PAYOR's COPY

Republic of the Philippines

SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
CON -
COLLECTION LIST SUMMARY

04-1074933-3-000
CRISTINA S. BORILLA
D. NADRES ST. SAN ROQUE ZN 2 TAYABAS QUEZON
4327 This is your official receipt when validated

Payment Reference Number

Due Date : September 30, 2019
Generation Date : September 02, 2019

Electronic Contribution Collection List Summary for the Month of (August 2019)
Total Number of Employees : 2
Breakdown of Contributions :
Social Security (SS) Php 960.00
Employee Compensation (EC) 20.00
Total Amount Due Php 980.00

Please pay on or before the due date at any SSS accredited collecting partner/bank or SSS Branch with Tellering Facility. A penalty of 3% per
month, pursuant to Section 22 (a) of RA 1161, as amended by RA 8282, shall be imposed on contributions not paid within the prescribed schedule.

The SSS reserves the right to determine and collect the true and correct contributions due the SSS if it finds other un-remitted/underpaid/out-of-
bracket contributions during or before the period billed. SSS shall conduct further verification and assessment on the details of the Electronic
Contribution Collection List Details (e-CL) and shall collect any balance, if any.

For inquiries, please email PRNHelpline@sss.gov.ph. You may contact us at 920-6446 or 917-7777.

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

SSS' COPY
Republic of the Philippines
SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
COLLECTION LIST SUMMARY
CON -
PAYMENT SLIP

04-1074933-3-000
CRISTINA S. BORILLA
August 2019

Payment Reference Number

 Republic of the Philippines
SOCIAL SECURITY SYSTEM
ELECTRONIC CONTRIBUTION
CON -
COLLECTION LIST

Payment Reference Number

04-1074933-3-000
CRISTINA S. BORILLA
August 2019

Name of Employee SS Number SS EC Total Contributions

1 AGUDILLA, AILEEN R 04-1441096-9 480.00 10.00 490.00
2 BORILLA, NOLIE N 04-0892681-2 480.00 10.00 490.00
Sub-total Php 960.00 Php 20.00 Php 980.00
Total Amount Due Php 980.00

This is a system-generated list, signature is not needed. Page 1 of 1