Republic of the Philippines

SOCIAL SECURITY SYSTEM

http://www.sss.gov.ph

THIS IS YOUR OFFICIAL RECEIPT WHEN VALIDATED

BEJERANO, DAISY JAMORALIN Reference Number: VG210947287672

Amount Due: P2,730.00
SS Number: 05-0853408-1 Due Date: August 02, 2021
Payor Type: Voluntary Generation Date: July 04, 2021

STATEMENT OF ACCOUNT

Note: Pursuant to Circular No. 2020-032 dated 24 November 2020, starting January 2021, SS contribution includes Workers' Investment and
Savings Program or WISP (SSS Provident Fund) contribution.

APPLICABLE PERIOD INDIVIDUAL PAYMENT REFERENCE AMOUNT

NUMBER
Apr 2021 to Jun 2021 VG210947287672 P2,730.00

Please pay on or before the due date at any SSS accredited collecting partner/bank or SSS Office with tellering Facility.

For inquiries, email us at PRNHelpline@sss.gov.ph

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

Republic of the Philippines

SOCIAL SECURITY
SYSTEM
http://www.sss.gov.ph

Payment Slip

BEJERANO, DAISY JAMORALIN Total Amount Paid

SS Number: 05-0853408-1 P ______________________
Cash ( ) Cheque ( ) Cheque No. ________________
Bank/Branch _______________
Bank Teller ________________