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Wallet Size ID Specimen Signature

Business Unit: Robinsons Supermarket Corp. Branch:

Full Name:
Surname Given name MI

Nick Name

Position:

Employee No:

Date Hired:

TIN No:

SSS N0:

New Issuance (Newly Hired)

ID Replacement

Replace For:

Lost ID (Please attach receipt paid to CSD with OR number:_________)

Worn-out ID(Please surrender worn-out ID)

(Worn-out ID within the year after issuance must also be PAID)

Transfer to different branch/department/position (with approval transfer memo)

Change of civil status (Maiden name supported by registered Marriage Contract

Incorrect Information Inputted

Approved by: JAZZIEL S. LEGARTO

Signature over Printed Name

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