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Agency 1000002353
Broker Report
Run Date
BILLING
POLICYNO BP NO LASTNAME FIRSTNAME MI PFX DUEDATE PS
LP59051902194 2000198973 MALANA LESTER ROMEO E Feb-13 0
BILLING REMITTANCE VARIANCE
GS EC TOTAL PS GS EC TOTAL PS GS EC
0.00 0 0.00 4,729.23 6,305.64 100 11,134.87 -4,729.23 -6,305.64 -100
IANCE
TOTAL
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RECONCILIATION BILLING ISSUES
Agency 1000002351
Broker Report
Run Date
BILLING
POLICYNO BP NO LASTNAME FIRSTNAME MI PFX DUEDATE PS
BILLING REMITTANCE VARIANCE
GS EC TOTAL PS GS EC TOTAL PS GS EC
IANCE REMARKS ADJUSTMENTS RECONCILED DEFICIENCY BILLING
TOTAL ISSUES DATE PS GS EC TOTAL PS GS EC
EFICIENCY BILLING
TOTAL
RECONCILIATION BILLING ISSUES
Agency
Broker Report
Run Date
BILLING
POLICYNO BP NO LASTNAME FIRSTNAME MI PFX DUEDATE PS
BILLING REMITTANCE VARIANCE
GS EC TOTAL PS GS EC TOTAL PS GS EC
IANCE
TOTAL
RECONCILIATION BILLING ISSUES
Agency
Broker Report
Run Date
BILLING
POLICYNO BP NO LASTNAME FIRSTNAME MI PFX DUEDATE PS
BILLING REMITTANCE VARIANCE
GS EC TOTAL PS GS EC TOTAL PS GS EC
IANCE
TOTAL REMARKS
REPUBLIKA NG PILIPINAS
PASEGURUHAN NG MGA NAGLILINGKOD SA PAMAHALAAN
(GOVERNMENT SERVICE INSURANCE SYSTEM)
Financial Center, Pasay City 1308
Our records show that you have under-remitted or failed to pay the correct amount of Compulsory Premiums for the month of
January 2012February 2013
Attached is the Reconciliation Billing Issues (RBI) showing the details of underpayment or no payment on compulsory premium of
your employees. We are giving you five (5) days to reconcile with our Billing and Collection Department, otherwise, please pay
immediately the total amount indicated below to avoid incurring interest and penalties.
UNPAID AMOUNT
RBI NUMBER DUE MONTH COMPULSORY PREMIUM
PS GS EC TOTAL
RBI-RO-2013-02-0000142 February-13 - - - -
TOTAL - - - -
Please be reminded of your obligation under Section 6, Paragraph (a) of R.A. 8291, to wit: "the employer shall deduct each month from the
monthly salary or compensation of each employee the contribution payable by him in accordance with the schedule prescribed in the rules and regulations
implementing this act." Failure to do so will constrain the GSIS to enforce the penalties prescribed under Section 52, Paragraphs (c) &
(d) of the GSIS Act of 1997.
To schedule our reconciliation and for further inquiries, please visit our GSIS Billing and Collection Unit, or call us at Telephone
Number _________. You can also email us at __________@gsis.gov.ph.
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RBS FORM
To be accomplished by RA and BCU representatives as a result of reconciliation.
Conforme: