Pag-IB

EMPLOYER / BUSINESS Name

Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY MEMBE
Name
Extensio
MID No. NO. PROGRAM Last Name First Name n Middle Name COVERED COMPENSATION EE
SHARE
101002534693 * ABALOS EDEN ODO Oct-19 100
121159222608 * ABAPO TREXIE MAE TORRES Oct-19 100
121186482023 * ABEJO JAN ERICA N/A Oct-19 100
108001957006 * ABELIS RIA JASTIVA Oct-19 100
109001113138 * ABINOMAN ANDRESITO AMBAIT Oct-19 100
121111984547 * ABRIGO LOUIE LUNA Oct-19 100
121224883937 * AGUILAR SHARON ARCEO Oct-19 100
121149550201 * AGUSTIN FRANCESCA ATABELO Oct-19 100
104001970995 * ALBERO FERNANDO CREDO Oct-19 100
121199428845 * ALCORIZA DONNALYN YUMOL Oct-19 100
192000159655 * ALEJANDRINO VERNADETH MEDINA Oct-19 100
121226818182 * ALMOSA FROILAN BUENAVENTURA Oct-19 100
121199433476 * ALQUILLERA DAISY RIVERA Oct-19 100
121158950917 * ALTACHIE JEFFERSON ANTAZO Oct-19 100
121156221944 * ALVERO MARY ANN CAPOQUIAN Oct-19 100
104002008210 * ALVIA SANNY BABAREIN Oct-19 100
108001955211 * AMANDY ERNESTO TEJANO Oct-19 100
914206202285 * AMANSEC BOYET CABATBAT Oct-19 100
121115994395 * AMAR RHINA BALASBAS Oct-19 100
121235375193 * AMPO JENRY JUSAY Oct-19 100
121060919358 * AMPO PHILIP JUSAY Oct-19 100
121061170876 * ANGELES ANTHONY SABALLERO Oct-19 100
121112153742 * ANGELES JEFFREY GENIZA Oct-19 100
121125355930 * ANGELES WILMAR CONTRETAS Oct-19 100
121184595281 * APOSTOL MARIBEL EJEDO Oct-19 100
121185258686 * AQUINO MARY ANN GABOTAN Oct-19 100
TOTAL FOR THIS PAGE 2,600
GRAND TOTAL ( If last page) 39,100
EMPLOYER CERTIFICATION
 I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge a
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
ER Total
SHARE
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200 38200
100 200
2,600 5,200 77,500.00
38,200 77,300
e and corrct to the best of my knowledge and belief. I

DATE

(V03,10/2016)
 Pag-IBIG E

EMPLOYER / BUSINESS Name

Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY MEMBERS
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION EE
SHARE
108001940682 * AQUINO NOEL QUERIMIT Oct-19 100
121094470942 * ARAZA LEONARD TAN Oct-19 100
121160623591 * ARBES REALINE PANALIGAN Oct-19 100
121107659288 * ARCAN KERVY GABIOTA Oct-19 100
101002555918 * ARCE CECILIA VIDEÑA Oct-19 100
121121076297 * ARCILLA ARNALDO JEAN GAJO Oct-19 100
121011983480 * ARMES ARLENE VILLASEÑOR Oct-19 100
121230699339 * ARTATES CYRIL JUNE LAGON Oct-19 100
109090493806 * ASNAR WILBERT SARAUSOS Oct-19 100
121136455318 * AUREA CHERRY MAE LUSUEGRO Oct-19 100
121178019238 * AUSTRIA DARELL CHRISTIAN HERMOSO Oct-19 100
121132924197 * AZADA JONALYN FELISMENO Oct-19 100
104002022955 * BALAGBIS EDUARDO MAESTRE Oct-19 100
121126607886 * BALAURO RICHELL LASTIMOSO Oct-19 100
109000174464 * BALDONADO JANNEFER MAGNO Oct-19 100
109003278862 * BANOSA FRANCISCO LATORRE Oct-19 100
121159651981 * BANTOLA PABLO JR TORRES Oct-19 100
121173044952 * BARRO ANDREW ORIENDO Oct-19 100
* BASAYA JENNIFER Oct-19 100
108009151872 * BATERNA NIEL DEMAFELIZ Oct-19 100
121261485582 * BAUBAYAN LOWEL MILA Oct-19 100
121008711174 * BAYAN RONELL PABLO Oct-19 100
121159592219 * BAYANI IRIS JAY FERNANDEZ Oct-19 100
121214706813 * BAYSIC RIC BRYAN VILLANOBOS Oct-19 100
102004086831 * BERANGO ARNEL SOLO Oct-19 100
121030517647 * BERJA JESUS PANTOJA Oct-19 100
121081728560 * BERMAS ALLAN ESTRELLANDO Oct-19 100
121110814037 * BICARME MIKE TOLENTINO Oct-19 100
108001938446 * BILOG ORLANDO BANARIA Oct-19 100
TOTAL FOR THIS PAGE 2,900
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
ER Total
SHARE
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
 2,900 5,800

