COOPERATIVE INSURANCE SYSTEM OF THE PHILLIPINES

No. 80 Malakas St.,Diliman, Quezon City

LIST OF INSURED MEMBERS

NAME OF POLICYHOLDER: San Felipe Neri Savings and Credit Cooperative

ADDRESS: #268 Rev. Aglipay St., cor. Boni Ave., Barangay Poblacion, Mandaluyong City
PLAN: GYRT

OR#/DATE 188400 5/10/2019

BS#DATE 64913 5/3/2019

PREMIUM
NO. MEMBERS' NAME BIRTHDATE AGE LIFE TERM EFFECTIVITY EXPIRY
DUE

RENEWAL
1 ARNAIZ JR YOLINO G 09/22/96 23 25,000.00 12 04/18/19 04/17/20 640.00
2 ABAD DANILO C 07/03/57 62 25,000.00 12 04/18/19 04/17/20 640.00
3 ABALA ARLENE R 08/15/62 57 25,000.00 12 04/18/19 04/17/20 640.00
4 ABALAJEN ROSA B 06/06/67 52 25,000.00 12 04/18/19 04/17/20 640.00
5 ABANTE LEONILA B 01/18/62 57 25,000.00 12 04/18/19 04/17/20 640.00
6 AFUANG CARMELA T 03/22/67 52 25,000.00 12 04/18/19 04/17/20 640.00
7 AGUILES MARY GENE F 09/29/83 36 25,000.00 12 04/18/19 04/17/20 640.00
8 ALDANASE ANGELINA S 12/06/63 55 25,000.00 12 04/18/19 04/17/20 640.00
9 ALIPASTE MARIA LUISA F 03/18/74 45 25,000.00 12 04/18/19 04/17/20 640.00
10 AMBABAG VICTORIA T 04/12/57 62 25,000.00 12 04/18/19 04/17/20 640.00
11 AMBROSIO JR ROSENDO N 09/20/67 52 25,000.00 12 04/18/19 04/17/20 640.00
12 AMIHAN ERLINDA C 09/15/61 58 25,000.00 12 04/18/19 04/17/20 640.00
13 ARCANGEL MARITES J 11/18/71 47 25,000.00 12 04/18/19 04/17/20 640.00
14 ARCILLA DAISY P 10/02/65 54 25,000.00 12 04/18/19 04/17/20 640.00
15 ARIAS GINA P 06/14/67 52 25,000.00 12 04/18/19 04/17/20 640.00
16 ARROGANTE BABYLONIA A 12/28/78 40 25,000.00 12 04/18/19 04/17/20 640.00
17 ARSOL ANICIA R 04/19/60 59 25,000.00 12 04/18/19 04/17/20 640.00
18 ATIENZA ROSEMARIE A 08/20/65 54 25,000.00 12 04/18/19 04/17/20 640.00
19 AVILA WILMA M 02/07/60 59 25,000.00 12 04/18/19 04/17/20 640.00
20 BACAL JULITO B 07/25/59 60 25,000.00 12 04/18/19 04/17/20 640.00
21 BADAYOS BELLA B 09/18/54 65 25,000.00 12 04/18/19 04/17/20 640.00
22 BAGADIONG LUCILA A 10/31/61 58 25,000.00 12 04/18/19 04/17/20 640.00
23 BALBERAN RENATO S 01/29/56 63 25,000.00 12 04/18/19 04/17/20 640.00
24 BANDIANON IMELDA C 06/08/65 54 25,000.00 12 04/18/19 04/17/20 640.00
25 BANTOG ESTER F 06/06/81 38 25,000.00 12 04/18/19 04/17/20 640.00
26 BASILIO OSCAR B 10/07/56 63 25,000.00 12 04/18/19 04/17/20 640.00
27 BAYQUIN RAQUEL N 11/26/57 61 25,000.00 12 04/18/19 04/17/20 640.00
28 BELOLO ROSITA D 12/30/58 60 25,000.00 12 04/18/19 04/17/20 640.00
29 BELOLO JR FELIZARDO D 01/03/81 38 25,000.00 12 04/18/19 04/17/20 640.00
30 BERMUNDO ANGELICA B 10/31/64 54 25,000.00 12 04/18/19 04/17/20 640.00
31 BERNARDO BRENDA R 10/03/64 55 25,000.00 12 04/18/19 04/17/20 640.00
32 BOLIVAR MARIA CRISTIN C 10/29/74 44 25,000.00 12 04/18/19 04/17/20 640.00
33 BOSITO RODA R 10/01/82 37 25,000.00 12 04/18/19 04/17/20 640.00
34 BRUCAL NERISSA B 11/11/85 33 25,000.00 12 04/18/19 04/17/20 640.00
35 CAASI GINA C 12/27/64 54 25,000.00 12 04/18/19 04/17/20 640.00
36 CABANLIG RAMONA T 10/02/62 57 25,000.00 12 04/18/19 04/17/20 640.00
37 CABISO CRISEN B 01/03/87 32 25,000.00 12 04/18/19 04/17/20 640.00
38 CAJUEVES ENDRINA C 04/22/62 57 25,000.00 12 04/18/19 04/17/20 640.00
39 CALIPUS THELMA B 03/03/60 59 25,000.00 12 04/18/19 04/17/20 640.00
40 CALLOS VERONICA V 06/05/55 64 25,000.00 12 04/18/19 04/17/20 640.00
41 CAÑEDA ALMA G 09/10/65 54 25,000.00 12 04/18/19 04/17/20 640.00
42 CANILAO ADELAIDA C 04/20/78 41 25,000.00 12 04/18/19 04/17/20 640.00
43 CANILAO MARIVIC P 03/30/69 50 25,000.00 12 04/18/19 04/17/20 640.00
44 CANUEL ELENA V 03/17/66 53 25,000.00 12 04/18/19 04/17/20 640.00
45 CAPORAL HELEN L 10/20/56 63 25,000.00 12 04/18/19 04/17/20 640.00
46 CARILLO NELSON S 07/31/66 53 25,000.00 12 04/18/19 04/17/20 640.00
47 CARILLO MARIA LINA T 09/23/63 56 25,000.00 12 04/18/19 04/17/20 640.00
48 CARTON GLENDA R 12/20/58 60 25,000.00 12 04/18/19 04/17/20 640.00
49 CASITAS NORIEL G 03/03/71 48 25,000.00 12 04/18/19 04/17/20 640.00
50 CATIVO ROWENA P 03/03/67 52 25,000.00 12 04/18/19 04/17/20 640.00
51 CAYASFON JOEFEL F 02/04/69 50 25,000.00 12 04/18/19 04/17/20 640.00
52 CHAVEZ MARISSA B 05/02/73 46 25,000.00 12 04/18/19 04/17/20 640.00
53 CHUA EDITHA N 08/18/66 53 25,000.00 12 04/18/19 04/17/20 640.00

