PAYOR's COPY

Republic of the Philippines

SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
CON -
COLLECTION LIST SUMMARY

80-0052633-7-000
FMT CARGO EXPRESS
64 RODRIGUEZ STREET JORDAN DRIVE
BAESA QUEZON CITY NCR, SECOND DISTRICT (NOT A This is your official receipt when validated
PROVINCE) 1106
Payment Reference Number
Due Date : December 02, 2019
Generation Date : November 01, 2019

Electronic Contribution Collection List Summary for the Month of (October 2019)
Total Number of Employees : 18
Breakdown of Contributions :
Social Security (SS) Php 18,720.00
Employee Compensation (EC) 220.00
Total Amount Due Php 18,940.00

Please pay on or before the due date at any SSS accredited collecting partner/bank or SSS Branch with Tellering Facility. A penalty of 2% per
month, pursuant to Section 22(a) of RA No. 11199 (Social Security Act of 2018), shall be imposed on contributions not paid within the prescribed
schedule.

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. SSS shall conduct further verification and assessment on the details of the Electronic
Contribution Collection List (e-CCL) and shall collect any balance, if any.

For inquiries, please email PRNHelpline@sss.gov.ph. You may contact us at 8-920-6446 or 7-917-7777.

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

SSS' COPY
Republic of the Philippines
SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
COLLECTION LIST SUMMARY
CON -
PAYMENT SLIP

80-0052633-7-000
FMT CARGO EXPRESS
October 2019

Payment Reference Number

 Republic of the Philippines
SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
CON -
COLLECTION LIST

Payment Reference Number

80-0052633-7-000
FMT CARGO EXPRESS
October 2019

Name of Employee SS Number SS EC Total Contributions

1 ARCALA, ROGELIO V 34-8629362-9 1,260.00 10.00 1,270.00
2 CASALJAY, ROMEO A 33-7646261-2 1,380.00 10.00 1,390.00
3 DE LUNAS, GREGORIO JIM T 33-7517804-6 1,800.00 30.00 1,830.00
4 DENURA JR, RODOLFO Z 10-0718747-5 0.00 0.00 0.00
5 DEOCAMPO, RAUL D 33-6618378-1 1,800.00 30.00 1,830.00
6 DRAMAYO, RESFREDO F 33-8513659-9 0.00 0.00 0.00
7 LAS PIÑAS, JENELYN S 34-7563989-6 1,800.00 30.00 1,830.00
8 LIBAO, SAMSON JR. M 02-2872063-8 1,200.00 10.00 1,210.00
9 MANDAGAN, ERIC S 34-1281151-2 1,800.00 30.00 1,830.00
10 MONTEMAYOR, NESTOR S 03-4641470-3 1,800.00 30.00 1,830.00
11 PASCUA, BON CHRISTIAN F 02-4604797-9 1,680.00 10.00 1,690.00
12 PENOLIAR, PANTOM C 34-8169100-6 1,380.00 10.00 1,390.00
13 PONTILLAS, SAMUEL MAY B 09-3335492-0 1,140.00 10.00 1,150.00
14 QUINDAO, NICKY H 34-5103037-0 0.00 0.00 0.00
15 QUITOLA, MARK RYAN M 34-6268334-7 0.00 0.00 0.00
16 RENACIA, WARREN T 10-1320696-8 0.00 0.00 0.00
17 ROQUE, MELVIN O 34-7058228-1 0.00 0.00 0.00
18 SUMAWAY, JESSE D 34-2636952-6 1,680.00 10.00 1,690.00
Sub-total Php 18,720.00 Php 220.00 Php 18,940.00
Total Amount Due Php 18,940.00

This is a system-generated list, signature is not needed. Page 1 of 1