CSHP ONLINE APPLICATION

Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office IV-A

Simplified Online Application

ALL CSHP APPLICATIONS ARE FREE OF CHARGE

Owner Details

Owner of Residential/small commercial building

Region (Owner)

Province (Owner)

City/Municipality (Owner)

Barangay (Owner)

Address (Owner)

Contact No.

Email Address

Project Details

You can download Simplified CSHP Template here

Specific Name of the Project

Region (Project Location)

Province (Project Location)

City/Municipality (Project Location)

Barangay (Project Location)

Address (Project Location)

Description of the residential/small commercial building

Number of storeys

Type of Building

Female Workers

Male Workers

Number of Workers on site

Project Date Start (Estimated date of project start)

Completion Date (Date of project completion)

Project Duration (in calendar days)

Upload Letter of Intent

Upload Accomplished CSHP Template

O.R. No.(First Aid Kit) (optional)

Upload O.R. First Aid Kit (optional)

Review Details

Owner Details

Name of Owner:
Region:
Province:
City/Municipality:
Barangay:
Address:
Contact No.:
Email Address:

Project Details

Name of the Project:
Region:
Province:
City/Municipality:
Barangay:
Address:

Description of the residential/small commercial building

Number of storeys:
Type of Building:
Female Workers:
Male Workers:
Total no. of workers:
Project Date Start:
Completion Date:
Project Duration:
Letter of Intent:
Accomplished CSHP Template:
O.R. No.(First Aid Kit):
O.R. First Aid Kit file:

I HEREBY: 1)Certify the truthfulness of the above-mentioned information based on my own personal knowledge and authentic records; 2)Commit to strictly implement the herein attached construction safety and health program designed for this specific project and comply with occupational and health standard required by law; and 3)Be responsible for any accident that will happen during the construction, especially for the welfare of the workers who are employed to perform the construction activities;

CONSENT NOTICE: The Department of Labor and Employment Regional Office No. IV-A values and is committed to comply with Republic Act No. 10173 otherwise known as the Philippine Data Privacy Act of 2012 (“Data Privacy Act”) to protect and safeguard your privacy. By accomplishing this form, you signify your acceptance to provide pertinent and personal information about you or data establishment. All information that will be collected through this form will be used for the sole purpose of monitoring and fulfilling the functions of this Office. We may only keep your information until such time that we have attained the purpose by which we collect them and when the information is no longer required the DOLE RO IVA procedure will be followed to dispose of said data. Under the foregoing circumstances and to the extent permissible by applicable law. You agree not to take action against DOLE RO IVA for the disclosure and retention of your information.