Page 1
 PREMIUM
NO. MEMBERS' NAME BIRTHDATE AGE LIFE TERM EFFECTIVITY EXPIRY
DUE

54 COLASITO JASMIN S 11/06/73 45 25,000.00 12 04/18/19 04/17/20 640.00

55 COMPERADA ARNALDO E 08/15/61 58 25,000.00 12 04/18/19 04/17/20 640.00
56 CONSUELO EMILDA M 01/12/65 54 25,000.00 12 04/18/19 04/17/20 640.00
57 CUENCA HELEN M 12/09/65 53 25,000.00 12 04/18/19 04/17/20 640.00
58 DAGOY LEDESMA B 03/10/58 61 25,000.00 12 04/18/19 04/17/20 640.00
59 DE GUZMAN MARICEL R 12/10/74 44 25,000.00 12 04/18/19 04/17/20 640.00
60 DE LEON EDUARDO C 02/27/57 62 25,000.00 12 04/18/19 04/17/20 640.00
61 DEL POZO CARLA P 05/18/88 31 25,000.00 12 04/18/19 04/17/20 640.00
62 DELA CRUZ LUCY I 12/05/77 41 25,000.00 12 04/18/19 04/17/20 640.00
63 DELA CRUZ DAISY D 12/31/69 49 25,000.00 12 04/18/19 04/17/20 640.00
64 DELA CRUZ ROSALINA R 06/11/60 59 25,000.00 12 04/18/19 04/17/20 640.00
65 DILLO MELINDA M 03/28/57 62 25,000.00 12 04/18/19 04/17/20 640.00
66 DINGDING EMMA L 05/15/72 47 25,000.00 12 04/18/19 04/17/20 640.00
67 DINGLASAN TERESITA B 03/06/55 64 25,000.00 12 04/18/19 04/17/20 640.00
68 DIRANGGARN RENA A 09/15/81 38 25,000.00 12 04/18/19 04/17/20 640.00
69 DIVINO MELBA N 01/04/60 59 25,000.00 12 04/18/19 04/17/20 640.00
70 DIZON RYAN L 09/21/95 24 25,000.00 12 04/18/19 04/17/20 640.00
71 DIZON VERONICA B 10/04/64 55 25,000.00 12 04/18/19 04/17/20 640.00
72 DIZON ELENA L 06/24/60 59 25,000.00 12 04/18/19 04/17/20 640.00
73 DOLOVINO ANTONIO J 05/10/56 63 25,000.00 12 04/18/19 04/17/20 640.00
74 DUEÑAS EMELYN B 01/26/72 47 25,000.00 12 04/18/19 04/17/20 640.00
75 DUMAGAN AMELITA O 02/26/68 51 25,000.00 12 04/18/19 04/17/20 640.00
76 EDRALIN ENRICO D 07/08/60 59 25,000.00 12 04/18/19 04/17/20 640.00
77 ERMENIO RONNEL S 10/16/71 48 25,000.00 12 04/18/19 04/17/20 640.00
78 ESPADILLA EDITHA B 12/13/57 61 25,000.00 12 04/18/19 04/17/20 640.00
79 ESPERANZA KENWORTH P 03/27/82 37 25,000.00 12 04/18/19 04/17/20 640.00
80 FELICIANO ELSA A 05/10/64 55 25,000.00 12 04/18/19 04/17/20 640.00
81 FELICIO DIANA T 08/05/73 46 25,000.00 12 04/18/19 04/17/20 640.00
82 FERNANDEZ CARMELITA C 09/09/55 64 25,000.00 12 04/18/19 04/17/20 640.00
83 FLORES ANTONIO 10/11/78 41 25,000.00 12 04/18/19 04/17/20 640.00
84 FRANCISCO ELSA T 11/12/70 48 25,000.00 12 04/18/19 04/17/20 640.00
85 FUNCLARA MELBA C 12/11/73 45 25,000.00 12 04/18/19 04/17/20 640.00
86 FUROG EFREN F 06/10/56 63 25,000.00 12 04/18/19 04/17/20 640.00
