Name of Bureau /Service/Division: Local Government Monitoring and Evaluation Division (LGMED) MASTER LIST OF MAINTAINED INTERNAL DOCUMENTED INFORMATION. Republic of the Philippines DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT CORDILLERA ADMINISTRATIVE REGION FM-SP-CAR-O1A-02 a REVISION DOCUMENT CODE DOCUMENT TITLE 0 a aa on om 7 [Processing of Death Benofit Claims (DBC) for Deceased Barangay Officials (QP-CAR-LGMED-05 [DBC Form 001: Application for Barangay 10.01.17 Official’s Death Benefit Claim (QP-CAR-LGMED-05 DBC Form 002: Transmittal Letter 10.01.17 QP-CAR-LGMED-05 DBC Form003-A: Provincial Consolidated List | 10.01.17 of Deceased Barangay Officials (QP-CAR-LGMED-05 DBC Form003-B: HUC Consolidated Listof | 10.0117 Deceased Barangay Officials QP-CAR-LGMED-05 DBC Form 004: Regional Consolidated List for | 10.01.17 Deceased Barangay Officials (QP-CAR-LGMED-05 Quality Process 10.01.17 (Q0- QP-CAR-LGMED-05 _ [Quality Objective 10.01.17 QME- QP-CAR-LGMED-05 |Quality Monitoring and Evaluation 10.01.17 FM-QP-DILG-CAR-05-01 [Process Summary Logsheet 10.01.17 DILG-CARG, CONTROL: - C5G - CORDILLERA ADMINISTRATIVE REGION EeMEDos | al ; QP-CAR-LGMED-0S QUALITY PROCEDURE (QP) { PROCESSING OF DEATH BENEFIT CLAIMS (DBC) FOR DECEASED | PROCEDURE TITLE | 5 ARANGAY OFFICIALS a i. | This process starts from the submission of DBC Form 1 to the DILG Municipal SCOPE | Ficld Office up to the submission of DBC Form 004 to NBOO-CO for Funding Allocation _ a ‘To define the standard procedures of processing of death and burial claims in pUREOSE | accordance with oxisting guidelines r sete PROCESS DESCRIPTION 5 INPUT PROCESS : OUTPUT suimbston or DBC Form Processing of Death Benefit Accomplished DBC Form 004 | 001 and supporting —P| Claims (DBC) for Deceased T]—> (Regional Consolidated asm Barangay Officials List) for Funding Allocation by NBOO CO DESCRIPTIVE STATEMENT: Application for Barangay Official’s Death and Burial Claims with complete documentary requirements submitted by the beneficiaries to the C/MLGOO for processing. After determining the accuracy & completeness of documents, the same shall be forwarded to the Provincial/City Office. The Provincial/City Focal Person reviews the completeness of the documents, and thereafter accomplishes DBC Form 003-A for provinces and DBC Form 003-B for HUCs and transmits the same to the Regional Office. Likewise, the Regional Office, checks data against the Barangay Officials Database System (BODS) and consolidates by using DBC Form 004 for submission to NBOO for | | [funding : pare | Ne. rca” Process/Activity Details References 1 | HUC/C/ Receives documentary |* Receive, record and |A. DBC Form 001: | MLGOO requirements submitted | review Application for | by beneficiaries completeness and Brgy Official’s accuracy of Death Benefit documentary Claim with requirements supporting submitted by the documents: beneficiaries of 1. Death deceased barangay | certificate | official/s; transmits issued bythe | the same to the RO LCR | for HUCand 2. Authenticated | Provincial Office for Marriage | C/MLGOO on or Certificate if | i ___|_before the 4th | claimantis | DILG-CAR GMS. —— DIES SAR SNS CONTROLLED COPY, 7)QUALITY DILG - CORDILLERA ADMINISTRATIVE REGION QP-CAR-LGMED-05 Lae PROCEDURE (QP) TooLi7 | 20f05 [ step | Responsible | proce iv Detail: References | No. | Personnel Process/Activity cod i working day ofthe | spouse ensuing month Cross-check the names of the DBOs in the BOIS to know ifthe DBO is incumbent or not and to validate correctness of indicated name, position, Barangay 3. Authenticated Birth