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PHILHEALTH INITIAL LIST (Attach to PhilHealth Form Er1)
REPORT OF EMPLOYEE-MEMBERS /
SUBSEQUENT LIST

NAME OF EMPLOYER/FIRM: EMPLOYER NO. 006000010213

ADDRESS: E-MAIL ADDRESS: isabela@deped.gov.ph

PHILHEALTH DATE OF (DO NOT FILL)
EFF. DATE OF PREVIOUS EMPLOYER
SSS/GSIS NAME OF EMPLOYEE POSITION SALARY EMPLOY-
COVERAGE ( IF ANY)
NUMBER MENT
01-025281036-1 BERNADINE J. TRINIDAD TEACHER 1 27,000 MARCH
31, 2023

TOTAL NO. LISTED ABOVE: BELINDA R. MATIAS, Ed.D

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