Form Name Employer SSS Profile

Description Contains all needed information of the Employer

Employer Name IPILAN NICKEL CORPORATION

Employer Address 1st Floor Corporate Business Centre 151 Paseo de
Roxas Cor Arnaiz Ave Makati City
Telephone Number 519 7888
Zip Code 1228

Employer SSS ID 0391285152

Employer SSS Locator C - NCR
Form Name Employer Pag-IBIG Profile
Description Contains all needed information of the Employer

Employer Name IPILAN NICKEL CORPORATION

Employer Address 1st Floor Corporate Business Centre 151 Paseo de
Roxas Cor Arnaiz Ave Makati City
Telephone Number 519 7888
Zip Code 1228

Employer PagIBIG ID 204460160003

PagIBIG Branch Code 01 - MAKATI I
Company Type P
Form Name Employer PhilHealth Profile
Description Contains all needed information of the Employer

Employer Name IPILAN NICKEL CORPORATION

Employer Address 1st Floor Corporate Business Centre 151 Paseo de
Roxas Cor Arnaiz Ave Makati City
Telephone Number 519 7888
Zip Code 1228

Employer Philhealth ID 001000008393

Philhealth Signatory NICKY CABREJAS
Position / Designation HR MANAGER
 Legend:
Date: Requied
Form Name : Employee Pre-validation File (EPF) -MM/DD/YYYY
Description : Contains SSS information of all employees on the initial transmission. SSS Number: Requ
of this file. Succeeding transmission contains SSS information of -No dash
new or separated employees.

Date 2/13/2017

SSS Number Surname First name MI Birthdate

1007937146 SALDANA GEE N 8/14/1983
Legend:
Date: Requied
-MM/DD/YYYY
SSS Number: Required
-No dash
Form Name Monthly Contribution List (MCL)
Description Employee's SSS Monthly Contribution File
For the Month 01/2018
Document # 012018
Payment Order # 01012018