87 GABATBAT ALICIA D 12/30/53 65 25,000.00 12 04/18/19 04/17/20 640.00
88 GALLETES JEANNETE R 01/11/75 44 25,000.00 12 04/18/19 04/17/20 640.00
89 GANANCIAL JOSE MARI E 08/19/71 48 25,000.00 12 04/18/19 04/17/20 640.00
90 GARVIDA CRISTINE JOY V 09/01/88 31 25,000.00 12 04/18/19 04/17/20 640.00
91 GATCHALIAN JOVITA S 07/24/62 57 25,000.00 12 04/18/19 04/17/20 640.00
92 GONZALES ANALIZA C 02/20/80 39 25,000.00 12 04/18/19 04/17/20 640.00
93 GONZALES VERONICA I 06/24/59 60 25,000.00 12 04/18/19 04/17/20 640.00
94 GUTUAL MERLY O 11/06/68 50 25,000.00 12 04/18/19 04/17/20 640.00
95 HISOLA FERNANDA B 05/30/54 65 25,000.00 12 04/18/19 04/17/20 640.00
96 HOYBIA ALICIA A 08/30/69 50 25,000.00 12 04/18/19 04/17/20 640.00
97 IBAÑEZ JR GREGORIO C 08/11/69 50 25,000.00 12 04/18/19 04/17/20 640.00
98 ILUSTRE VALENTINA D 08/24/81 38 25,000.00 12 04/18/19 04/17/20 640.00
99 KIAMCO SERINA D 01/03/62 57 25,000.00 12 04/18/19 04/17/20 640.00
100 LA CHICA EILEEN S 11/06/68 50 25,000.00 12 04/18/19 04/17/20 640.00
101 LANDAS ROMMEL J 12/09/69 49 25,000.00 12 04/18/19 04/17/20 640.00
102 LAURENTE MISHELLE A 10/31/81 37 25,000.00 12 04/18/19 04/17/20 640.00
103 LEUTERIO REYNALDO A 12/17/58 60 25,000.00 12 04/18/19 04/17/20 640.00
104 LIGON FLORIDA G 04/16/55 64 25,000.00 12 04/18/19 04/17/20 640.00
105 LLENA ESPERANZA C 01/24/54 65 25,000.00 12 04/18/19 04/17/20 640.00
106 LLONA CELERINA V 10/15/54 65 25,000.00 12 04/18/19 04/17/20 640.00
107 LUCIM SOL M 11/30/81 37 25,000.00 12 04/18/19 04/17/20 640.00
108 MADERA LEYNE M 01/19/77 42 25,000.00 12 04/18/19 04/17/20 640.00
109 MAGNAYE MA. FRINCES A 04/02/94 25 25,000.00 12 04/18/19 04/17/20 640.00
110 MAGNAYE LUESITO J 01/30/93 26 25,000.00 12 04/18/19 04/17/20 640.00
111 MAGNAYE RAZEL JEAN A 06/10/91 28 25,000.00 12 04/18/19 04/17/20 640.00
112 MAGNAYE MA. LUZ J 11/01/60 58 25,000.00 12 04/18/19 04/17/20 640.00
113 MANAGASE FELIX L 05/28/71 48 25,000.00 12 04/18/19 04/17/20 640.00
114 MANALANG EVANGELINE J 02/17/60 59 25,000.00 12 04/18/19 04/17/20 640.00
115 MANSUJETO LUISA C 10/09/57 62 25,000.00 12 04/18/19 04/17/20 640.00
116 MANTAC LORNA O 02/22/54 65 25,000.00 12 04/18/19 04/17/20 640.00
117 MARALILI JR ANTONIO B 10/12/66 53 25,000.00 12 04/18/19 04/17/20 640.00
118 MARCELINO WILLY M 06/25/66 53 25,000.00 12 04/18/19 04/17/20 640.00
119 MARTE TERESA N 06/27/55 64 25,000.00 12 04/18/19 04/17/20 640.00

Page 2
 PREMIUM
NO. MEMBERS' NAME BIRTHDATE AGE LIFE TERM EFFECTIVITY EXPIRY
DUE

120 MARTINEZ MARYANN C 10/09/70 49 25,000.00 12 04/18/19 04/17/20 640.00

121 MAYHAY MARIA CELINA S 09/17/81 38 25,000.00 12 04/18/19 04/17/20 640.00
122 MEDINA YOLANDA M 06/12/57 62 25,000.00 12 04/18/19 04/17/20 640.00
123 MERCADO MARIA RUBY R 08/08/68 51 25,000.00 12 04/18/19 04/17/20 640.00
124 MOGOL ARISTOTLE C 04/13/80 39 25,000.00 12 04/18/19 04/17/20 640.00
125 MOLARO IRENE MAY A 09/09/70 49 25,000.00 12 04/18/19 04/17/20 640.00
126 MOLON JR ALEJANDRO L 12/03/71 47 25,000.00 12 04/18/19 04/17/20 640.00
127 MORALES HELEN S 10/04/54 65 25,000.00 12 04/18/19 04/17/20 640.00
128 MORENO JOHN PAULO B 09/06/85 34 25,000.00 12 04/18/19 04/17/20 640.00
129 NANZAN KAREN C 09/26/77 42 25,000.00 12 04/18/19 04/17/20 640.00
130 NAVALON NENITA B 11/03/61 57 25,000.00 12 04/18/19 04/17/20 640.00
131 NELLO ROSALIA R 09/25/57 62 25,000.00 12 04/18/19 04/17/20 640.00
132 NORCIO LUCY M 08/16/78 41 25,000.00 12 04/18/19 04/17/20 640.00
133 O' SANTOS FLORDELIZA D 10/12/74 45 25,000.00 12 04/18/19 04/17/20 640.00
134 OBLEA NORA M 01/10/55 64 25,000.00 12 04/18/19 04/17/20 640.00
135 OBORRO ZENAIDA S 10/20/76 43 25,000.00 12 04/18/19 04/17/20 640.00
136 OLEA ESTELA P 11/06/71 47 25,000.00 12 04/18/19 04/17/20 640.00
137 PAHINAG AMARICHU F 05/21/62 57 25,000.00 12 04/18/19 04/17/20 640.00
138 PALENTINOS GLORIA A 12/25/53 65 25,000.00 12 04/18/19 04/17/20 640.00
139 PANGILINAN JOSE A 07/11/78 41 25,000.00 12 04/18/19 04/17/20 640.00
140 PANGILINAN JENNIFER C 06/23/77 42 25,000.00 12 04/18/19 04/17/20 640.00
141 PASCO JEFFREY R 12/05/76 42 25,000.00 12 04/18/19 04/17/20 640.00
142 PASCO SALVACION R 02/09/54 65 25,000.00 12 04/18/19 04/17/20 640.00
143 PENAFLOR MELY A 08/11/74 45 25,000.00 12 04/18/19 04/17/20 640.00
144 PENDON PEACHIE MARIEP 01/21/88 31 25,000.00 12 04/18/19 04/17/20 640.00
145 PILAR MERCEDITA C 05/11/60 59 25,000.00 12 04/18/19 04/17/20 640.00
146 PONTERO ELDA G 01/10/59 60 25,000.00 12 04/18/19 04/17/20 640.00
147 PORRAS ARACELI P 09/27/57 62 25,000.00 12 04/18/19 04/17/20 640.00
148 QUEJADA ROLDAN H 10/22/75 44 25,000.00 12 04/18/19 04/17/20 640.00
149 QUEJADA MELISSA C 09/05/71 48 25,000.00 12 04/18/19 04/17/20 640.00
150 QUINTO LALAIN V 01/15/74 45 25,000.00 12 04/18/19 04/17/20 640.00
151 RACUYA ALBERT U 04/09/81 38 25,000.00 12 04/18/19 04/17/20 640.00
152 RAFOL ANNABEL L 10/20/77 42 25,000.00 12 04/18/19 04/17/20 640.00
153 RAYMUNDO MERAYLA P 07/04/56 63 25,000.00 12 04/18/19 04/17/20 640.00
154 RECILLA MA AMABEL A 08/16/61 58 25,000.00 12 04/18/19 04/17/20 640.00
155 RECTO JR JAIME R 10/09/81 38 25,000.00 12 04/18/19 04/17/20 640.00
156 REYES EDITHA B 01/20/60 59 25,000.00 12 04/18/19 04/17/20 640.00
157 RIVAS MARICEL C 06/11/75 44 25,000.00 12 04/18/19 04/17/20 640.00
158 ROA ROLANDO D 09/05/80 39 25,000.00 12 04/18/19 04/17/20 640.00
159 ROXAS DELIA C 04/11/60 59 25,000.00 12 04/18/19 04/17/20 640.00
160 RUPISAN ROGER E 03/04/58 61 25,000.00 12 04/18/19 04/17/20 640.00
161 SALAGUBANG BABY LINDA I 03/31/63 56 25,000.00 12 04/18/19 04/17/20 640.00
162 SALAMIA HERMELINA A 06/01/64 55 25,000.00 12 04/18/19 04/17/20 640.00
163 SALAZAR SEGUNDINA M 01/15/59 60 25,000.00 12 04/18/19 04/17/20 640.00
164 SALES MILAGROS S 07/12/55 64 25,000.00 12 04/18/19 04/17/20 640.00
165 SALTIBAN VICTORIA M 07/28/62 57 25,000.00 12 04/18/19 04/17/20 640.00
166 SALVADOR ALVIN C 07/13/78 41 25,000.00 12 04/18/19 04/17/20 640.00
167 SALVADOR EVELYN A 06/23/70 49 25,000.00 12 04/18/19 04/17/20 640.00
168 SALVADOR GLORIA C 03/17/65 54 25,000.00 12 04/18/19 04/17/20 640.00
169 SALVADOR EDUARDO P 11/24/55 63 25,000.00 12 04/18/19 04/17/20 640.00
170 SANCHEZ LINA B 05/25/77 42 25,000.00 12 04/18/19 04/17/20 640.00
171 SANTIAGO FLORENTINA L 05/10/55 64 25,000.00 12 04/18/19 04/17/20 640.00
172 SANTIAGO JOSEFINA C 09/18/55 64 25,000.00 12 04/18/19 04/17/20 640.00
173 SANTOS MARIA CECILIA M 08/01/76 43 25,000.00 12 04/18/19 04/17/20 640.00
174 SANTOS ZOILA C 06/27/57 62 25,000.00 12 04/18/19 04/17/20 640.00
175 SAUQUILLO JOCELYN E 04/08/90 29 25,000.00 12 04/18/19 04/17/20 640.00
176 SISON RAQUEL S 10/25/70 49 25,000.00 12 04/18/19 04/17/20 640.00
177 SO ESTELITA Q 07/06/67 52 25,000.00 12 04/18/19 04/17/20 640.00
178 SOLO MARIA LENNIE D 09/17/66 53 25,000.00 12 04/18/19 04/17/20 640.00
179 SORIANO NERISA S 05/05/71 48 25,000.00 12 04/18/19 04/17/20 640.00
180 SORIANO ERNESTO C 03/23/54 65 25,000.00 12 04/18/19 04/17/20 640.00
181 SOTOMAYOR ARTHUR R 01/14/71 48 25,000.00 12 04/18/19 04/17/20 640.00
182 TAGO-O JOYCELYN O 01/29/78 41 25,000.00 12 04/18/19 04/17/20 640.00
183 TANOLA JOEL I 03/24/80 39 25,000.00 12 04/18/19 04/17/20 640.00
184 TELIC DELIA D 12/19/85 33 25,000.00 12 04/18/19 04/17/20 640.00
185 TISTON JEFFREY L 08/01/85 34 25,000.00 12 04/18/19 04/17/20 640.00

