Republic of the Philippines

SOCIAL SECURITY SYSTEM

http://www.sss.gov.ph

THIS IS YOUR OFFICIAL RECEIPT WHEN VALIDATED

CARANGCARANG, DULCE SARAH BACALA Reference Number: SJ221287771669

Amount Due: P2,370.00
SS Number: 35-0978996-8 Due Date: January 31, 2023
Payor Type: Self Employed Generation Date: October 21, 2022

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
Oct 2022 to Dec 2022 SJ221287771669 P2,370.00

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

CARANGCARANG, DULCE SARAH BACALA Total Amount Paid

SS Number: 35-0978996-8 P ______________________
Cash ( ) Cheque ( ) Cheque No. ________________
Bank/Branch _______________
Bank Teller ________________