Areas Affected - refers to the areas or communities affected by displacement, which may include the host communities. Identify the Province, City/Municipality and Barangays. Use Form 1-A1 for additional areas affected. Prepared by and Date – refers to the name and signature of a member/s of the CHR Monitoring Team (COMT, RIT, or RMT) who conducted and prepared the report. Date – refers to the date when the report was submitted. Verified by and Date – refers to the name and signature of the Monitoring Team leader (MT-leader) assigned to monitor displacement. Date – refers to the date when the MT-leader verified the report. 12