Page 3
 PREMIUM
NO. MEMBERS' NAME BIRTHDATE AGE LIFE TERM EFFECTIVITY EXPIRY
DUE

186 TORIBIO LIANE M 03/28/78 41 25,000.00 12 04/18/19 04/17/20 640.00

187 TORRES ROBERT ANTHOM 01/19/63 56 25,000.00 12 04/18/19 04/17/20 640.00
188 TUMBAGAHON MARIA LUDIVIN S 04/14/65 54 25,000.00 12 04/18/19 04/17/20 640.00
189 UDTOHAN ARLENE T 06/05/76 43 25,000.00 12 04/18/19 04/17/20 640.00
190 URSUA PAZ U 02/19/55 64 25,000.00 12 04/18/19 04/17/20 640.00
191 VELASCO GERALDINE T 08/06/68 51 25,000.00 12 04/18/19 04/17/20 640.00
192 VENTURA II ALFRED M 07/25/70 49 25,000.00 12 04/18/19 04/17/20 640.00
193 VERGARA LOLITA P 09/10/65 54 25,000.00 12 04/18/19 04/17/20 640.00
194 VILLAFUERTE ANDREA C 11/30/92 26 25,000.00 12 04/18/19 04/17/20 640.00
195 VILLANUEVA GLENDA S 06/12/73 46 25,000.00 12 04/18/19 04/17/20 640.00
196 VISTAL ANA MARIE F 03/19/70 49 25,000.00 12 04/18/19 04/17/20 640.00
197 VIVO RONEL C 01/03/64 55 25,000.00 12 04/18/19 04/17/20 640.00
198 YANA ELIZABETH T 02/12/63 56 25,000.00 12 04/18/19 04/17/20 640.00
RENEWAL - OVERAGE
199 ABANES LORNA B 08/18/53 66 25,000.00 12 04/18/19 04/17/20 640.00
200 AGUEDAN MARIANITA C 06/08/49 70 25,000.00 12 04/18/19 04/17/20 640.00
201 AGUOT PURIFICACION B 01/27/51 68 25,000.00 12 04/18/19 04/17/20 640.00
202 ALBALATE GLICERIA S 12/21/49 69 25,000.00 12 04/18/19 04/17/20 640.00
203 ANAQUE EUTIQUIA C 09/29/47 72 25,000.00 12 04/18/19 04/17/20 640.00
204 BAUTISTA CORAZON Y 04/20/53 66 25,000.00 12 04/18/19 04/17/20 640.00
205 BAUTISTA FLORENCE D 10/18/48 71 25,000.00 12 04/18/19 04/17/20 640.00
206 BUGAOAN MARINA A 07/30/49 70 25,000.00 12 04/18/19 04/17/20 640.00
207 BUQUIS WELMA A 11/04/46 73 25,000.00 12 04/18/19 04/17/20 640.00
208 CABANGON LETICIA C 09/25/48 71 25,000.00 12 04/18/19 04/17/20 640.00
209 CASTRO VICTORIA L 09/20/47 72 25,000.00 12 04/18/19 04/17/20 640.00
210 CORONADO ROSARIO B 10/04/53 66 25,000.00 12 04/18/19 04/17/20 640.00
211 CORONADO SEBASTIAN B 01/20/51 68 25,000.00 12 04/18/19 04/17/20 640.00
212 CRUZ LEONOR C 11/09/48 70 25,000.00 12 04/18/19 04/17/20 640.00
213 DELA CRUZ LOURDES M 10/14/47 72 25,000.00 12 04/18/19 04/17/20 640.00
214 DELA CRUZ MARCELINO R 04/26/47 72 25,000.00 12 04/18/19 04/17/20 640.00
215 DESALESA JUANITA E 10/20/48 71 25,000.00 12 04/18/19 04/17/20 640.00
216 DOMINGO CARMELITA P 01/30/46 73 25,000.00 12 04/18/19 04/17/20 640.00
