Add New Insured Person
Create a new insurance record with beneficiaries and premium details
Group Personal Accident Insurance Form
Personal Information
Last Name
*
First Name
*
Middle Name
Position
*
Office / Department
*
-- Select Office --
OFFICE OF THE MUNICIPAL MAYOR
MUNICIPAL ADMINISTRATOR OFFICE
MUNICIPAL ACCOUNTING OFFICE
MUNICIPAL BUDGET OFFICE
MUNICIPAL TREASURER'S OFFICE
MUNICIPAL ASSESSOR'S OFFICE
BUS TERMINAL & WHARF OPERATION
CIVIL SECURITY SERVICE
HOTEL OPERATIONS
HUMAN RESOURCE MANAGEMENT OFFICE
LOCAL YOUTH & SPORTS DEVELOPMENT OFFICE
MARKET OPERATIONS
MUNICIPAL AGRICULTURE'S OFFICE
MUNICIPAL CIVIL REGISTRAR
MUNICIPAL DISASTER RISK REDUCTION MANAGEMENT OFFICE
MUNICIPAL ENVIRONMENT & NATURAL RESOURCES OFFICE
MUNICIPAL GENERAL SERVICES OFFICE
MUNICIPAL HEALTH OFFICE
MUNICIPAL PLANNING & DEVELOPMENT OFFICE
MUNICIPAL SOCIAL WELFARE AND DEVELOPMENT OFFICE
MUNICIPAL TOURISM, HERITAGE, DEVELOPMENT, CULTURE & ARTS
SANGGUNIANG BAYAN OFFICE
SB SECRETARY
SLAUGHTERHOUSE OPERATION
MUNICIPAL ENGINEERING OFFICE
ABUYOG COMMUNITY COLLEGE
Employment Status
*
-- Select Status --
PERMANENT
TEMPORARY
ELECTIVE
CO-TERMINOUS
CONTRACTUAL
CASUAL
JOB ORDER / COS
Date of Birth
*
Age
*
Auto-calculated from Date of Birth
Home Address
Insurance Details
Total Amount of Insurance
*
₱
Annual Premium Amount Due
*
₱
Beneficiaries
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