VAW Desk Form 5
VAW Desk Form 5
VAW Desk Form 5
Barangay: ________________________
City/Municipality: _________________
Province: ________________________
Region: __________________________
Total Population: __________________
No. of Males: _______ No. of Females: _______
No. of Adults: (18 years old and above) No. of Minors: (Below 18 years old)
Nature of Case Total Total No. of Cases Referred Total No. Total
No. of C/MSWDO PNP Court Hospital Others of Victims No. of
Victims (i.e. NBI, PAO, etc.) Who BPOs
Applied Issued
for BPO
Violence Against
Women and their
Children
(RA 9262)
Physical
Sexual
Psychological
Economic
Rape (RA 8353)
Trafficking in
Persons
(RA 9208/10364)
Sexual Harassment
(RA 7877)
________________________ ______________________
Barangay VAW Desk Person Punong Barangay
Date: ___________________
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