217 DUMANGLAS REBECCA A 10/23/52 67 25,000.00 12 04/18/19 04/17/20 640.00
218 GANTUANGCO CARMENCITA C 02/06/50 69 25,000.00 12 04/18/19 04/17/20 640.00
219 GAPUD CECILIA AGNES M 02/01/50 69 25,000.00 12 04/18/19 04/17/20 640.00
220 LAPADA CORAZON S 09/29/46 73 25,000.00 12 04/18/19 04/17/20 640.00
221 LEYVA BELEN WINONA L 08/05/53 66 25,000.00 12 04/18/19 04/17/20 640.00
222 MAGDAEL EDNA I 07/27/50 69 25,000.00 12 04/18/19 04/17/20 640.00
223 MARALIT LETICIA G 10/23/48 71 25,000.00 12 04/18/19 04/17/20 640.00
224 PABLO ALEX S 07/21/53 66 25,000.00 12 04/18/19 04/17/20 640.00
225 PAJANOSTAN LOURDES B 10/02/50 69 25,000.00 12 04/18/19 04/17/20 640.00
226 PERIO VIVENCIA R 08/23/51 68 25,000.00 12 04/18/19 04/17/20 640.00
227 RABE ELLEN M 12/30/52 66 25,000.00 12 04/18/19 04/17/20 640.00
228 RABINA EPIFANIA C 07/12/46 73 25,000.00 12 04/18/19 04/17/20 640.00
229 RACUYA ELISA U 03/25/52 67 25,000.00 12 04/18/19 04/17/20 640.00
230 RAMIRO ROSITA L 10/02/51 68 25,000.00 12 04/18/19 04/17/20 640.00
231 RAMOS PRISCILA T 10/20/50 69 25,000.00 12 04/18/19 04/17/20 640.00
232 RAYNERA LUCINA M 06/30/51 68 25,000.00 12 04/18/19 04/17/20 640.00
233 SARMIENTO RODOLFO M 12/15/52 66 25,000.00 12 04/18/19 04/17/20 640.00
234 SAUQUILLO TITA A 10/07/53 66 25,000.00 12 04/18/19 04/17/20 640.00
235 SERQUINA ESTELA G 02/04/46 73 25,000.00 12 04/18/19 04/17/20 640.00
236 TORIBIO ERLINDA M 12/23/52 66 25,000.00 12 04/18/19 04/17/20 640.00
237 VALLESTEROS GREGORIA R 07/07/45 74 25,000.00 12 04/18/19 04/17/20 640.00
238 YUSON JOSEFINA R 08/27/48 71 25,000.00 12 04/18/19 04/17/20 640.00
NEW
239 ANABE ELMER G 11/03/78 40 25,000.00 12 04/18/19 04/17/20 640.00
240 ARAGON ZENAIDA R 12/16/75 43 25,000.00 12 04/18/19 04/17/20 640.00
241 ARIZOBAL MARYJANE M 08/25/73 46 25,000.00 12 04/18/19 04/17/20 640.00
242 BAUTISTA CHRISTIANNE RA 11/08/86 32 25,000.00 12 04/18/19 04/17/20 640.00
243 BIGCAS ANNALYN G 06/07/75 44 25,000.00 12 04/18/19 04/17/20 640.00
244 CRUZ MARILYN A 10/02/65 54 25,000.00 12 04/18/19 04/17/20 640.00
245 DELANTAR JEMUEL D 03/23/74 45 25,000.00 12 04/18/19 04/17/20 640.00
246 JOCSON LORENA L 05/26/68 51 25,000.00 12 04/18/19 04/17/20 640.00
247 LANSANGAN ANALYN R 11/05/67 51 25,000.00 12 04/18/19 04/17/20 640.00
248 LAURENTE MARIA MERICA E 11/02/58 60 25,000.00 12 04/18/19 04/17/20 640.00
249 LORESCA ROSEMARIE R 01/18/67 52 25,000.00 12 04/18/19 04/17/20 640.00

