Republic of the Philippines

SOCIAL SECURITY SYSTEM

http://www.sss.gov.ph

EUFROCINO JABILLES CARILLO

3302643104 THIS IS YOUR OFFICIAL RECEIPT WHEN VALIDATED

PAYMENT REFERENCE NUMBER (PRN)

STATEMENT OF ACCOUNT FOR DECEMBER 2020

Loan Type/Loan Date: SALARY - 09/06/2001 Due Date: 01/31/2021
Total Amount Due: P 5,516.16 Generation Date: 01/30/2021
IL200000495741

Please pay on or before the due date at any SSS accredited collecting partner/bank or SSS Office with Tellering Facility. A penalty of 1% per month, pursuant
to Annex A of Circular No. 2019-014, shall be imposed on loan amortization not paid within the prescribed schedule.

The SSS reserves the right to determine and collect the true and correct loan amortization due the SSS if it finds other unremitted/underpaid loan remittances
during or before the period billed. Also, SSS shall conduct further verification and assessment on the details of the submitted loan 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.

Reminder: Please print in two (2)copies (1 - Payor and 1– SSS)