PAYOR's COPY

Republic of the Philippines

SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
CON -
COLLECTION LIST SUMMARY

80-0106174-9-000
TAKI'S JAPANESE DINER
DOMINGO-VELEZ STREET
BARANGAY 29 (POB.) CAGAYAN DE ORO CITY (CAPITAL) This is your official receipt when validated
MISAMIS ORIENTAL 9000
Payment Reference Number
Due Date : December 02, 2019
Generation Date : November 01, 2019

Electronic Contribution Collection List Summary for the Month of (October 2019)
Total Number of Employees : 10
Breakdown of Contributions :
Social Security (SS) Php 12,480.00
Employee Compensation (EC) 120.00
Total Amount Due Php 12,600.00

Please pay on or before the due date at any SSS accredited collecting partner/bank or SSS Branch with Tellering Facility. A penalty of 3% per
month, pursuant to Section 22 (a) of RA 1161, as amended by RA 8282, shall be imposed on contributions not paid within the prescribed schedule.

The SSS reserves the right to determine and collect the true and correct contributions due the SSS if it finds other un-remitted/underpaid/out-of-
bracket contributions during or before the period billed. SSS shall conduct further verification and assessment on the details of the Electronic
Contribution Collection List Details (e-CL) and shall collect any balance, if any.

For inquiries, please email PRNHelpline@sss.gov.ph. You may contact us at 920-6446 or 917-7777.

This is a system-generated summary, signature is not needed.

SSS' COPY
Republic of the Philippines
SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
COLLECTION LIST SUMMARY
CON -
PAYMENT SLIP

80-0106174-9-000
TAKI'S JAPANESE DINER
October 2019

Payment Reference Number

 Republic of the Philippines
SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
CON -
COLLECTION LIST

Payment Reference Number

80-0106174-9-000
TAKI'S JAPANESE DINER
October 2019

Name of Employee SS Number SS EC Total Contributions

1 ARCA, DARLEENE G 34-8660286-7 1,140.00 10.00 1,150.00
2 CABANA, ANDRIA V 08-2717717-4 1,140.00 10.00 1,150.00
3 CHAVEZ, ANNA MARIEL C 08-2830083-0 1,140.00 10.00 1,150.00
4 DEMETILA, EMILY C 08-2965180-5 1,140.00 10.00 1,150.00
5 HINAMPAS, JAMES N 08-1353778-6 1,260.00 10.00 1,270.00
6 LOPEZ, DANIEL M 08-0985972-4 1,140.00 10.00 1,150.00
7 MUSICO, DEVVIE J 06-3061023-9 1,860.00 30.00 1,890.00
8 PAASA, MARIA GABRIELA E 08-2940013-7 1,140.00 10.00 1,150.00
9 QUIMBO, EDELYN MAE B 08-2970689-9 1,140.00 10.00 1,150.00
10 SALCEDO, DIANA SHAENE M 08-2748637-3 1,380.00 10.00 1,390.00
Sub-total Php 12,480.00 Php 120.00 Php 12,600.00
Total Amount Due Php 12,600.00

This is a system-generated list, signature is not needed. Page 1 of 1