Scribd Logo
Upload

Welcome to Scribd!

  • Ara Form D

    Uploaded by

    Karissa
    1K views1 page
    This document provides instructions for an agency remittance advice form. It explains that Form D is a list of employees who have not had premiums remitted for their membership in the agency for two consecutive months. The form includes fields for each employee's member number, name, suffix, middle initial, reason for lack of remittance such as transfer or resignation, effective date, and remarks such as new office if transferred.

    Original Description:

    Hj

    Original Title

    ARA-FORM-D

    Copyright

    © © All Rights Reserved

    Available Formats

    XLS, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document provides instructions for an agency remittance advice form. It explains that Form D is a list of employees who have not had premiums remitted for their membership in the agency for two consecutive months. The form includes fields for each employee's member number, name, suffix, middle initial, reason for lack of remittance such as transfer or resignation, effective date, and remarks such as new office if transferred.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    1K views1 page

    Ara Form D

    Uploaded by

    Karissa
    This document provides instructions for an agency remittance advice form. It explains that Form D is a list of employees who have not had premiums remitted for their membership in the agency for two consecutive months. The form includes fields for each employee's member number, name, suffix, middle initial, reason for lack of remittance such as transfer or resignation, effective date, and remarks such as new office if transferred.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Agency Name:

    Agency BP Number:

    FOR AGENCY REMITTANCE ADVICE

    FORM D. List of employees with no premium remittance for 2 consecutive months.

    Member BP Number Last Name First Name Suffix MI Reason 1 Effectivity Date Remarks 2

    1 Reason: please specify whether transferred to other office / resigned / retired / deceased / dismissed / laid-off /
    end of term / end of contract / dropped from the rolls / suspended / on Leave without pay, etc.

    2 Remarks: in case transferred to other office, please indicate new office (if available)

    Issue No. 01, Rev No. 0, (16 August 2016), FM-GSIS-OPS-UMR-04

    You might also like