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REPUBLIC OF THE PHILIPPINES rime:
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT ee, ol
DILG-NAPOLCOM Center, EDSA comer Quezon Avenue, West Triangle, Quezon Ci!09 ry
http: / [wedi gov.ph
GUIDELINES IN MONITORING THE FUNCTIONALITY OF
LOCAL COMMITTEES ON ANTI-TRAFFICKING AND
VIOLENCE AGAINST WOMEN AND THEIR CHILDREN (LCAT-VAWC)
Memorandum Circular N 006
Date: 20 JAN 207/
BACKGROUND
1.1 The State values the dignity of every human person and guarantees full respect for
human rights. Hence, the State shall undertake measures to protect the people from
any form of violence and exploitation, and eliminate trafficking in persons (TIP)
and violence against women and their children (VAWC).
12 Pursuant to this policy, Republic Act (RA) No. 9208 or the Anti-Trafficking in
Persons Act of 2003, as amended by RA No. 10364 or the Expanded
Anti-Trafficking in Persons Act of 2012 was enacted to give highest priority to the
enactment of measures and development of programs and services that will promote
human dignity, protect the people from any threat of violence and exploitation,
eliminate TIP, and mitigate pressures for involuntary migration and servitude of
persons, not only to support trafficked persons but more importantly, to ensure their
recovery, rehabilitation and reintegration into the mainstream of society.
1.3. Further, RA No. 9262 or the Anti-Violence Against Women and Their Children Act
of 2004 was enacted to protect the family and its members particularly women and
children, from violence and threats to their personal safety and security.
1.4 To implement the provisions of these Acts, the Department of the Interior and Local
Government (DILG), Department of Social Welfare and Development (DSWD),
and Department of Justice (DOJ) issued Joint Memorandum Circular (JMC) No.
2010-1 dated 18 October 2010, entitled, “CREATION OF LOCAL COMMITTEES.
ON ANTI-TRAFFICKING AND VIOLENCE AGAINST WOMEN AND THEIR.
CHILDREN (LCAT-VAWC)” which provides for the basic standards in the
creation of a mechanism that will collaboratively address the problem of TIP and
VAWC at the local level.
1.5. Afer the issuance of the JMC, the functionality of said committees is yet to be
determined. Hence, there is a need to assess the performance of LCAT-VAWC to
serve as basis for policy and capacity development to strengthen the capability of
LGUs in combating TIP and eliminating violence against women and children.
SM OFFICIAL 4,
RELEASED’
s
Yor2.0
40
PURPOSE
‘The Guidelines is intended to provide the local government units (LGUs) and other
concemed entities with a tool to assess the functionality of and strengthen the
LCAT-VAWC as the primary mechanism to address TIP and VAWC.
SCOPE/COVERAGE
This Guidelines shall cover all Provincial Governors, City/Municipal Mayors,
BARMM Minister of Local Government, DILG Regional Directors and Field Officers,
and others concerned.
POLICY CONTENT AND GUIDELINES
4.1 Functionality Indicators of LCAT-VAWC
The functionality of LCAT-VAWC shall be assessed in the following areas:
1. Organization
2. Meetings
3. Policies, Plans and Budget
4, Accomplishments,
4.1.1. Organization
‘The LCAT-VAWC shall be organized at the provincial, city and municipal
levels, through an executive order or other similar issuances, in accordance
with IMC No. 2010-1.
Composition of Provincial Committee on Anti-Trafficking and
Violence Against Women and their Children (PCAT-VAWC)
Provincial Governor
Provincial Planning and Development Coordinator
Provineial Social Welfare and Development Officer
Provincial Health Officer
Chairperson of the Committee on Women, Children and Family,
Sangguniang Panlalawigan
Provincial Public Employment and Services Officer
Provincial Schools Superintendent, DepEd
Field Office Director, CSC
Provincial Prosecutor, DOJ
Provincial Director, DILG
Provincial Director, PNP
NGO Representatives of the following sectors:
1. Women
2. Children
3. Overseas Filipino Workers4.12,
4.13.
Composition of City/Municipal Committee on Anti-Trafficking and
Violence Against Women and their Children (C/MCAT-VAWC)
City/Municipal Mayor
City/Municipal Planning and Development Coordinator
City/Muunicipal Social Welfare and Development Officer
City/Municipal Health Officer
Chairperson of the Committee on Women, Children and
Family, Sangguniang Panlungsod/Bayan
City/Municipal Public Employment Services Officer
City/Municipal Prosecutor
City Director/City/Municipal Local Government Operations Officer
City/Municipal Chief of Police
NGO Representatives of the following sectors:
1. Women
2. Children
3. Overseas Filipino Workers
Meetings
‘The LCAT-VAWC shall conduct regular quarterly meetings. Special
meetings may be conducted when necessary.
The agenda of such meetings shall include, but not limited to, the
development and implementation of policies/programs/projects/activities
(PPPAs) relative to the promotion, protection, and fulfillment of women’s
and children’s rights specially those who are victim-survivors of TIP and
VAWC.
‘The meetings conducted shall be supported by Minutes of Meetings duly
signed by the Secretariat Head, Notices of Meetings, Attendance Sheets and
pictures (if available).
Policies, Plans, and Budget
4.13.1. Policies
Policies refer to LGUs’ executive and legislative issuances to
protect people from any form of TIP and VAWC and provide
Support to trafficked persons and VAWC victim-survivors.
4.13.2. Plans and Budget
The LCAT-VAWC Annual Work and Financial Plan (AWFP)
may include, but not limited to, the following activities:
a. Maintain database on cases of TIP and VAWC;
‘b. Undertake information, education and advocacy campaign
against TIP and VAWC;
3. Conduct capacity-building programs for all stakeholders
involved in handling TIP and VAWC cases;
4. Provide services to trafficked persons and VAWC
victim-survivors, including services that respond to their
special needs, interests and concerns;
. Create and establish systems on surveillance, investigation and
Tescue to ensure effective and efficient coordination; and
£. Institute policies and programs to protect women and children
who are victims of trafficking and violence (formulate local
ordinances and resolutions).
LCAT-VAWC’s AWFP shall be submitted to the LGU concemed
for inclusion in the Local Development Investment Program/Annual
Investment Program to ensure its funding.
4.1.4. Accomplishments
The accomplishment report of LCAT-VAWC shall include the activities
undertaken based on the approved AWFP.
4.2 Creation of Inter-Agency Monitoring Team (IMT)
4.2.1 The IMT shall be created in every region and province to monitor and
assess the functionality of LCAT-VAWC.
Provincial IMT Composition
Chairperson : DILG Provincial Focal Person
Members: Provincial Social Welfare & Development Office
five
representati
Provincial Prosecutor’s Office representative
Provincial Health Office representative
PNP Provincial Office Representative
One (1) representative from any of the
Provincial LGU-accredited/recognized civil society
organizations on women, children or Overseas
Filipino Workers
Regional IMT Composition
Chairperson : DILG Regional Focal Person
Members: DSWD Regional Office representative
DOJ Regional Prosecutor’s Office representative
DOH Regional Office representattive
PNP Regional Office representative
‘One (1) representative from any NGO/CSO member of
RCAT-VAWG, if available43 IMT Duties and Responsibilities
43.1
43.2
‘The Provincial IMT shall:
a. Assess the City/Municipal Committee on Anti-Trafficking and Violence
Against Women and their Children (C/MCAT-VAWC) based on the
documents presented using LCAT-VAWC Form No. 1;
b. Discuss with the concemed city/municipal mayors the outcome of the
assessment and provide recommended actions to address issues
concerning the functionality of C/MCAT-VAWC; and
¢. Consolidate and submit report using the LCAT-VAWC Form No. 3, in
soft and hard copies, to Regional IMT not later than April 15 of every
year.
The Regional IMT shall:
a Assess — Provincial/Highly-Urbanized City Committee on
Anti-Trafficking and Violence Against Women and their Children
(P/HUCCAT-VAWC) based on the documents presented using
LCAT-VAWC Form No. 2;
b. Discuss with the concemed governors and city mayors the outcome of
the assessment and provide recommended actions to address issues
concerning the functionality of P/HUCCAT-VAWC; and
¢. Consolidate and submit report using LCAT-VAWC Form Nos. 4 and 5,
in soft and hard copies, to DILG Central Office through the National
Barangay Operations Office (NBOO) not later than May 15 of every
year.
4.4 Documents to be presented to IMT
441
‘The Provincial/City/Municipal Committee on Anti-Trafficking and
Violence Against Women and their Children shall present copies of the
following documents to IMT:
a. Ordinance/Resolution/Executive Order organizing the
P/C/IMCAT-VAWC;
b. Minutes of Meetings duly signed by the Secretariat Head, Notices of
Quarterly and Special Meetings with Agenda, Attendance Sheets
certified by the Secretariat Head, and Pictures (if available);
©. Approved LCAT-VAWC AWFP;
4d. Approved AIP reflecting PPPAs to address TIP and VAWC;
©. Post-Activity Report/s on the capacity-building activities conducted;nm
Post-Activity Report/s on the information, education and advocacy
campaign activities conducted;
8. Data of all TIP and VAWC cases and mandatory services provided to
trafficked persons and VAWC victim-survivors;
h. Ordinance / Resolution / Executive Order / Guidelines to protect
trafficked persons and VAWC victim-survivors;
i. Ordinance appropriating funds for the implementation of the
P/CIMCAT-VAWC AWFP;
J. Semestral Accomplishment Reports submitted to PCAT-VAWC by
C/MCAT-VAWC or RCAT-VAWC by PCAT-VAWC and
HUCCAT-VAWC; and
k. Annual Report, Newsletter, Minutes of Meeting, Website Post, etc.
reflecting LCAT-VAWC accomplishments.
4.5 Allocation of Funds for Monitoring
Funds for monitoring the LCAT-VAWC functionality shall be charged against
LGU budget, subject to the usual accounting and auditing rules and regulations.
46 Indicator and Rating
4.6.1. The functionality of LCAT-VAWC shall be rated in the following areas:
INDICATOR
RATING
10%
Organization
‘@. LCAT-VAWC is organized
* Yes (5%)
# No (0%)_
%
¢|
Composition of LCAT-VAWC isin accordance with
JMC No. 2010-1 (Creation of Local Committees on
Anti-Trafficking and Violence Against Women and Their Children)
= Yes (5%)
= No (0%)
Bonus points: Add 2% for expanded membership other than the
prescribed members per JMC 2010-1
Meetings
10%
‘a. Regular Quarterly Meetings conducted
* 4 regular quarterly meetings (10%)
* 3 regular quarterly meetings (7.5%)
= 2 regular quarterly meetings (5.0%)
* 1 regular quarterly meeting (2.5%)
* No regular meeting conducted (0%)
Bonus points: Add 1% if there is Special Meeting conducted
10%INDICATOR
RATING
Policies, Plans, and Budget
30%
a. LCAT-VAWC Annual Work and Financial Plan (AWFP) reflecting
PPPAs to address TIP and VAWC developed
= Yes (10%)
= No (0%)
10%
b. Approved LCAT-VAWC AWFP is integrated in the Annual
Investment Program of the LGU
* Yes (10%)
= No (0%)
10%
. Policy to protect trafficked persons and VAWC victim-survivors
formulated by LCAT-VAWC.
* Yes (10%)
= No (0%)
10%
‘Accomplishments
50%
‘a. Database on TIP and VAWC cases is maintained and updated
* Yes (10%)
= No (0%)
10%
’. Information, education and advocacy campaign against TIP and
VAWC conducted
* Yes (10%)
= No (0%)
10%
¢. Capacity-building activities for all stakeholders involved in
handling TIP and VAWC cases conducted
# Yes (15%)
* No (0%)
15%
d. Mandatory services provided to trafficked persons and VAWC
victim-survivors such as, but not limited to, psycho-social
services/counselling, medical, legal, education or livelihood
assistance, skills training, and emergency/temporary shelter are
monitored
* Yes (5%)
* No (0%)
3%
e. Semestral accomplishment reports submitted to PCAT-VAWC by
C/MCAT-VAWC or RCAT-VAWC by HUCCAT-VAWC and
PCAT-VAWC
* 2 semestral reports (5%)
* 1 semestral report (2.5%)
* No semestral report (0%)
5%
£ Accomplishments of LCAT-VAWC are reflected in the LGU
annual report, newsletter, website, etc. or presented/discussed
during meetings or other similar activities
5%INDICATOR. RATING
= Yes (5%)
= No (0%)
‘Bonus points: Add 2% for two (2) or more relevant PPAs fully
implemented, or 1% for one (1) relevant PPA fully implemented
TOTAL | 100%
or more,
ifthere
are bonus
_points
4.7 Level of Functionality
4.7.1 The level of functionality of LCAT-VAWC shall be described as follows:
Basic —if the LCAT-VAWC obtained a rating of 20% and below
Progressive — if the LCAT-VAWC obtained a rating of 21% to 50%
© Mature —if the LCAT-VAWC obtained a rating of 51% to 80%
Ideal ifthe LCAT-VAWC obtained a rating of 81% and above
48 Period Covered and Frequency of Assessment
The monitoring of LCAT-VAWC functionality shall be conducted annually or
every 1% quarter of every year starting CY 2020. The period to be assessed shall be
the previous year.
