1. Republic of the Philippines
SOCIAL SECURITY SYSTEM
BALANGA
SALARAY/CALAMITY/EDUCATIONAL/EMERGENCY LOAN
BILLING STATEMENT
As of 04-30-2013
Employer Name: JAICY MICHAELA TRANSIT
Employer ID Number: 02-0958923-8
PART I
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| | | | |
| Amount Due | |
|
| | | | |
|-----------------------------------------------| Total |
|
| SS Number | Name of Borrower | Loan | Date |
Amount of | | Overdue | Amount |
Remarks |
| | | Type | Granted |
Loan | |-------------------------------| Due |
|
| | | | |
| Current | Print + Int | Penalty | |
|
|-------------------------------------------------------------------------------
--------------------------------------------------------------------------------
-------------------|
|-------------------------------------------------------------------------------
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-------------------|
| | | | |
| | | | |
|
| | SUBTOTAL: | | |
| 0.00 | 0.00 | 0.00 | 0.00 |
|
| | | | |
| | | | |
|
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PART II
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| | | | |
| Amount Due | |
|
| | | | |
|-----------------------------------------------| Total |
|
| SS Number | Name of Borrower | Loan | Date |
Amount of | | Overdue | Amount |
Remarks |
| | | Type | Granted |
Loan | |-------------------------------| Due |
|

2. | | | | |
| Current | Print + Int | Penalty | |
|
|-------------------------------------------------------------------------------
--------------------------------------------------------------------------------
-------------------|
| 02-2071844-4 | MARIANO, MICHAEL MARK C | S | 04-14-2011 |
6,000.00 | 262.50 | 3,812.03 | 106.26 | 4,180.79 |
|
|-------------------------------------------------------------------------------
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| | | | |
| | | | |
|
| | SUBTOTAL: | | |
| 262.50 | 3,812.03 | 106.26 | 4,180.79 |
|
| | GRAND TOTAL (PART I AND II): | | |
| 262.50 | 3,812.03 | 106.26 | 4,180.79 |
|
| | | | |
| | | | |
|
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Ref. No.: 209593418