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PHILHEALTH INITIAL LIST (Attach to PhilHealth Form Er1)
REPORT OF EMPLOYEE-MEMBERS SUBSEQUENT LIST

NAME OF EMPLOYER/FIRM: A-1 DRIVING COMPANY, INC. EMPLOYER NO. 2004-7430-9903

ADDRESS: #2 STA LUCIA ST., BRGY. PLAINVIEW, MANDALUYONG CITY E-MAIL ADDRESS: deocancel.antonie@yahoo.com.ph
PHILHEALTH DATE OF (DO NOT FILL)
EFF. DATE OF PREVIOUS EMPLOYER
SSS/GSIS NAME OF EMPLOYEE POSITION SALARY EMPLOY-
COVERAGE ( IF ANY)
NUMBER MENT

02-026529728-6 MERCADO, IAN MARCO DE PURCHASING 13,962 12/06/2018

LEON

TOTAL NO. LISTED ABOVE: 1 ALJUN C. GARCIA

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