5.0 REFERENCES
5.1. The monitoring of LCAT-VAWC functionality is supported by the provisions
of the following:
5.1.1. DILG-DOJ-DSWD Joint Memorandum Circular No. 2010-1 dated
October 18, 2010 entitled “Creation of Local Committees on
Anti-Trafficking and Violence Against Women and their Children
(LCAT-VAWC)”
5.1.2. Performance Standards Assessment Tools for Services Addressing Violence
Against Women in the Philippines (Services of Local Government Units),
Department of the Interior and Local Government, Local Government
Units, National Commission on the Role of Filipino Women and United
Nations Population Fund 2008
5.1.3. Republic Act No. 7610 (Special Protection of Children Against Abuse,
Exploitation and Discrimination Act)
5.1.4. Republic Act No. 9208 (Anti-Trafficking in Persons Act of 2003), as,
amended by Republic Act No. 10364 (Expanded Anti-Trafficking in
Persons Act of 2012)5.1.5. Republic Act No. 9262 (Anti-Violence Against Women and Their Children
Act of 2004)
6.0 ANNEXES
70
8.0
6.1.
62.
63.
Annex “A” LCAT-VAWC Form No. 1: City/Municipal Committee on
Anti-Trafficking and Violence Against Women and their Children Functionality
Assessment Form
Annex “B” LCAT-VAWC Form No. 2: Provincial Committee on Anti-Trafficking
and Violence Against Women and their Children Functionality Assessment Form
Annex “C” LCAT-VAWC Form No. 3: Provincial Consolidated Report on the
Functionality Level of the City/Municipal Committee on Anti-Trafficking and
Violence Against Women and their Children
64. Annex “D” LCAT-VAWC Form No. 4: Regional Consolidated Report on the
65.
Functionality Level of the Provincial/ City/Municipal Committee on Anti-
‘Trafficking and Violence Against Women and their Children
Annex “E” LCAT-VAWC Form No. 5: Regional Summary on the Functionality
Level of the Provincial/City/Municipal Committee on Anti-Trafficking and
Violence Against Women and their Children
EFFECTIVITY
This Memorandum Circular shall take effect immediately.
MONITORING AND SUBMISSION OF ASSESSMENT REPORT
8.1.
8.2.
83.
8.4,
The DILG Regional Directors and Field Officers shall facilitate and Provide
necessary technical assistance in the implementation of this Memorandum Circular.
The DILG Regional Office shall submit the accomplished DILG NBOO
LCAT-VAWC Form Nos. 4 and 5, in soft and hard copies, to NBOO through email
address:
[email protected] not later than May 15 of every year.
‘NBOO shall oversee the overall annual monitoring of LCAT-VAWC functionality.
It shall see to it that the process and requirements are faithfully adhered to, and that
documents submitted are complete. Further, it shall be responsible in the
maintenance and updating of database of the National Summary of LCAT-VAWC
functionality.
To facilitate these tasks, monitoring sheets shall be developed and made available
in a google drive, Link to the online facility shall be provided accordingly.
Further, the Community Capacity Development Division (CCDD) of NBOO shall
monitor the progress and take appropriate action to address concems along the
process, notify DILG Regional Offices concerning incidence of non-compliance,
whenever necessary.9.0 APPROVING AUTHORITY
Seoretaryy
10. FEEDBACK
For related inquiries, please contact NBOO-CCDD at telephone no, (02) 876-3454
local nos. 4403 and 4404 or send email to:
[email protected].
