Rks Form 5 PDF Details

Welcome to the world of Rks Form 5! If you're looking for an efficient and easy-to-use tool for creating professional forms, then look no further than this powerful piece of software. With drag & drop design capabilities, advanced document editing and signature solutions, integrated online payment options and more – you'll find all the features needed to create any kind of form quickly and easily. In this blog post we'll cover what makes Rks Form 5 a must have solution for businesses in need of streamlined data collection processes.

QuestionAnswer
Form NameRks Form 5
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesrks form 5 2021, establishment termination report dole, dole retrenchment form, form 5 dole

Form Preview Example

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOT FOR SALE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Republic of the Philippines

 

 

 

 

 

 

 

 

 

 

 

 

RKS Form 5 of

 

 

DEPARTMENT OF LABOR AND EMPLOYMENT

 

 

 

 

 

 

 

 

 

 

______________________________________

 

 

 

 

 

Page 1 of 3

 

 

2020

 

 

 

 

 

 

 

 

 

 

Region-PO/FO-Year-Month-Count

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(ex. NCR-MFO-2020-05-001)

 

 

 

Certificate Number: AJA15-0048

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Instructions:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Accomplish this form when filing a notice of: a) Flexible Work Arrangement/Alternative Work Scheme; b) Temporary Closure;

 

 

 

 

c) Retrenchment or Reduction of Workforce; or d) Permanent Closure.

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

The report is considered as duly filed when the complete list of workers affected is made part of the submission. Fields with asterisks

 

 

(*) should be accomplished by the company representative.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

This form should be submitted to the DOLE Provincial/Field Office as soon as possible in the case of adoption of flexible work

 

 

arrangement or temporary closure.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

For establishments that will retrench or permanently close, the form should be submitted 30 days prior to the effectivity of

 

 

termination.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Page 1 should contain general information about the establishment and the number of workers affected.

 

 

 

 

 

 

6.

Page 3 should enumerate the names of workers affected, their addresses and contact numbers, and other information stated therein.

7.

Total number of workers listed should equal the total number of workers affected as reported in this page.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ESTABLISHMENT REPORT

 

 

 

 

 

 

 

 

 

 

FLEXIBLE WORK ARRANGEMENT (FWA) / ALTERNATIVE WORK SCHEME (AWS)

 

 

 

 

 

 

 

 

 

 

TEMPORARY CLOSURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RETRENCHMENT/REDUCTION OF WORKFORCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERMANENT CLOSURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Filing (mm-dd-yyyy):

 

 

m

 

m

 

-

 

d

 

d

-

 

y

y

 

y

y

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. ESTABLISHMENT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Name of Establishment:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Floor/Bldg/No/Street/Subdivision

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Barangay/City/Municipality

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Geo Code

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Kind of Business/Economic

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Activity/Principal Product:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PSIC Code

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Company TIN

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Company SSS Number

:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Number of Workers

Male

:

 

Managerial Employees

:

 

Female

:

 

Supervisory

:

 

Total

:

 

Rank-and-File

:

 

 

 

 

Total

:

B. SUMMARY OF AFFECTED EMPLOYEES DUE TO

B.1 Flexible Work Arrangement / Alternative Work Scheme*

 

 

 

 

Period of Adoption of FWA / AWS

 

 

 

Type of FWA/AWS to

Primary Reason of

 

 

 

No. of Workers

 

 

 

 

 

 

 

 

 

 

 

be Implemented

 

Adoption of FWA/AWS

 

 

 

 

Start

 

 

 

 

 

End

 

 

 

 

 

 

 

Covered/Affected

 

 

 

 

 

 

 

 

(Use code below, select only

(Use code below, select only

 

 

 

(mm/dd/yyyy)

 

 

 

(mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

one)

 

 

one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Codes for Types of FWAs/AWS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOE

-

Transfer of employees to another branch or outlet of the same

ROW

-

Rotation of workers

 

 

 

 

 

 

 

employer

 

 

 

 

 

 

FCL

-

Forced leave

 

 

 

 

AOE

- Assignment of employees to other function or position in the

BTS

-

Broken-time schedule

 

 

 

 

 

 

 

same or other branch or outlet of the same employer

 

CWW

-

Compressed Work Week

 

 

 

 

RWD

-

Reduction of workdays per week

 

 

 

 

 

 

TWA

-

Telecommuting Work Arrangement

 

RWH

-

Reduction of workhours per day

 

 

 

 

 

 

OTH

-

Others (please specify)

 

 

 

 

JR

-

Job rotation alternately providing employees with work within

 

 

 

 

 

 

 

 

 

 

 

 

 

the workweek or within the month

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PCE

-

Partial closure of establishment where some unit or departments

 

 

 

 

 

 

 

 

 

 

 

 

 

of the establishment are continued while other units or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

department are closed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Codes for Primary Reason for Adoption of FWA/AWS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Economic Reasons

 

 

 

 

 

 

 

 