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 PREMIUM
NO. MEMBERS' NAME BIRTHDATE AGE LIFE TERM EFFECTIVITY EXPIRY
DUE

250 MALILLIN JR EMMANUEL D 12/15/65 53 25,000.00 12 04/18/19 04/17/20 640.00

251 MARTINEZ MARITES P 08/01/79 40 25,000.00 12 04/18/19 04/17/20 640.00
252 MENES DJALMA M 08/01/72 47 25,000.00 12 04/18/19 04/17/20 640.00
253 OLIS JERLYN T 09/13/68 51 25,000.00 12 04/18/19 04/17/20 640.00
254 RESULTAY LUDIVINA M 03/08/58 61 25,000.00 12 04/18/19 04/17/20 640.00
255 REYES MARY JANE C 01/08/75 44 25,000.00 12 04/18/19 04/17/20 640.00
256 ROMERO GLORIA L 03/30/56 63 25,000.00 12 04/18/19 04/17/20 640.00
257 SALANGUSTE MA. ERLINDA S 04/23/56 63 25,000.00 12 04/18/19 04/17/20 640.00
258 SALVADOR SHIELA B 01/30/62 57 25,000.00 12 04/18/19 04/17/20 640.00
259 SELIBIO LORENZO C 07/21/71 48 25,000.00 12 04/18/19 04/17/20 640.00
260 TORRIJOS EVELINDA R 06/09/59 60 25,000.00 12 04/18/19 04/17/20 640.00

260 AVE. AGE 53 6,500,000.00 166,400.00

(REMARKS)
NEW - OVERGAE
MIRAFLOR ELENA D 09/09/50 69
CARDEL ESTHER P 06/18/48 71

TOTAL Premium Due . . . . . . . . . . . . . . . . . . 166,400.00

.
Remittance as per OR# 188400 DTD 5/10/2019 . .167,680.00
..
TOTAL OVER(UNDER)PAYMENT . . . . . . . . . . 1,280.00 ..

Processed by: Approved by:

KAREL ANNE MORTOS GLADY JEAN R. DE VERA

Underwriting Analyst Underwriting Head

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