Republic of the Philippines

SOCIAL SECURITY SYSTEM

http://www.sss.gov.ph

THIS IS YOUR OFFICIAL RECEIPT WHEN VALIDATED

JLL GAS STATION Reference Number: 50319004808251

ALIMANAO HILLS PENABLANCA CAGAYAN Amount Due: P13,010.00
3502 Due Date: April 30, 2019
01-1326964-4-000 Generation Date: March 20, 2019

Collection List Summary for the Month of March 2019

Total Number of Employees: 12
Breakdown of Contributions:
Social Security 12,870.00
Employee Compensation 140.00
Total 13,010.00

Grand Total Php 13,010.00

Please pay on or before the due date at any SSS accredited collecting partner or SSS Office with Tellering Facility. A penalty of 3% per month,
pursuant to Section 22 (a) of RA 1161, as amended, shall be imposed on contributions not paid within the prescribed schedule. If already paid, kindly
provide the SSS the Official/Special Bank Receipt Number, date and amount paid so that the payment will be credited to your account.
The SSS reserves the right to determine and collect the true and correct contributions due the SSS if it finds other un-remitted/underpaid/out-
of-bracket contributions during or before the period billed. Also, SSS shall conduct further verification and assessment on the details of the submitted
collection list and shall collect any balance, if any.

For inquiries, email us at member_relations@sss.gov.ph

This is a system-generated statement, signature is not needed.

Republic of the Philippines

SOCIAL SECURITY SYSTEM

http://www.sss.gov.ph

Payment Slip
JLL GAS STATION Total Amount Paid
01-1326964-4-000 March 2019 P ______________________

Cash ( ) Cheque ( ) Cheque No. ________________

Bank/Branch _______________
Bank Teller ________________
 Republic of the Philippines

SOCIAL SECURITY SYSTEM

http://www.sss.gov.ph
01-1326964-4-000 March 2019 Collection List Details
Name SS No SS EC Total Contribution
1 ALICUM, CRIZEL G 01-2682833-1 880.00 10.00 890.00
2 ARAO, ROWENA C 01-2416704-9 935.00 10.00 945.00
3 ATTABAN, JONATHAN D 34-1009655-9 990.00 10.00 1,000.00
4 BAGGAY, JHONEL M 01-2339643-9 990.00 10.00 1,000.00
5 BAUTISTA, KRISTLE B 01-2629262-4 935.00 10.00 945.00
6 DALIUAG, NORMA S 01-1004618-7 1,375.00 10.00 1,385.00
7 LAGUITAO, GRACE T 01-0821746-5 1,210.00 10.00 1,220.00
8 LUMIDO, JAYMAR B 01-2629271-8 935.00 10.00 945.00
9 LUMIDO JR, LAURO M 01-1632765-1 1,650.00 30.00 1,680.00
10 SIBBALUCA, KEINETTE B 01-1963648-8 1,045.00 10.00 1,055.00
11 SINIGUIAN, MARVIN B 01-1963646-2 1,045.00 10.00 1,055.00
12 TUNGCUL, PRISCILLA D 01-2501815-5 880.00 10.00 890.00

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