form includes sections for identifying information about the parties and their representatives, the nature of the dispute which includes options like money claims, unfair labor practices, and occupational safety issues, and the outcomes of the SENA process.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca DOCX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 1

    Republic of the Philippines Document Code SENA FORM 1

    DEPARTMENT OF LABOR AND EMPLOYMENT


    Regional Office No. 2 Revision No. 00
    Tuguegarao City, Cagayan Page No. Page 1 of 1
    Date Effective August 3, 2015
    Date Filed :
    SINGLE-ENTRY APPROACH (SENA)
    (Per Department Order No.107, Series of 2010)
    Reference No.:SEAD-

    Name of Requesting Party: Name of Responding Party:


    (Pangalan) (Pangalan)
    ___________________________________________________ __ _______________________________________
    [[

    Pls.check() MaleFemale Pls.check() MaleFemale


    UnionCompany UnionCompany
    Address: Nature of Business: ______________________________
    (Tirahan) _____________________________________ ______________________________________________
    _________________________________________________ Total no. of employee:

    Tel. /Cel./Fax/E-mail: Male Female


    __________________________________________________
    Date of Employment: Contact Person:
    (Kailan napasok sa trabaho) (Taong Kakausapin sa Kumpanya)

    Years of Service: Position:


    (Taon sa Serbisyo) (Katungkulan)

    Nature of work: Address:


    (Trabaho):
    Tel. /Cel./Fax/E-mail:

    CLAIMS/ISSUES RELIEF ACTION TAKEN


    (Please check the appropriate box/es) (Tobe filled-out by SENA Desk Officer)
    PRAYEDFOR
    (Ano ang gusto niyong solusyon sa Advise and Counseling
    a) Money claims reklamo o problema?)
    Set for Joint Conference on
    Non-payment/underpayment
    __________________________
    of: Payment of Money Claims
    Settlement agreement signed on
    1. wage Reinstatement
    2. OvertimePay Cessation of ULP acts
    3. Night-Shift Differential Restitution/Correction of Withdrawal by either or both
    Pay violations of Occupational parties
    4. Service incentive leave Safety and Health Standards Referred to_____________________
    5. Holiday pay Conduct Certification Election BY REASON OF:
    6. SSS Conduct of Election of Union Failure of the parties to reach
    7. Philhealth Officers an agreement within
    the 30-day mandatory
    8. PAG-IBIG Audit/Examination of Union
    conciliation-mediation period;
    b) Unfair LaborPractice(ULP) Funds Failure of the requesting party
    c) IllegalDismissal Others (Please Specify) to appear in two (2) scheduled
    d) Illegal Dismissal with Money consecutive conferences despite
    Claims due notice.
    e) Non-compliance with Occupational Pre-termination of the
    Health and Safety Standards proceedings with request of
    f) CertificationElectionDispute g) issuance of Referral from
    Inter/Intra UnionDispute _________________________.
    h) Cancellation of Union Registration _________________________
    REMARKS:
    i) Others(Please Specify) Requesting Party’s Signature
    ___________________________
    SENA Desk Officer
    (Signature over Printed Name)

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