Date Hired
Surname First name MI SSS Number Premium EC Premium Status
Separated
AMORA MAY ELAINE C 0627974661 1760 30.00 8/1/2014 3
Angkani Arvin U 0439051109 770 10.00 4/1/2017 3
ARABIS ALEX C 0384060805 1760 30.00 1/2/2017 3
Astile Keven T 0438838310 880 10.00 6/1/2017 3
Banggon Twilik T 0439672119 825 10.00 4/4/2017 3
BATERNA NELBERT D 0437055880 825 10.00 2/1/2016 3
Batoy Freddie J 0418753473 715 10.00 4/6/2017 3
BERNAS ALVIN D 0438243167 935 10.00 10/12/2016 3
BUNAG JHONMARK B 0437044820 550 10.00 1/22/2016 3
Caabay Jorge M 0428081931 825 10.00 4/6/2017 3
CELINO ROLLY S 0430885439 1375 10.00 11/2/2015 3
DACANAY FLORANTE G 3387168219 1485 10.00 4/1/2007 3
DAGANTA AILEEN JANE S 0439217707 770 10.00 6/17/2017 3
Dandallo Benerio Sr T 0439418739 770 10.00 5/8/2017 3
DEJARME EMMANUEL M 0914935782 1265 10.00 6/1/2017 3
DELA CRUZ DAISY C 0436007363 715 10.00 6/17/2017 3
DELGADO BRYAN L 0437055958 605 10.00 2/1/2016 3
DONOZ REX R 3455507553 1760 30.00 12/7/2015 3
Emik Reydon M 0435715944 715 10.00 4/6/2017 3
Estrada Francisco T 3335013439 715 10.00 4/6/2017 3
GARCIA IMELDA C 0386356410 1760 30.00 7/7/2006 3
JARDIN ELMER D 0419549880 990 10.00 11/2/2015 3
JARDIN ROOSEVELT D 0437055835 1155 10.00 1/22/2016 3
JARDIN TOMMY C 0417492049 1760 30.00 7/17/2017 3
LIBATIQUE FERDINAND D 0105126562 1760 30.00 1/2/2017 3
Lindas Rogen S 0439032047 825 10.00 4/4/2017 3
LIRAZAN JOJO R 0436568608 1100 10.00 11/2/2015 3
Malvas Joven S 0439028996 825 10.00 5/7/2017 3
Manabat Alberto T 0439052810 770 10.00 4/4/2017 3
MINDOC NICANOR D 0438048595 825 10.00 6/6/2016 3
NAVARRO DOMINADOR L 3318925560 1265 10.00 7/16/2014 3
NAVARRO RONALD R 0811436339 1760 30.00 7/1/2014 3
Ombao Richard B 0439046509 770 10.00 4/6/2017 3
Onding Jerald A 0439030722 825 10.00 4/8/2017 3
Orpia Rodel J 0413110613 715 10.00 4/8/2017 3
Panahon Mojic D 3459367414 825 10.00 4/6/2017 3
PIALA FELIX L 0608602648 1760 30.00 5/15/2015 3
Quezon Rey T 0439037518 715 10.00 4/6/2017 3
Ragudos Leonardo B 0429137758 715 10.00 4/6/2017 3
RANCHES EDISON R 0810983443 1760 30.00 6/1/2014 3
SANTOS ELVIRA M 3316155659 1760 30.00 8/22/2006 3
SETIAS KATE BEA B 0439514921 715 10.00 6/19/2017 3
Sularte Arnel M 0439037628 880 10.00 4/10/2017 3
TARRAY JOHN ERZEN S 3386400350 825 10.00 1/22/2016 3
TESORO ALFONSO JR G 0417923369 825 10.00 6/16/2014 3
TOROY GLESSY B 3319377638 1760 30.00 6/1/2017 3
VALDEZ MINERVA C 3359761767 1760 30.00 11/2/2015 3
SALDANA GEE N 1007937146 605 10.00 1/18/2018 1
Legends:
For the Month: Required
-MM/YYYY
Document #: Required
-Remittance number assigned by sender
-Must be unique per employee transaction
-6 characters only
Payment Order #: Required
-Number assigned by sender
-Must be unique per employee transaction
-Must not be empty
SSS Number: Required
-No dash
Premium: Required
-Combined - employee and employer share
Date Hired/Separated: Required
-MM/DD/YYYY
Status: Required
-1 - New
-2 - Separated
-3 - Normal
 Legend:
For the Month of: Required
-MM/YYYY
Form Name SSS Loan Payment SSS Number: Required
For the Month of 01/2021 (mm/yyyy) -No Dash
Loan Date: Required
Loan -MM/DD/YYYY
Surname First name MI SSS Number Loan Date Amount Paid Loan Type
Amount Loan Type: Required
-1 - Salary Loan Early Renewal Program
-S Salary Loan
-C - Calamity Loan

CELINO ROLLY S 0430885439 8/27/2019 23,000.00 1,061.34 S

TESORO JR ALFONSO G 0417923369 9/23/2015 14,000.00 646.04 S
RANCHES EDISON R 0810983443 3/11/2019 32,000.00 2,214.96 S
TARRAY JOHN ERZEN S 3386400350 3/11/2019 8,000.00 369.16 S

BAUTISTA KARL CHRISTIAN C 0424785383 3/5/2019 9,000.00 415.30 S

JARDIN ROOSEVELT D 0437055835 3/5/2019 11,000.00 507.60 S
JARDIN ELMER D 0419549880 11/4/2019 23,000.00 1,061.34 S
NAVARRO DOMINADOR L 3318925560 7/20/2020 24,000.00 1,107.48 S
OMBAO RICHARD B 0439046509 7/20/2020 7,000.00 323.02 S
QUEZON JERIC D 0439034139 8/11/2020 7,000.00 323.02 S
RAGUDOS LEONARDO B 0429137758 8/12/2020 7,000.00 323.02 S
SULARTE ARNEL M 0439037628 8/11/2020 7,000.00 323.02 S
JARDIN TOMMY C 0417492049 9/23/2020 40,000.00 922.90 S
RANCHES EDISON R 0810983443 7/27/2020 20,000.00 886.40 C
JARDIN ELMER D 0419549880 7/23/2020 11,000.00 487.52 C
CELINO ROLLY S 0430885439 7/18/2020 12,000.00 531.86 C
NAVARRO DOMINADOR L 3318925560 7/23/2020 12,000.00 531.86 C
OMBAO RICHARD B 0439046509 7/23/2020 7,000.00 310.24 C
BAUTISTA KARL CHRISTIAN C 0424785383 7/17/2020 10,000.00 443.22 C
JARDIN TOMMY C 0417492049 7/27/2020 20,000.00 886.40 C
JARDIN ROOSEVELT D 0437055835 443.22 C
MANABAT ALDRIN L 0439039749 310.24 C
310.24
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ALLEGO ROBINSON COLILI 121210780140 100.00 100.00
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AMBO RONALD SERBIN 121226123269 63.90 63.90
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ARCENA LHAN GIBSON BALMONTE 121297578151 100.00 100.00
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ARRUIRA ANEVEL CABREJAS 121298784350 100.00 100.00
ARRUIRA REY-J BERGADO 121303362542 100.00 100.00
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ASTILE NOLITO TABTAB 121206080188 100.00 100.00
ASTILI FRANCIS MALINGAS 121298040579 100.00 100.00
ATING ALDAZER ULAT 121300962959 100.00 100.00
ATUD KIMBERLY UBALDO 121298225058 100.00 100.00
ATUD EMELIO MERCED 121254542310 100.00 100.00
AUSTRIA ALVIN ARRO 121215825221 100.00 100.00
AUSTRIA RAYMARK ANSIONG 121302879309 100.00 100.00
AVANCEÑA JOHN VINCENT JARDIN 121302183122 100.00 100.00
BABAY RITCHAN DANACIO 121291962461 100.00 100.00
BACALLA REY MARK LADICA 121280623979 100.00 100.00
BACANI JASON TASA 121301103300 100.00 100.00
BACOSA JAYSON SANCHEZ 121148328238 100.00 100.00
BACOSA LITO 121293389504 100.00 100.00
BACOSA MIDWIN CADLAON 121123843614 100.00 100.00
BACOSA MARICHELL CADLAON 121303007349 100.00 100.00
BACOSA ALCHIE ANDIAO 121307384856 78.10 78.10
BACOSA JR NIXON SIOCO 121301027322 100.00 100.00
BADUA GRETCHEN RAMBONGA 121303007762 100.00 100.00
BAGALAY REYDANTE JR DALAGUIT 121213604193 100.00 100.00
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BALANAC ECRAM CARNAIN 121289075259 100.00 100.00
BALANG ALVIN CARIM 121303835659 100.00 100.00
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BALMONTE REX PADON 121296554538 100.00 100.00
BALMONTE RICHARD JOHN MORTEL 121240067056 100.00 100.00
BALMONTE JR ADOLFO MORTEL 001775772301 100.00 100.00
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BARING DATUJAMAHUL TAHAN 121276682965 100.00 100.00
BARRAMEDA EDIRECK GORECHO 101000194269 100.00 100.00
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BAUTISTA WILLIAM ZUMARRAG 121292807437 100.00 100.00
BAUTISTA ALBERT JR GONZALES 121294524587 100.00 100.00
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BAUTISTA KARL CHRISTIAN CELINO 121097937630 13.81 27.62
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CAABAY CHRISTIAN KIER NIEVES 121299871241 100.00 100.00
CAABAY ALVIN KIM URIETA 121285131244 72.32 72.32
CABANSA CERUEL ROMAHAN 121207094447 92.30 92.30
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DAUNO ARJIE KABANGCALAN 121301339461 100.00 100.00
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DE LEON ROSENDO BAGONA 121270081189 100.00 100.00
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DEHE JOSEPH NASTRAL DEVIS 121296192335 100.00 100.00
DELA CRUZ JOMAR DAMASCO 121280214647 100.00 100.00
DELA CRUZ KEVIN DAGUINOTAN 121301351886 100.00 100.00
DELA CRUZ FLORDELINO JR. VILLONES 147001251163 100.00 100.00
DELA CRUZ JOHN MIKE 121296728797 100.00 100.00
DELA CRUZ JR DAVID TIQUE 121191252301 100.00 100.00
DELA TORRE JOJIE LAGROSA 121290642696 100.00 100.00
DELGADO JOFAISA LUNE 121297781620 100.00 100.00
DELGADO BRYAN LUNE 121307570250 71.00 71.00
DELOS REYES VICTOR JR GARCIA 121296286475 100.00 100.00
DELOS REYES WENILYN GARCIA 121296962058 100.00 100.00
DELOS SANTOS KENT JOEM MAHAYAG 121213201591 100.00 100.00
DELOS SANTOS RICHARD FERNANDEZ 121301526906 100.00 100.00
DENIEGA ARNOLD BONBON 121296258676 100.00 100.00
DEVELOS MARK ARNOLD BARRAMEDA 121231126365 79.55 79.55
DEZA MARION EARL DOMINICSAGAYAP 121295293470 100.00 100.00
DIAZ JAMES OSORIO 121122699196 100.00 100.00
DICAR MARK JUSTIN TIANGSE 121301985040 100.00 100.00
DILLOZON ALFRED PONTI 121203230590 100.00 100.00
DISPO REYNOLD RODRIGUEZ 121162454249 100.00 100.00
DOCE ELMINIER PUASA 121293502316 100.00 100.00
DOMINGO CHRISTINE JOY TAMPOC 121302996153 100.00 100.00
DONGUINES MIKE JOHN BOGLOSA 121300467393 100.00 100.00
DUMALAN SAHIPAL LONDAC 121302499910 100.00 100.00
DUMALAN PALBEN SAMMA 121301357723 100.00 100.00
DUMANDA FAISAL CARIM 121020791412 100.00 100.00
DUMANDA JEFFREY CARIM 121235885380 100.00 100.00
EDANG ELJIE CASTRO 121207807102 100.00 100.00
EDING ARNOLD REMO 121240748439 100.00 100.00
EGUIRON RALPH ANTHONY DANGAN 121080138475 86.79 86.79
EHEM WILSON TEQUILLO 121279784997 78.10 78.10
ELIB JAY-R SEGOVIA 121302577676 100.00 100.00
ELIB ARNEL SEGOVIA 121169135785 100.00 100.00
ELING DANNY BEDRO 121258894613 100.00 100.00
ELISTRISIMO KRISTINE JOY TUPAS 121289279325 100.00 100.00
ELISTRISIMO JOPHET TUPAS 121297643139 100.00 100.00
EMBING ASMIN AMBATAL 121231494677 100.00 100.00
EMIK ELLY BARALUDIN 121207129565 100.00 100.00
EMIK FERDINAND BARALUDIN 121207099481 100.00 100.00
EMIK REYDON MABLEN 121207099801 100.00 100.00
EMIK REXAN MABLEN 121222654415 100.00 100.00
ENDRECOSO MADELYN TOLENTINO 121307564519 81.37 81.37
ENTING JAMAEL TUGBOK 121206040909 100.00 100.00
EPPIE JAMMIL DELA CRUZ 121158834463 100.00 100.00
ESCUADRO JORGE PABUAYA 121301517537 100.00 100.00
ESPINO RINO ZALDY UBOGAN 121287438385 100.00 100.00
ESPIRITU JEO GARIANDO 121296719503 100.00 100.00
ESTANISLAO NOE ADDIE 121186413950 100.00 100.00
ESTIANDAN JEREMIAS GUEVARRA 121140251729 100.00 100.00
ESTOLANO JENNIFER BALMONTE 121032204991 100.00 100.00
ESTRADA FRANCISCO TAGALA 121206044905 100.00 100.00
EVANGELISTA FELIMON GALICIA 121155309097 100.00 100.00
FABREGAS MICHAEL JAY MANIO 121307259765 36.16 36.16
FACUN JINNO BIOGOS 121274332813 100.00 100.00
FERNANDO JERICO CUADRA 121290606513 100.00 100.00
FERNANDO KELVIN JAMES DE VEGA 121301531426 100.00 100.00
FERNANDO KEVIN OLAHIO 121067871495 100.00 100.00
FERRER MA FAITH VIKTORIA BRAVO 121254563992 100.00 100.00
FLORA EDDIE MANGLICMOT 121207336904 100.00 100.00
FLORES JICKIERY ADVIENTO 121247096523 100.00 100.00
FLORES DANIEL BETITA 121280111904 100.00 100.00
FLORES EDDIE MALONES 121296302625 100.00 100.00
FLORES EDU MALONES 121307262664 89.50 89.50
FRAGINAL MARK IAN ARRUIRA 121301174618 100.00 100.00
FRANCISCO RONIE LOPEZ 121296439359 100.00 100.00
FRANCISCO RONEL LOPEZ 121298480504 100.00 100.00
FRIAS FREDDIE ACUDISEN 121151742355 100.00 100.00
GABAYNO ALDO DUGAY 121290184864 100.00 100.00
GABAYNO EDMAR BACUEL 121302570862 100.00 100.00
GABUCO REYMOND MADARCOS 121067890667 100.00 100.00
GALICIA LOVELYN CATUCOD 121179745849 100.00 100.00
GALICIA JOHN VINCENT RANAY 121295095129 100.00 100.00