 

 

 

Non-Economic Reasons

 

CI

-

Competition from Imports

 

LRM

-

 

Lack of raw materials

 

 

 

 

INV

-

Inventory

 

CMM

-

Change in management/merger

 

MR

-

 

Increase in minimum wage rate

 

NMC

-

Natural or man-made calamity

 

FL

-

Financial losses

 

PD

-

 

Peso depreciation

 

 

 

 

PC

-

Project completion

 

GR

-

Government regulation

 

UPP

-

 

Uncompetitive price of products

 

RGM

-

Repair or general maintenance

 

HCP

-

High cost of production

 

OTH

-

 

Others (please specify):

 

 

 

 

WSO

-

Work stoppage order/ cease and

 

LC

-

Lack of capital

 

 

 

 

 

 

 

 

 

 

 

 

 

desist order

 

LM

-

Lack of market/ slump in demand/

 

 

 

 

 

 

 

 

 

 

OTH

-

Others (please specify):

 

 

 

 

cancellation of orders

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOT FOR SALE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Republic of the Philippines

 

 

 

 

 

 

 

 

 

 

 

 

RKS Form 5 of

 

 

 

 

DEPARTMENT OF LABOR AND EMPLOYMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

______________________________________

 

 

 

 

 

Page 2 of 3

 

 

 

2020

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Region-PO/FO-Year-Month-Count

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(ex. NCR-MFO-2020-05-001)

 

 

Certificate Number: AJA15-0048

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B.2 Temporary Closure*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No. of Workers

 

 

 

Period of Temporary Closure

 

 

 

 

 

Primary Reason of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Temporary Closure

 

 

 

 

 

 

 

 

 

 

Start

 

 

 

End

 

 

 

 

 

 

 

 

 

 

 

 

 

Covered/Affected

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(mm/dd/yyyy)

 

(mm/dd/yyyy)

 

 

(Use code below, select only one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B.3 Retrenchment/Reduction of Workforce*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No. of Workers

 

 

Effectivity Date

 

Primary Reason of Retrenchment

 

 

 

 

 

 

 

Covered/Affected

 

 

(mm/dd/yyyy)

 

 

(Use code below, select only one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B.4 Permanent Closure*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No. of Workers

 

Effectivity Date of

 

Primary Reason of Permanent Closure

 

 

 

 

 

 

 

 

 

Termination

 

 

 

 

 

 

 

 

Covered/Affected

 

 

 

 

(Use code below, select only one)

 

 

 

 

 

 

 

 

 

(mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Codes for Primary Reason Temporary Closure (B.2)/Retrenchment (B.3) / Permanent Closure (B.4):

 

 

 

 

 

 

 

 

 

Economic Reasons

 

 

 

 

 

 

 

 

 

Non-Economic Reasons

CI

 

-

Competition from Imports

 

 

MR

-

 

Increase in minimum wage rate

 

AWOL

-

 

Absence without leave

CMM

 

-

Change in management/merger

PD

-

 

Peso depreciation

 

 

CCO

 

- Commission of a crime or offense

FL

 

-

Financial losses

 

 

R

-

 

Redundancy

 

 

FWBT

 

- Fraud or willful breach of trust

COE

 

- Closure or cessation of operation of an

RDS

-

 

Reorganization/downsizing

 

GHN

 

- Gross and habitual neglect of duty

 

 

 

 

 

establishment not due to serious losses

RPL

-

 

Retrenchment to prevent losses

 

INV

-

 

Inventory

 

 

 

 

 

of financial reverses

 

 

OTH

-

 

Others (please specify):

 

 

IR

-

 

Impossible reinstatement

EDC

 

- Employee suffering from a disease not

 

 

 

 

 

 

 

NMC

 

- Natural or man-made calamity

 

 

 

 

 

curable within the period of six (6)

 

 

 

 

 

 

 

PC

-

 

Project completion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

months

 

 

 

 

 

 

 

 

 

RES

-

 

Resignation

GD

 

-

Government decision

 

 

 

 

 

 

 

 

 

RET

-

 

Retirement

HCP

 

-

High cost of production

 

 

 

 

 

 

 

 

 

RGM

 

- Repair or general maintenance

LC

 

-

Lack of capital

 

 

 

 

 

 

 

 

 

SMWD

-

 

Serious misconduct or willful

LRM

 

- Lack of raw materials

 

 

 

 

 

 

 

 

 

 

 

 

 

disobedience

LM

 

- Lack of market/ slump in demand/

 

 

 

 

 

 

 

WSO

 

- Work stoppage order/ cease and

 

 

 

 

 

cancellation of orders

 

 

 

 

 

 

 

 

 

 

 

 

 

desist order

LSA

 

- Lack of service assignment

 

 

 

 

 

 

 

 

 

OTH

-

 

Others (please specify):

LSD

 

-

Installation of labor-saving devices

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C. AGREEMENT ON ADOPTION OF FWA/AWS

 

 

 

 

 

 

 

 

 

 

 

 

 

This is to certify as to the following:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. That I am the employeesrepresentative;

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

That the data provided in Item B.1 Summary of Affected Employees - Flexible Work Arrangement/Alternative Work

 

 

 

 

Scheme are accurate;

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. That a consultation with the workers was undertaken prior to the adoption of FWA; and

 

 

 

 

 

 

 

4.

Attached is a copy of the Agreement.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature Over Printed Name of Employees’ Representative and Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Designation:

Mobile No.:

 

 

 

Telephone No.:

 

 

 

 

 

E-mail Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D. CERTIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This is to certify as to the accuracy of the data provided in this report.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature Over Printed Name of Owner or Company Representative and Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Designation:

Mobile No.:

 

 

 

Telephone No.:

 

 

 

 

 

E-mail Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOT FOR SALE

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT

Intramuros, Manila

CERTIFICATE NUMBER: AJA15-0048

LIST OF AFFECTED WORKERS

Instruction: If necessary, use additional sheets following the same format.

Page 3 of 3

CONSENT NOTICE: By accomplishing this form, you agree that the information submitted shall be used solely for purposes of monitoring and planning. We may likewise disclose your personal information to the extent that we are required to do so by the Data Privacy Act of 2012. As a general rule, we may only keep your information until such time that we have attained the purpose by which we collect them. Under the foregoing circumstances and to the extent permissible by applicable law, you agree not to take any action against the DOLE for the disclosure and retention of your information.

 

Name of Worker*

 

 

 

 

Home Address*

 

 

 

 

Employment

 

Monthly Salary (in Peso)*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Birthday*

Sex*

 

 

 

 

 

Contact

Email

 

Status*

 

 

 

 

 

Adopted

No.

Last

First

Middle

House

 

 

City/

 

Designation*

(regular,

4,000-

10,001-

16,001-

22,001-

28,001

Work

 

 

 

 

 

 

 

(dd/mm/yyyy)

(F/M)

Street

Brgy.

Province

No*

Address*

and

 

Name

Name

Name

 

 

Number

 

 

Municipality

 

 

 

 

contractual,

10,000

16,000

22,000

28,000

above

Arrangement*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

etc.)

 

 

 

 

 

 

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

*Mandatory fields to be accomplished by the company representative

How to Edit Rks Form 5 Online for Free

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Step 1: Access the PDF form in our tool by clicking on the "Get Form Button" above on this page.

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It will be an easy task to fill out the pdf using this detailed guide! Here is what you want to do:

1. Begin completing the rks form 5 2020 with a selection of necessary blank fields. Gather all of the information you need and make sure there is nothing overlooked!

Stage number 1 in completing dole rks form 5

2. Soon after the last part is completed, go on to enter the relevant details in all these: Male Female Total, Managerial Employees Supervisory, Name of Establishment, B SUMMARY OF AFFECTED EMPLOYEES, B Flexible Work Arrangement, No of Workers, CoveredAffected, Period of Adoption of FWA AWS, Start, mmddyyyy, End, mmddyyyy, Type of FWAAWS to, Primary Reason of, and be Implemented.

be Implemented, B SUMMARY OF AFFECTED EMPLOYEES, and No of Workers inside dole rks form 5

3. Completing employer Assignment of employees, RWD RWH JR, Reduction of workdays per week, Job rotation alternately providing, ROW FCL BTS CWW TWA OTH, PCE, Partial closure of establishment, of the establishment are continued, Rotation of workers Forced leave, Competition from Imports Change in, Codes for Primary Reason for, Government regulation High, Lack of capital Lack of market, LRM MR PD UPP OTH, and Lack of raw materials Increase in is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

PCE, Codes for Primary Reason for, and Government regulation  High in dole rks form 5

People who work with this PDF frequently make errors while filling out PCE in this area. Don't forget to go over whatever you type in right here.

4. Your next section requires your details in the subsequent areas: CoveredAffected, Start, mmddyyyy, End, mmddyyyy, Primary Reason of Temporary Closure, Use code below select only one, B RetrenchmentReduction of, No of Workers, CoveredAffected, Effectivity Date, mmddyyyy, B Permanent Closure, No of Workers, and CoveredAffected. Just be sure you fill in all of the needed information to go forward.

A way to complete dole rks form 5 stage 4

5. Lastly, this final portion is what you will need to wrap up prior to using the PDF. The blanks here include the next: Economic Reasons CI CMM FL COE EDC, months Government decision, MR Competition from Imports PD, Lack of capital Lack of raw, Peso depreciation Redundancy, NonEconomic Reasons AWOL CCO FWBT, Inventory Impossible reinstatement, Absence without leave Gross, Project completion Resignation, NMC, PC RES RET RGM SMWD WSO OTH, desist order, C AGREEMENT ON ADOPTION OF FWAAWS, This is to certify as to the, and That I am the employees.

Ways to complete dole rks form 5 step 5

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