Certificate if claimant is parent or | children | | whichever is applicable 4. Any valid ID of the claimant | B. DBC Form 002: served and date of | Transmittal/ | death Indorsement & | supporting | | + Ifno discrepancy documents (ies), proceed to | Step 2 Cc. Logbook/ | | + Ifwith discrepancy/ | logsheet | incomplete | | documents, advise | | beneficiaries | | concerned to | comply with the lacking documents | 2 | PO Admin Receives documents [+ Record receiptof | DBC Form 002: Aide from MLGOO documents and Transmittal/ routes to PFP by the | Indorsement & receiving clerk supporting documents 3 | Provincial Reviews completeness |= Cross-check the Focal Person of documents names of the DBOs | Documentary in the BODS to requirements; confirm ifthe DBO | BODS; DBC is incumbent or not, | Logbook mr DULG CAR OMS er, CONTROLLED —. A and to validate correctness of indicated name, position, Barangay served and date of death DBC Form 001;DILG - CORDILLERA ADMINISTRATIVE REGION QUALITY PROCEDURE (QP) _for his approval Division Chief for review. forwards to Regional Director step | Responsible | ‘Nor_| “Personnel Process/Activity Details _References 4 | Provincial/ | Accomplish DBC Form |= Prepare transmittal |+ Duly HUC Focal 003-A for c/province letter; accomplished Person and DBC Form 003-B for | __ Accomplished DBC DBC Form HUC Form 003-A/ 003-A for transmittal letter municipality for review by PM& | and DBC Form signature of PD 003-B for city; + Submit Transmittal accomplished DBC Letter Form 003-A/Bto | RO on or before the 4th working day of 4 E the ensuing month. ae 5 | Regional Receive the documents |* Recordreceiptof |* Duly Records from the documents and accomplished Officer Provincial/HUC Office | routes to LGMED DBC Form 003-4; Transmittal | = a : Letter 6 | Regional Focal Receive the + Receive the [+ Accomplished i Person accomplished DILG- accomplished DILG- | DILG-NBOO NBOO NBOO DBC Form DBC Form DBC Form 003-A /B 003-A/B 003-A/B | + Record in the + DBC Process | Process Summary Summary if a Logbook Logbook 7 | Regional Focal | Cross checknames of |* Cross-check the Person DBOs in the BODS names of the DBOs in the BODS to confirm ifthe DBO is incumbent or not, and to validate correctness @ | Regional Focal | Prepare the DBC Form |* Prepare the DBC | Person 004 Form 004 + Forwards DBC Form 004 to LGMED DILG-CAR ANS. CONTROLLED CO. /, tODILG - CORDILLERA ADMINISTRATIVE REGION QUALITY PROCEDURE (QP) Step | Responsible Process/Activity Details References No. | Personnel a Es Regional Focal Person scans and photocopies documents for record purposes. ‘The original copy is sent to NBOO through the records section on or before | | the 15th day of the | | ensuing month; 1 | copy is retained by the Regional Focal | Person; and another copy is provided to | the Division |___Records Officer, 9 | Regional Focal Retain Records | * Update the DBC + Process Person Process Summary Summary | Logbook | Logbook + Controlof | + Maintain records in Records | | accordance with the Procedure | Controlof Records |* Masterlist of | Procedure and Records | | Masterlist of | | Records _ | Definition of Terms: © DBC Form No. 004 (Regional Consolidated List for Deceased Barangay Officials - used by the ROs to consolidate regional death benefit claims sent by the Provincial Offices. It is transmitted to NBO for crosschecking and verification of deceased barangay officials in the Barangay Officials Database System and the Database of Paid and Database of Funded Death Benefit Claims. © DBC Form No, 003-A (Provincial Consolidated List of Deceased Barangay