HRSEA – 19

Rev. May 2014

ADVANCE PAYMENT FOR SSS’ SICKNESS / MATERNITY /

EMPLOYEE’S COMPENSATION BENEFIT
Sickness Benefit EC Benefits
AREA TYPE: Monthly Daily DATE
Maternity Benefit
PAY TO Voucher No.
The amount representing Advance Payment for: Period Covered:
Social Security System’s SICKNESS / MATERNITY / EC Benefit Claim of:
P

COMPUTATION

Total Monthly Salary Credit P _____________________________

Divided by 180 _____________________________
Average Daily Salary Credit _____________________________
Multiplied by 100% _____________________________
Daily Sickness Allowance _____________________________
Multiplied by no. of days approved _____________________________

Compensation Due P __________________________

Prepared by: Noted by:

_________________________________ _______________________ _______________________________ ______________________

HRSEA Benefits Personnel Date Finance Manager Date

Noted by:

___________________________________ ___________________________________
Operations Manager, HRSEA EVP/General Manager

Received from FOREMOST FARMS, Inc. the sum of ___________________________________________________

_____________________________________ (P __________________) in full / partial settlement of the amount
described above.

Received by:

______________________________________
Employee Signature over Printed Name

Cc: Orig. – Finance; (1) HRSEA Office; (2) Employee Concerned