Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

www.philhealth.gov.ph

Date/Time Generated : 08/16/2019 13:41:31

SPA No : SPA100018738152
Applicable Period : 07-2019
Report Type : Regular
EMPLOYEES PREMIUM REMITTANCE LIST
PhilHealth Number : 220174000016
Employer Name : UNIQUE AUTO CAR SPECIALIST COMPANY
Employer Address : 2701 NEW PANADEROS ST. STA. ANA MANILA 1ST DISTRICT METRO MANILA NCR, CITY OF MANILA, FIRST DISTRICT
Employer TIN : 211341738
Employer Type : Private
No. PhilHealth No. Surname Given Name Middle Name PS ES Status | Remarks
1 190894676195 ATIENZA ANNABEL BARRETTO 550.00 550.00 A

2 190895493833 ATIENZA KEVIN BARRETTO 206.25 206.25 A

3 190503767639 ATIENZA MALCOLM BARRETTO 550.00 550.00 A

4 010517983972 BERNARDINO MERRY JOY FERNANDEZ 208.94 208.95 A

5 190524462889 BRIGIDA CESAR OCAMPO 275.00 275.00 A

6 010256679774 CANIMO JESSICA GLO SUNGA 247.50 247.50 A

7 020506808600 CELSO VIII GAVINO MENDOZA 331.10 331.10 A

8 022527758762 CULA KRISTINE DESIREE MALAPIT 247.50 247.50 A

9 010515625998 DUNGCA JEAN BELTRAN 191.98 191.98 A

10 020502563034 ELADRO KIMBERLY CODERA 352.69 352.69 A

11 010504525606 MILLENA EDUARDO PAULE 275.00 275.00 A

12 010517009763 PADERES RIESA MANALO 226.27 226.27 A

13 030260739111 PADUA JANU CLAVERIA 195.19 195.20 A

14 190900402523 SABANG JR ALFREDO ARRANGUEZ 352.69 352.69 A

15 010259921509 SAGARIO MARIA LEONIZA POYATOS 191.98 191.98 A

16 010500782361 VARGAS RYAN GADIA 191.98 191.98 A

Subtotal 4,594.07 4,594.09

GRAND TOTAL 9,188.16

Prepared by : Certified True and Correct by :

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