GALO LADISLAS BERNARD CASABUENA 121273984399 86.79 86.79
GAMAYON RENAN CUBID 101000553919 100.00 100.00
GAMBIL ALMER SUANA 121190598051 100.00 100.00
GAMBIL AMUEL SUANA 121206049268 100.00 100.00
GANTES MICHAEL GALAN 121187894997 100.00 100.00
GARAY MARVIN DALISAY 121299280902 100.00 100.00
GARCIA JESELYN USMAN 121296847294 100.00 100.00
GARCIA MICHAEL 121232923522 100.00 100.00
GAVINO AGRITO JR DAPITAN 121043636909 100.00 100.00
GAYOMALI MARRY JEAN BALLARBARE 121286619894 100.00 100.00
GENEGABUAS JONARD DUMA-OG 121307573401 82.85 82.85
GESTAM JEROME MEDINA 121281169632 100.00 100.00
GESTAM RODEL MEDINA 121296771740 100.00 100.00
GESTAM ROSMILYN MACLES 121137030846 100.00 100.00
GILUA EVENSIR JR ONAPAN 121179259530 100.00 100.00
GLOVA CARLO JOY ANDICO 121255281405 100.00 100.00
GOMEZ ERIC GONZAGA 121252952016 100.00 100.00
GONZAGA ALEJANDRO JR VEGA 121301970578 100.00 100.00
GONZAGA JAYZON PALABRICA 121307202102 79.55 79.55
GONZALES REGAN EDEN 121206092208 100.00 100.00
GONZALES RICARDO JR MARUDI 121173393571 100.00 100.00
GONZALES KEVIN ALBA 121243972681 94.02 94.02
GUANTERO WILFREDO PALAGUIWAN 121207178009 100.00 100.00
GUBAT NORCILA TORRES 121252579599 100.00 100.00
GUIPAYA LORESON JORTE 121296702029 100.00 100.00
GUISEM JOEGEN PASCUAL 121217713120 100.00 100.00
GUNTING LOBERT NALEN 121304613722 100.00 100.00
HALON ADMIRAL USOP 121302041468 100.00 100.00
HASAN STEVEN MARVIC 121286541230 100.00 100.00
HASSAN MICHAEL ARQUERO 121197240881 100.00 100.00
HEREDERO GENLY OMILDA 121077771860 100.00 100.00
HIDALGO DANTE ASIL 121296312328 100.00 100.00
HONRUBIA JANUAMAY BONANZA 121304708247 100.00 100.00
IBAÑEZ DARRYL RELON 121302848203 100.00 100.00
IBRAHIM JAN USMAN 121300307798 100.00 100.00
IGNACIO JEANELYN TEJADA 121227928540 100.00 100.00
IGNACIO FREDDIE AGUSTIN 121106845602 100.00 100.00
IGNACIO WILMAR ATCHERA 121104030904 100.00 100.00
ISANAN MARK KEVIN GALPO 121296721159 100.00 100.00
ISMAEL RICHARD CANDOLESAS 121059352926 100.00 100.00
ISMAEL ALIASER USMAN 121207162036 100.00 100.00
ISMAEL HAMSARIN AMERASAN 121297493361 100.00 100.00
JACENA JAMAR ALPAD 121163352428 100.00 100.00
JALADIN ALLAN SIRIN 121212936300 93.35 99.40
JAMIL HAMLI BASA 121300252283 100.00 100.00
JAMILI JIMBRE DUMANDA 121301677290 79.55 79.55
JANAIRO CHRISTIAN TEJADA 121281924572 100.00 100.00
JARDIN ROOSEVELT DADULE 121174502061 100.00 100.00
JARDIN LEONARD NARRAL 121220555533 100.00 100.00
JARDIN RUDY BACOSA 121213622255 100.00 100.00
JARDIN MANNY TABANGAY 121293513718 100.00 100.00
JARDIN FRINEROSE GERMAN 121292036435 100.00 100.00
JARDIN ALFONSO JR ABID 121299671061 100.00 100.00
JARDN ARIEL GADIANO 121298481283 100.00 100.00
JASMIN JAYSON RUFA 121195279289 100.00 100.00
JEREZA RYAN MARCELO 121290568301 100.00 100.00
JONTILANO IVAN ADONIS 121301447244 100.00 100.00
JONTILLANO ROLLY NAVARRA 121305410278 100.00 100.00
JOPIN JHON MANDOD 121306897628 99.40 99.40
JORTE JERSON NALI 121165882854 100.00 100.00
JURATIL RICKMAN SALIHUN 121116320004 100.00 100.00
JURI RHOEL ARCHE 121127269637 100.00 100.00
KATON ERWIN ASIM 121073999323 100.00 100.00
KEONG PAREDJA USMAN 121272560182 11.68 28.40
KULAS JEZAR AWANG 121291547933 100.00 100.00
LABANA EPIFANIO BAHANDE 121304769163 100.00 100.00
LABAY MICHAEL PEGUERRA 121301970767 100.00 100.00
LABIAN JEREMY TERADO 121302905487 100.00 100.00
LABOR ROLDAN MABASA 121177947238 100.00 100.00
LACHICA AL MUKADER JAAPAL 121230748229 100.00 100.00
LADAG ANALIE CULAS 121297397308 100.00 100.00
LAGAN GRETCHEN DELA CRUZ 121296652421 100.00 100.00
LAGAN PETER FERIA 121295420528 100.00 100.00
Form Name Pag-IBIG Short-Term Loan (ST)
Description Employee's Pag-IBIG Short-Term Loan File
Applicable Month 202209

