Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

Citystate Centre Building, 709 Shaw Boulevard, Pasig City
Healthline: 441-7444 Website: www.philhealth.gov.ph

STATEMENT OF PREMIUM ACCOUNT (SPA) - FORMAL SECTOR

Date generated : September 15, 2022
PEN: 009010000665
Employer Type : PRIVATE SPA100030503539
Business/Agency Name : CYLINDER ENTERPRISES

Group Name :

CURRENT CHARGES :
Applicable Month : September 2022
No. of Employees : 8

Amount of Premium:
Employee Share : 1,600.00
Employer Share : 1,600.00

Premium Due for the Current Applicable Period 3,200.00

Due Date:
TOTAL AMOUNT DUE 3,200.00 On or Before 20October
2022

IMPORTANT REMINDER
Per available records, it appears that your account has deficiencies as follows:

Reference Deficiency Applicable Month/s Amount

SPA100030503518 No Premium payment Aug 2022 3,285.83
No SPA generated Jul 2022

Please settle the above deficiencies immediately as indicated. All reports must be posted within five (5) days after payment.
For assistance, coordinate with the PAIMS assigned to your account or visit the nearest PhilHealth Office. Thank you.

Date generated : September 15, 2022

PEN: 009010000665
Employer Type : PRIVATE SPA100030503539
Business/Agency Name : CYLINDER ENTERPRISES

Group Name :

CURRENT CHARGES :
Applicable Month : September 2022
No. of Employees : 8

Amount of Premium:
Employee Share : 1,600.00
Employer Share : 1,600.00

Premium Due for the Current Applicable Period 3,200.00

Due Date:
TOTAL AMOUNT DUE 3,200.00 On or Before 20October
2022