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

NAME OF EMPLOYER/FIRM: LUXACRAFT PHILIPPINES, INCORPORATED 20-017430046-1

EMPLOYER NO.

ADDRESS: 168 HAIG ST. NEAR GEN. KALENTONG, BRGY. DAANG BAKAL, MANDALUYONG CITY E-MAIL ADDRESS: accountingdept@luxacraft.com
PHILHEALTH DATE OF (DO NOT FILL)
EFF. DATE OF PREVIOUS EMPLOYER
SSS/GSIS NAME OF EMPLOYEE POSITION SALARY EMPLOY-
COVERAGE ( IF ANY)
NUMBER MENT
02-050624441-3 ARCIBAL, FULTON S. Installer/Safety
Officer

19-051640342-3 BARAHAN, RENEBOY C. Installer

23-003116827-4 BAUTISTA, GARY M. Quality Control

10-900284044-7 BAYBAYON, OSCAR B. Installer

03-050161808-6 BULAON, MARY GRACE B. PurchasingAssistant

02-026821719-4 CABANELA, GERALDINE D. Estimator

07-050100143-9 CALICDAN, GERARDO T. Site Supervisor

01-051447537-2 CAÑAL, CHARLIE E. IT/Graphic Artist

01-025047586-7 CANO, ANTONIO A. Machine

Maintenance

02-026649163-9 CASABUENA, ANALYN S. Estimator

01-050159618-9 CLARICIA, BRODERICK R. Driver

05-050097234-0 CUNANAN, JANET J. Sales Architect

TOTAL NO. LISTED ABOVE: Veronica S. Paray

PAGE ___ OF ___ SHEETS SIGNATURE OVER PRINTED NAME

TO BE ACCOMPLISHED IN DUPLICATE