Officials) submitted by the provincial offices to RO for consolidation and submission to NBOO for funding. * DBC Form No. 003-B ( HUC Consolidated List of Deceased Barangay Officials) submitted by the highly urbanized city office to RO for consolidation and submission to NBOO for funding. © Barangay Offcials’s Information Sheet (BOIS) form duly accomplished by newly-elected and re-elected barangay officials upon his/her assumption to duty and filedat the DILG HUC, ICC, CC and Municipal Office. PILG-CAR ANEDILG- CORDILLERA ADMINISTRATIVE REGION QUALITY joo117 | 30ft5 | Barangay Officials Database System (BODS) used in crosschecking and verifying the records of incumbent deceased barangay officials during the processing of death benefit claim. Legal References: ‘e Executive Order (EO) 115: issued by former President Gloria Macapagal Arroyo on August 5, 2002 entitled “Authorizing Payment of Death Benefits to Barangay Officials who Die During their Term of Office."It authorizes the DILG to “determine the amount and administer the payment of the death benefits of barangay officials who die during their term of office chargeable against the fund appropriated in the General Appropriations Act for the purpose DILG MC 2008-124 dated August 21, 2008: Revised Rules and Regulations and Implementing £0 115. a Ye | DANILO E. AZARCON, JR. y | EVELYN B. TRINIDAD | MA LARINGAN Deputy Quafity Process Owner Management Ee Top Management Representative ee = | CAR OMS ee PUG IEA ONS CONTROLLED COPY. A‘ttachmont "A" DILG -NBOO DBC Form 001 APPLICATION FOR BARANGAY OFFICIAL'S DEATH BENEFIT CLAIM Instructions: This form shall be accomplished by the claimants and submit immediately to the DILG Provincia/City Office. NAME OF BARANGAY OFFICIAL: POSITION: BARANGAY: CITY/MUNICIPALITY: PROVINCE: DATE OF APPOINTMENT: a DALE OF DEAIH : ATTACHED A CERTIFIED TRUE COPY OF DEATH CERTIFICATE: CIGNATIIRE VER PRINTED NAME OF C1 ATMANT DATE ACCOMPLISHED PILG-CAR “CONTROLLED COPY,Attachment "8" DILG-NBOO DBC Form 002 Date Dear. We are submitting herewith is the application for death benefit claims of the beneficiary/ beneficiaries of the following deceased barangay officials ame of the Deceased Barangay Officials Name of Beneficiaries Very truly yours, City Director/CLGOOIMLGOO Attachment: 1 Accomplished Application Form 2 Certified True copy of Death Certificate 3 Xerox copy of Identification Card of beneficaries/Certification from Barangay ——RUIS-CAR OWS CONTROLLED COPY < J‘tachment °C ite -NBOO DBC Form 003A PROVINCIALICITY CONSOLIDATED LIST OF DECEASED BARANGAY OFFICIALS REGION: PROVINCEICITY: NO. NAME POSITION CITYIMUNICIPALITY BARANGAY DATE OF DEATH | __ AMOUNT 1 L Er Certified Correct: DILG-CAR GMS. CONFROLLED COPY DILG Provincial DirectorAttachment "D" DILG -NBOO DBC Form 002-8 HUC CONSOLIDATED LIST OF DECEASED BARANGAY OFFICIALS REGION: city: NO. NAME POSITION |__ CITY/MUNICIPALITY BARANGAY DATE OF DEATH ‘AMOUNT Certified Correct: ILG-CAR NS CONTROLLED COPY, AL DILG City Director‘tachment "E LG -NB0O (DBC Form 004 REGIONAL CONSOLIDATED LIST OF DECEASED BARANGAY OFFICIALS REGION: NO, NANE POSITION] PROVINCE | GITY/MUNICIPALITY | BARANGAY [DATE OF DEATH] AMOUNT : E Prepared by: CouTR | Porson Certified Comect: DILG Regional Director= ‘ite |) QUALITY Sn’ OBJECTIVE (QO) DILG - CORDILLERA ADMINISTRATIVE RE ae QO- QP-CAR-LGMED-05 ECE LE MaR OE OFFICE DILG-CAR coal PROCEDURE | processiNG OF DEATH BENEFIT CLAIMS (DBC) FOR DECEASED BARANGAY OFFICIALS | Key Performance Indicators (KPI) | | Applicable] Documents (e.g. | | Frequency of | Responsible eolaries to Function