OONA INSULAR INSURANCE CORPORATION

8F Oona Center, 1220 Acacia Ave., Madrigal Business Park, Credit Memo No. : CM-HO-22000000001
Ayala Alabang, Muntinlupa City
TEL (02) 8876-4444
info@oona-insurance.com.ph, www.myoona.ph

CREDIT MEMO
ATTACHED TO AND FORMING PART OF POLICY NO: 2002401000406
RESIDENTIAL
POLICY SCHEDULE
WATER
POLICY HOLDER / INSURED SEGUNDA FENIQUITO PICAR
MAILING ADDRESS 027 GOV TUPAS ST SAN PEDRO
MORONG RIZAL PHILIPPINES 1960
TIN 308-680-010
INSURED IDENTIFICATION PAS-P8547683B
INTERMEDIARY CODE 1101

POLICY NO. 2002401000406 ENDORSEMENT PREMIUM

ENDORSEMENT NO. 1 NET PREMIUM (263.99)
POLICY TERM 14-Mar-2024 04:00 pm DOCUMENTARY STAMPS (33.00)
14-Mar-2025 04:00 pm VALUE ADDED TAX (31.69)
TRANSACTION TYPE ADDITIONAL LOCAL GOVERNMENT TAX (1.31)
CURRENCY PHILIPPINE PESO FIRE SERVICE TAX (2.84)
EFFECTIVITY DATE 14-Mar-2024 TOTAL PREMIUM DUE (332.83)
ISSUE DATE 19-Mar-2024

*Not valid for claiming of input tax.