Interview Sheet

LABOR STANDARDS REVIEW

Atty. Matugas
Fourth Year
Disclaimer: This answer sheet is for educational discussion purpose only. All information
provided will be kept confidential.
Date:
COMPANY PROFILE
Name of Establishment:
Address:
Owner/Branch Manager
Kind of Business:
Contact No/s.

__Head Office

__Branch

Email Address

EMPLOYEE PROFILE
Name:
Age:
Educational Attainment:
First Job:
__Yes __No
Working Hours:
Shifting: __Yes:_____ __
Years in Service:
__Regular
If probationary, no. of months/years__
Other work assignment (other than delivery):

__No
__Others:_________

LABOR RELATIONS
Union Member: __Yes
__No
If Yes, name of Union:
No. of union members:
SEBA: __Yes __No
Registered: __Yes
__No
With Existing CBA: __Yes
__No
Union fees/dues:
__Yes
__No
If yes, enumerate:
EMPLOYMENT SET-UP
Mode of Employment:
__Agency
If with agency or subcon, name:
Address:
Name of owner:
Industry:
Registered: __Yes
__No
GENERAL LABOR STANDARDS
Wage payment:
__Piece/rate:
Wage: __Minimum
__Above:
COLA: __Yes:
__None

__Subcontractor

__Commission-based:
__Below:

__Others

__Others:

Productivity or performance-based incentive: __Yes

Other facilities:

__None

Meal Period: __hour

__minutes, or less
Weekly Rest Periods:
Overtime Pay:
Regular Holiday Pay:
Premium Pay for Special Day:
Premium Pay for Rest Day:
Night Shift Differential pay:
Service Incentive Leave pay:
Separation Pay:
13th Month Pay:
Maternity/paternity leave:

__Availed?Y/N

Solo Parent Leave:

Retirement Pay:
Service Charge:
Records Keeping, available: __Yes

__No: In what conditions:

Time of Payment of Wages:

OTHER BENEFITS:
Lactation Station:
__Yes
__No
If yes, lactation period:
__Yes
_No
Anti-Sexual Harassment implementation:
If yes, what services/programs:
Alien employee:
__Yes
__None
Flexible Work arrangement:
__Yes
If availed, schedule:
PWD Accessibility:
__Yes
__None
Trainings, development programs for employees:
If availed, briefly discuss:

__No

__Yes

__None

REMITTANCES
SSS: __Yes
__No
PAG-IBIG:
__Yes
__No
PhilHealth:
__Yes
__No
OCCUPATIONAL SAFETY AND HEALTH
Type of workplace: __Hazardous
__Non-hazardous
Establishment registered:
__Yes
__No
Good Housekeeping:
__Yes
__No
Personal Protective Equipment (In delivery service):
__Yes
Medical Facilities:
_Yes
__No
Training/orientation on safety standards:
__Yes
__None
If yes, how often:

__Highly-hazardous
__No

Other safety facilities, enumerate: