r3_fill_in - Republic of the Philippines R-3 SOCIAL...

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R-3 REV. 08-99 Republic of the Philippines SOCIAL SECURITY SYSTEM Contribution Collection List (Please Read Instructions at the Back. Print All information in Black Ink) EMPLOYER ID NUMBER REGISTERED EMPLOYER NAME TEL. NO. ADDRESS SS NUMBER NAME OF MEMBER (Surname) (Given Name) (MI) SOCIAL SECURITY EMPLOYEE COMPENSATION 1st Month 2nd Month 3rd Month 1st Month 2nd Month TYPE OF EMPLOYER TOTALS FOR THIS PAGE (to be filled out on every page) Appl.Mo . Social Security Employee Compensation GRAND TOTAL Grand Total PAYMENT DETAILS TR/SBR NO. Date Paid Amount Paid ADJUSTMENT TYPE: Addition to Previously Submitted R-3 Deduction from Previously Submitted R-3 CERTIFIED CORRECT AND PAID: Signature Over Printed Name Official Designation Date PROCESSED BY/DATE: ENCODED BY/DATE: OTHER NOTATIONS: RECEIVED BY/DATE: Signature Over Printed Name Signature Over Printed Name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. SEPARATION DATE (MM DD YYYY) QUARTER ENDING M Y Y 3rd Month Regular Household PAGE OF PAGES 1st 2nd 3rd FOR SSS USE u
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This note was uploaded on 01/13/2012 for the course ECO 402 taught by Professor Rednimes during the Spring '11 term at Illinois State.

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r3_fill_in - Republic of the Philippines R-3 SOCIAL...

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