10*” DILG-NBOO * ANNEX A
“LCAT-VAWC ‘Form I:
CITY/MUNICIPAL COMMITTEE ON ANTI-TRAFFICKING AND
VIOLENCE AGAINST WOMEN AND THEIR CHILDREN
FUNCTIONALITY ASSESSMENT FORM
City/Municipality:
Province:
Region:
‘Year Under Review:
Functionality Level:
INDICATOR, RATING
‘Organization 10%
‘a LCAT-VAWC is organized 3%
* Yes (5%)
= No (0%)
6. Composition of LCAT-VAWC is in accordance with JMC No. 2010-1 (Creation of | 5%
Local Committees on Anti-Trafficking and Violence Against Women and Their
Children)
# Yes (5%)
= No (0%)
Bonus points: Add 2% for expanded membership other than the prescribed members
|__per JMC 2010-1
‘Meetings 10%
‘a. Regular Quarterly Meetings conducted 10%
* 4 regular quarterly meetings (10%)
* 3 regular quarterly meetings (7.5%)
* 2 regular quarterly meetings (5.0%)
* 1 regular quarterly meeting (2.5%)
* No regular meeting conducted (0%)
Bonus points: Add 1% if there is Special Meeting conducted
Policies, Plans, and Budget 30%
‘« LCAT-VAWC Annual Work and Financial Pian (AWFP) reflecting PPPAs to address | 10%
TIP and VAWC developed
Yes (10%)
= No (0%)
b. Approved LCAT-VAWC AWFP is integrated in the Annual Investment Program of | 10%
the LGU
= Yes (10%)
= No (0%)
©. Policy to protect trafficked persons and VAWC victim-survivors formulated by | 10%
LCAT-VAWC
Yes (10%)
* No (0%)
‘Accomplishments 50%
‘a. Database on TIP and VAWC cases is maintained and updated 10%
# Yes (10%)
© No (0%) _INDICATOR
RATING
Information, education and advocacy campaign against TIP and VAWC conducted
# Yes (10%)
= No (0%)
10%
‘e. Capacity-building activities for all stakeholders involved in handling TIP and
‘VAWC cases conducted
* Yes (15%)
= No (0%)
15%
‘@._ Mandatory services provided to trafficked persons and VAWC victim-survivors such
as, but not limited to, psycho-social services/counselling, medical, legal, education or
livelihood assistance, skills training, and emergency/temporary shelter are monitored
# Yes (5%)
= No (0%)
3%
. Semestral accomplishment reports submitted to PCAT-VAWC (or RCAT-VAWC for
HUCs)
= 2 semestral reports (5%)
* 1 semestral report (2.5%)
= No semestral report (0%)
%
Accomplishments of LCAT-VAWC are reflected in the LGU annual report,
newsletter, website, etc. or presented/discussed during meetimgs or other similar
Yes (5%)
= _No (0%)
3%
‘Bonus points: Add 2% for two (2) or more relevant PPAs fully implemented, or 1% for
one (1) relevant PPA fully implemented
TOTAL
Assessed by Provincial IMT:
Name Offfice/Agency Signature
Chairperson
Member
Member
‘Date Assessed:. DILG-NBOO ‘ANNEX B
“LCAT-VAWC Form 2
PROVINCIAL/HIGHLY-URBANIZED CITY COMMITTEE ON
ANTI-TRAFFICKING AND VIOLENCE AGAINST WOMEN AND THEIR:
CHILDREN FUNCTIONALITY ASSESSMENT FORM
Province:
Region:
‘Year Under Review:
Functionality Level
INDICATOR RATING
tion 10%
a. LCAT-VAWC is organized 5%
= Yes (5%)
# No (0%)
. Composition of LCAT-VAWC is in accordance with IMC No. 2010-1 (Creation of | 5%
Local Committees on Anti-Trafficking and Violence Against Women and Their
Children)
= Yes (5%)
= No (0%)
Bonus points: Add 2% for expanded membership other than the prescribed members
|__per JMC 2010-1
10%
Meetings
‘a. Regular Quarterly Meetings conducted 10%
* 4 regular quarterly meetings (10%)
* 3 regular quarterly meetings (7.5%)
* 2 regular quarterly meetings (5.0%)
* 1 regular quarterly meeting (2.5%)
* No regular meeting conducted (0%)
Bonus points: Add 1% if there is Special Meeting conducted
Policies, Plans, and Budget 30%
‘a. LCAT-VAWC Annual Work and Financial Plan (AWFP) reflecting PPPAs to address | 10%
TIP and VAWC developed
*# Yes (10%)
* No (0%)
B. Approved LCAT-VAWC AWFP is integrated in the Annual Investment Program of the | 10%
LGU
= Yes (10%)
= No (0%)
. Policy to protect trafficked persons and VAWC victim-survivors formulated by| 10%
LCAT-VAWC
"Yes (10%)
#No (0%),
‘Accomplishments 30%
‘a. Database on TIP and VAWC cases is maintained and updated 10%
= Yes (10%)
= No (0%)5 : INDICATOR RATING
“|b, Information, education and advocacy campaign against TIP and VAWC conducted 10%
= Yes (10%)
= No (0%)
‘e. Capacity-building activities for all stakeholders involved in handling TIP and VAWC | 15%
cases conducted
* Yes (15%)
= No (0%)
‘d. Mandatory services provided to trafficked persons and VAWC victim-survivors such | 5%
as, but not limited to, psycho-social services/counselling, medical, legal, education or
livelihood assistance, skills training, and emergency/temporary shelter are monitored
= Yes (5%)
= No (0%),
. Semestral accomplishment reports submitted to RCAT-VAWC 3%
* 2 semestral reports (5%)
* 1 semestral report (2.5%)
= No semestral report (0%)
£ Accomplishments of LCAT-VAWC are reflected in the LGU annual report, 3%
newsletter, website, etc. or presented/discussed during meetings or other similar
activities
= Yes (5%)
= No(0%)
‘Bonus points: Add 2% for two (2) or more relevant PPAs fully implemented, or 1% for
cone (1) relevant PPA fully implemented
TOTAL
Assessed by Regional IMT:
Name Offfice/Agency Signature
Date Assessed:DILG-NBOO
“LEAT-VAWC Form 3
ANNEX C
PROVINCIAL CONSOLIDATED REPORT ON THE FUNCTIONALITY LEVEL OF
THE CITY/MUNICIPAL COMMITTEE ON ANTI-TRAFFICKING AND
VIOLENCE AGAINST WOMEN AND THEIR CHILDREN
Functionality Level Remarks
Tdentified Issues and Concerns (if any)
Recommended Actions Required from the
National Government Agencies
Prepared by: Submitted by:
Provincial Focal Person Provincial Director
Date Submitted:DILG-NBOO an ANNEX D
“LEAT-VAWC Form 4
REGIONAL CONSOLIDATED REPORT ON THE FUNCTIONALITY LEVEL OF
‘THE PROVINCIAL/CITY/MUNICIPAL COMMITTEE ON ANTI-TRAFFICKING
AND VIOLENCE AGAINST WOMEN AND THEIR CHILDREN
Region:
Year Under Review:
Province City/Municipality | Rating | Functionality | Remarks
Level
Tdentified Issues and Concerns (if any) Recommended Actions Required
from the National Government
Agencies
Prepared by: Submitted by:
Regional Focal Person Regional Director
Date Submitted:DILG-NBOO
LCAT-VAWC Form 5 ANNEX E
REGIONAL SUMMARY ON THE FUNCTIONALITY LEVEL OF THE PROVINCIAL/CITY/MUNICIPAL COMMITTEE ON ANTI-TRAFFICKING
AND VIOLENCE AGAINST WOMEN AND THEIR CHILDREN
Region:
Year Under Review:
‘A. Provinces
NO.OF — | NO. OF PROVINCES | % OF PROVINCES FUNCTIONALITY LEVEL REMARKS:
PROVINCES ASSESSED ASSESSED IDEAL MATURE _ | PROGRESSIVE BASIC
No. % | No. % | No. % No. %
B._Cities (HUC/ICCICC)
NO. OF NO. OF CITIES % OF CITIES _ FUNCTIONALITY LEVEL REMARKS
cITies ‘ASSESSED. ASSESSED IDEAL MATURE — | PROGRESSIVE BASIC
No. | % | No] % | No. % No. %
NO. OF NO. OF % OF FUNCTIONALITY LEVEL REMARKS
MUNICIPALITIES | MUNICIPALITIES | MUNICIPALITIES [~ IDEAL MATURE | PROGRESSIVE
ASSESSED ASSESSED No] Ne) TN. %
Prepared by: Submitted by: Date Submitted:
Regional Focal Person Regional Director