VERONICA INTEGRATED PRESTIGE MARKETING, INC. VERONICA INTEGRATED PRESTIGE MARKETING, INC.

146 ONE SOUTH TRIANGLE,Suite 301, 3F, Sgt. Esguerra St., cor. Panay Ave., 146 ONE SOUTH TRIANGLE,Suite 301, 3F, Sgt. Esguerra St., cor. Panay Ave.,
Diliman, Quezon City Diliman, Quezon City

OUTRIGHT PAY-OUT FORM OUTRIGHT PAY-OUT FORM

Date: Date:

Member Code: Member Code:

Full Name: Full Name:

Date Clicked: Date Clicked:

Encashment Amount: Encashment Amount:

Signature: Signature:

************For Office Use Only********* ************For Office Use Only*********

Gross: Processing Fee: 50.00 Gross: Processing Fee: 50.00

Withholding Tax (10%): Net Income: Withholding Tax (10%): Net Income:

Verified by: Verified by:

Note: Please present any valid ID Note: Please present any valid ID

VERONICA INTEGRATED PRESTIGE MARKETING, INC. VERONICA INTEGRATED PRESTIGE MARKETING, INC.
146 ONE SOUTH TRIANGLE,Suite 301, 3F, Sgt. Esguerra St., cor. Panay Ave., 146 ONE SOUTH TRIANGLE,Suite 301, 3F, Sgt. Esguerra St., cor. Panay Ave.,
Diliman, Quezon City Diliman, Quezon City

OUTRIGHT PAY-OUT FORM OUTRIGHT PAY-OUT FORM

Date: Date:

Member Code: Member Code:

Full Name: Full Name:

Date Clicked: Date Clicked:

Encashment Amount: Encashment Amount:

Signature: Signature:

************For Office Use Only********* ************For Office Use Only*********

Gross: Processing Fee: 50.00 Gross: Processing Fee: 50.00

Withholding Tax (10%): Net Income: Withholding Tax (10%): Net Income:

Verified by: Verified by:

Note: Please present any valid ID Note: Please present any valid ID