Supplemental Pass (Read before Applying)

For house members who are going outside to buy basic needs and medicines.
Every household members must have individual Supplemental Pass.
The holder must present the Supplemental pass along with the Home Quarantine Pass.
The Household Head must apply their household members.
MUST ENTER THE HEAD'S "NEW" HOME QUARANTINE PASS CONTROL NUMBER. (IT CAN BE FOUND BELOW THE QR CODE)
The Household Head must bring the member or an ID of the member. (For image capturing)
Invalid entered details or mismatch in our records will not be processed.

NOTE:

All data collected will be used ONLY for contact tracing purposes and will be shared ONLY to the relevant department.

Name: (FIRST M.I LAST) *

I HAVE READ THE INSTRUCTIONS ABOVE. *
Purok *

Barangay *

Contact No. *

Household Head *

Household Head (NEW) HQP Control No. found just below the QR Code *

Household Head Contact No. *

Would you like it laminated? (Just pay P10.00 on your claim date) *

Terms & Conditions: I certify that the information provided are true and I agree that the information provided will be used for contact tracing purposes and will be shared to the relevant department only. *

Supplemental Pass (Read before Applying)

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