Pag-IBIG / SSS
Surname First name Middle Name
Number
ALONZO ERNESTO PIHAYON 121107326591
ABON APRIL JANE BILLONES 121051448230
ADVIENTO JR FIDEL AVILA 121296478627
ASTILE KEVEN TANING 121206080208
BUNDAC JHUN MARK BUHARI 121127522338
ESTRADA FRANCISCO TAGALA 121206044905
IGNACIO JEANELYN TEJADA 121227928540
JARDIN LEONARD NARRAL 121220555533
JARDIN ROOSEVELT DADULE 121174502061
LUNGAY TIFFANY CC PACQUEO 121132471539
MABLEN ELJUN NANE 121206028106
MANABAT ALDRIN LAWANG 121206037278
ONDING JERALD ALIBASE 121206048023
QUEZON JERIC DALISAY 121206077390
RAGUDOS LEONARDO BERNAS 121123885255
RANCHES EDISON ROSARIO 121029234007
SULARTE ARNEL MARIANO 121206097337
VALERIANO NAZARINO ASTILE 121206035169
VILLALOBOS NELVIA ONDING 121229543568
 Legend:
Applicable Month: Required
-yyyymm
PagIBIG/SSS Number: Required
-No Dash
BirthDate: Required - MM/DD/YYYY
TIN: Optional
Loan
Amortization
BirthDate TIN
687.50 03/19/1992
4/11/1989
461.48 6/6/1983
347.74 11/4/1974
1,203.60 03/24/1991
373.18 11/15/2000
213.24 1/3/1999
245.62 11/4/1977
479.92 11/14/2001
01/22/1990
278.22 12/26/1983
324.56 01/30/1995
348.70 5/11/1991
322.26 01/21/2002
613.06 3/20/1995
8/23/1978
347.54 7/21/1986
328.98 10/7/1995
333.36 7/31/1981
Form Name Pag-IBIG Calamity Loan (CL)
Description Employee's Pag-IBIG Calamity Loan File
Applicable Month 201701