Indicator/Formula Monitoring for objective cae (if applicable) Results | Monitoring | Shestsomnary | Report, Memo, | etc) @ Process the | ©80% ofthe requests | ¢80% | Total number of requests [Monthly | eHUC/C/ | e DBC Process Issuance of | for Death Benefit received for DBC acted upon MLGOO Summary death and | Claims processed and on or before the 4" working Logsheet burial submitted by the HUC day of the ensuing month claims to to RO and C/MLGOO to x 100 claimant/ | PO onor before the 4% Total number of requests received | beneficiary | working day of the | bane ___|_ ensuing month. ‘80% of the received | ©80% | Total number of submission Monthly PO ‘© DBC Process Death Benefit Clai received for DBC acted upon Summary processed and | onor before the 4% working | Logsheet submitted by the PO to | day of the ensuing month the RO on or before es) | | the 4% working day of ‘Total number of requests received the ensuing month, ef om PILG-CAR GMS. COM ikOLLED COPY ———_—_—_—_—_—_—_—DILG- CORDILLERA ADMINISTRATIVE REGION a QUALITY | QO- QP-CAR-LGMED-05 OBJECTIVE (QO) Lo as 0 | toon} 2ot02 a Key Performance Indicators (KPI) ack | Applicable | | c rs | Documents (e.g. | | | | | Frequency of | Responsible wea | | Function Objective Target Indicator/Formula Monitoring | for Sheet, ancy (ifapplicable) Results | Monitoring | "Toe Shect, | | Report, Memo, en alan | etc.) | 80% ofthe received | 80% | Total number of submission ‘© Monthly RO | © DBC Process Death Benefit Claims received for DBC acted upon Summary processed and | | onor before the 15% day of Logsheet | submitted by the RO t the ensuing month | the NBOO on or before . x 100 | the 15 day of the | Total number of requests received | __|_ ensuing month, [ea 7 ae | | DANILO E. AZARCON, JR. iF airganc ___|___EVELYN B. TRINIDAD | Deputy Quality Management Quality Management Process Owner: Representative Representative | Top Management DELS LAR EMS ereen CONTROLLED COPY,DILG - CORDILLERA ADMINISTRATIVE REGION PROCESS QUALITY MONITORING QME- QP-CAR-L LGMED-05 _ AND EVALUATION (QME) OFFICE DILG-CAR He a PROCEDURE TITLE PROCESSING OF DEATH BENEFIT CLAIMS (DBC) FOR DECEASED BARANGAY OFFICIALS © 80% of the requests for Death Benefit Claims processed and submitted by the HUC to RO and C/MLGOO to PO on or before the 4* working day of the ensuing month. OBECTIVESTATEMENT © 80% of the received Death Benefit Claims processed and submitted by the PO to the RO on or before the 4% working day of the ensuing month. ‘® 80% of the received Death Benefit Claims processed and submitted by the RO to the NBOO on or before the 15 day of the ensuing month. CURRENT PERIOD INDICATORS [Jan | Feb | Mar | Apr | May | Jun | July | Aug | Sep | Oct [Nov | Dec| Total Objective: 80% of the requests for Death Benefit Claims processed and submitted by the HUC to RO and C/MLGOO to PO on or before the 4th working day of the ensuing month. of the ensuing month A | Total number of requests for DBC acted upon on or before the 4% working day B | Total number of requests received Formula: A_ x 100 B Target | | Result | :80% | met) Gap Analysis: (In case the objective is not met, put your analysis why it is not ee IESE OS cere CONTROLLED COPY, SRDILG - CORDILLERA ADMINISTRATIVE REGION “DILG*) PROCESS QUALITY MONITORING 'QME- QP-CAR-LGMED-05 “tees” AND EVALUATION (QME) ; : wo. Too | zara INDICATORS Jan | Feb | Mar | Apr | May | Jun | july | Aug | Sep | Oct | Nov | Dec | Total ensuing month. Objective: 80% of the received Death Benefit Clai ims processed and submitted by the PO to the RO on or before the 4% working day of the A | Total number of received DBC acted upon on or before the 4" working day 80% of the ensuing month E B | Total number of requests received [ c A Target Formula “A x100 Pee | D | Gap Analysis: (In case the objective is not met, put your analysis why it is not met) Objective: 80% of the received Death Beni ensuing month. efit Clai ims processed and submittec od by the RO to the NBOO on or befoi re the 15% day of the A | Total number of received DBC acted upon on or before the 15" day of the ensuing month Total number of requests received ale Target Formula: A. x100 Reni :80% D | Gap Analysis: (In case the objective is not met, put your analysis why it is not met) Note: For unmet targets of two (2) consecutive periods, concerned Deputy QMR initiate correction and corrective action using the Corrective Action Report (CAR) and attach it to this form. CONTROLLED CO!i », DILG - CORDILLERA ADMINISTRATIVE REGION vite :) PROCESS QUALITY MONITORING “cee” AND EVALUATION (QME) Zot | CaF aiphn A-s DANILO E. AZARCON, JR. EVELYN B. TRINIDAD ee QME- QP-CAR-LGMED-05 7 wou | Sots Deputy Quality Management Quality Management Process Owner Representative Representative Top Management DILG-CAR GNS eee PEG EES ee CONTROLLED CO! |DILG-CORDILERA ADMINISTRATIVE REGION ) PROCESSING OF DEATH BENEFIT CLAIMS (DBC) FOR DECEASED BARANGAY OFFICIAL Process Summary Logsheet (PSL) FM-OP-CARAGMED.O5-01 onecTwenssut Date wane a (Dat coca Rael Otel Forde o NEDO) Reterence’ | goatee | Barangay! Municip! ate Forwante | 8 bape N° | Cont’ Ho. : Province) = ‘ono | forwases OCT roueret [RO Lev! Remarks = ecelved irdorsement ‘1800 Complete | supmiied to Taat | et] Met | vot | Mat] vo} ete Reason Po tor Action Met Mat teat | _Tarvetts Unmet) z 2 z 5 2 Fora resuur a a a DANILO E. AZARCON, JR. TNF aL PAYANG | EVELYN B. TRINIDAD M. RINGAN Process Owner Deputy Quality Management Representative —— DILG-SAR. OME ne, CONTROLLED CO. Quality Management Representative Top ManagementRepublic of the Philippines FM-SP-CAR-01B-02 DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT font. | bee] he] CORDILLERA ADMINISTRATIVE REGION | soous7 [aot Name of Bureau/Service/Division: Local Government Monitoring and Evaluation Division MASTER LIST OF MAINTAINED EXTERNAI, DOCUMENTED INFORMATION J ___ DOCUMENT CODE DOCUMENT TITLE REVISION/EDITION [Executive Order 115 08.05.02 IDILG MC 2008-124 08.21.08. LOLLED OlFM-SP-CAR-10-01 erie [eam | — Pa Name of Bureau/Service/Division: Local Government Monitoringand Evaluation Division (LGMED) MASTER LIST OF RETAINED DOCUMENTED INFORMATION FILING SYSTEM RETENTION PERIOD DOCUMENT CODE DOCUMENT TITLE CUSTODIAN | LOCATION FOLDER | SCHEME [AcTIvE|sToRaG|_ ToTAL| DISPOSAL Regional Death Benefit Claim RequesttoNBOO] DEA] [Shelf 1, Layer 1, Mega | Sequentialby | PerVear | 1VYear| 2Vears] 3Vears | thruthe {for October, 2017 with the following Box 1, Folder 1 year records unit documents: (current to Transmittal Letter previous) = DBC Form 004 = DBC Form 003-A/B of 6 provinces and 1 HUC Regional Death Benefit Claim Requestto NBOO | DEA) _|shelf 1, Layer 1, Mega for November, 2017 with the following Box 1, Folder 1 documents: + Transmittal Letter = DBC Form 004 - DBC Form 003-A/B of 6 provinces and 1 HUG, Regional Death Benefit Claim Request to NBOO | DEA) | Shelf, Layer 1, Mega for December, 2017 with the following Box 1, Folder 1 documents: ~ Transmittal Letter = DBC Form 004 = DBC Form 003-A/B of 6 provinces and 1 HUC Regional Masterlist of Deceased Barangay DEAI |Shelf 1, Layer 1, Mega | Sequential by | Per Year | 1year |permane| NA NA officials Box 1, Folder 2 year nt