Вы находитесь на странице: 1из 1

Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION


www.philhealth.gov.ph

Date/Time Generated : 04/17/2017 02:17:35


SPA No : SPA100009253513
Applicable Period : 03-2017
Report Type : Regular
EMPLOYEES PREMIUM REMITTANCE LIST
PhilHealth Number : 008030004102
Employer Name : ESTELA C BUENSUCESO ENTERPRISE
Employer Address : SAN PEDRO LAGUNA
Employer TIN : 210328145000
Employer Type : Private
No. PhilHealth No. Surname Given Name Middle Name PS ES Status | Remarks
1 080514391282 BASBAS EDNA PEREZ 0.00 0.00 NE

2 080514381937 BELTRAN SOLEDAD BAUTISTA 0.00 0.00 NE

3 190511293360 BUENSUCESO ALOYSIUS C 100.00 100.00 A

4 080514381953 CASTILLO ROLAND ENERLAN 0.00 0.00 NE

5 080258502314 CESAR JIMSON PEAFLORIDA 100.00 100.00 A

6 080514391312 LIANZA VIRGINIA HERNANDEZ 100.00 100.00 A

7 080514381961 MARQUEZ JOAN VALDEMORO 0.00 0.00 NE

8 080514381996 PADAGDAG EPIFANIA ADVINCULA 0.00 0.00 NE

9 020511355363 PAGTALUNAN TRISTAN JAY null 100.00 100.00 A

10 080514535454 PILAR JOSEPHINE CEZAR 100.00 100.00 A

11 190512636415 PILAR ROBERTO RICARRO 100.00 100.00 A

Subtotal 600.00 600.00


GRAND TOTAL 1,200.00

Prepared by : Certified True and Correct by :

Signature over Printed Name and Designation Signature over Printed Name and Designation