Pag-IBIG / SSS
Surname First name Middle Name
Number
 Legend:
Applicable Month: Required
-YYYYMM
PagIBIG/SSS Number: Required
-No Dash
BirthDate: Required - MM/DD/YYYY
TIN: Optional
Loan
Amortization
BirthDate TIN
Form Name Pag-IBIG Housing Loan (HL)
Description Employee's Pag-IBIG Housing Loan File
Applicable Month 201701

Pag-IBIG / SSS
Surname First name Middle Name
Number
 Legend:
Applicable Month: Required
-YYYYMM
PagIBIG/SSS Number: Required
-No Dash
BirthDate: Required - MM/DD/YYYY
TIN: Optional
Loan
Amortization
BirthDate TIN
 Legend:
Period Covered: Required (MM/YYYY)
EMPNO: Optional
PhilHealth Number: Required
Compensation: Required
EC01: Requied -Employee Share only
(Applicable Months: Jan, Apr, Jul,Oct)

Form Name Simple Philhealth Contribution (SPC) Period Covered

Description Employee's Simple Philhealth Contribution File

MIDDLE
EMPNO LAST NAME FIRST NAME Philhealth Number
INITIAL
AMORA MAY ELAINE C 12050709155
DACANAY FLORANTE G 010500107699
GARCIA IMELDA C 190904844741
SANTOS ELVIRA M 040000277462
SOLER CHRISTINE FIL B 120508557520
CELINO ROLLY S 090501912491
DOÑOZ REX R 010521823300
JARDIN ELMER D 090250858913
LIRAZAN JOJO R 090254769125
NAVARRO DOMINADOR L 090501608059
NAVARRO RONALD R 090000391114
PIALA FELIX L 190891855587
RANCHES EDISON R 180500228855
VALDEZ MINERVA C 090501766223
BALBUTIN EPENITO G 090501794707
MAESTRECAMPO ROEL R 090503914211
TESORO ALFONSO JR G 090501608121
BALMONTE HARLY B 010521823394
BATERNA NELBERT D 230020600409
BERNAS ALVIN D 010522145292
BUÑAG JHONMARK B 010521823416
DELGADO BRYAN L 010521820999
JARDIN ROOSEVELT D 092015449421
MINDOC NICANOR D 01521820956
TARRAY JOHN ERZEN S 080504252233
ARABIS ALEX C 190001090252
LIBATIQUE FERDINAND D 090254769125
 EC02: Requied -Employee Share only -NE - No Earning
d: Required (MM/YYYY) (Applicable Months: Feb, May, Aug, Nov) -NH - Newly Hired
EC03: Requied -Employee Share only Or leav it blank for
mber: Required (Applicable Months: Mar, Jun, Sep, Dec) regular payments
Required DATE_HIRED: Required -MM/DD/YYYY
-Employee Share only STATUS: Required
nths: Jan, Apr, Jul,Oct) -SP - Separated

02/2017

COMPENSATION EC01 EC02 EC03 DATE_HIRED STATUS

50,000.00 437.50 8/1/2014
13,083.00 162.50 4/1/2007
64,875.00 437.50 7/7/2006
63,458.34 437.50 8/22/2006
35,000.00 437.50 4/6/2015
15,537.86 137.50 11/2/2015
20,862.14 287.50 12/7/2015
15,537.86 100.00 11/2/2015
15,537.86 112.50 11/2/2015
10,000.00 125.00 7/16/2014
63,811.42 437.50 7/1/2014
70,000.00 437.50 5/15/2015
107,929.05 437.50 6/1/2014
14,668.68 175.00 11/2/2015
7,150.00 100.00 6/16/2014
7,280.00 100.00 10/29/2015
7,150.00 100.00 6/16/2014
6,840.00 100.00 1/22/2016
5,557.50 100.00 2/1/2016
8,607.45 100.00 10/12/2016
6,840.00 100.00 1/22/2016
5,415.00 100.00 2/1/2016
10,260.00 125.00 1/22/2016
6,270.00 100.00 6/6/2016
6,840.00 100.00 1/22/2016
40,000.00 437.50 1/2/2017
40,000.00 437.50 1/2/2017