R CERTIFICATION

ments made herein are true and corrct to the best of my knowledge and belief. I

DATE

R SALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION

121240628109 * BISMAR JEDRIC DAVE JAVIER Oct-19

121007298579 * BLANCA RAZEL OPIANGA Oct-19
121126472628 * BLANES EDCEL MENDEZ Oct-19
121153761795 * BOLDA RICO PADILLA Oct-19
121139747629 * BOTONA ROCRIS CONSIGNA Oct-19
121167737145 * BRAGA SUSAN MANDIA Oct-19
108001962904 * BUADO ACE YORK MATUTINO Oct-19
121184513095 * BUELO JOHN REX CHRISTIAN BAGAC Oct-19
106000258163 * BUENABAJO RICHARD BEDES Oct-19
121066930897 * BUSTAMANTATE RHEA N/A Oct-19
121138050918 * CABAL EDMOND MANOCDOC Oct-19
121186296849 * CABASE ROXAN MANOCDOC Oct-19
121256996334 * CABRERA JOMARIE CENTENO Oct-19
121187337561 * CADIZ JOSE ALON Oct-19
121155323877 * CALICOY ARNEL LABIDE Oct-19
121022205044 * CALIVA GEORGE RIN Oct-19
108001964925 * CALLAO EMMANUEL ALEJO Oct-19
121231674030 * CALLEJA MARK FRANCIS BORJA Oct-19
121140868020 * CALUBAD JANICE ALEJANDRE Oct-19
121127166696 * CALUBAG ABNER CHRISTOPHER SILVA Oct-19
105000344074 * CALUNSAG RICHARD ERANES Oct-19
109000761115 * CALUNGSOD JOANNE BRISTOL Oct-19
108001961528 * CAMPILLA THERESA ANNE FEDERON Oct-19
121174629427 * CANOZA WARREN ROBLES Oct-19
121213574176 * CAPOS NORIEL GUERIBA Oct-19
121102891776 * CARBONEL LOVELY POYOAN Oct-19
121141370327 * CARVAJAL JESON SARAHINA Oct-19
121158714434 * CASTAÑO ISRAEL DELOS ANGELES Oct-19
121256920523 * CASTELL TONI ROSE PELINGON Oct-19
TOTAL FOR THIS PAGE
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowled
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
2,900 2,900 5,800
ER CERTIFICATION

nts made herein are true and corrct to the best of my knowledge and belief. I

DATE

OR SALE (V03,10/2016)
 Pag-IBI

EMPLOYER / BUSINESS Name

Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY MEMBE
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION EE
SHARE
121127764616 * CASTRO BAYANI JR ANASTACIO Oct-19 100
121229385851 * CASTRO EDDIE HERNANDEZ Oct-19 100
121167673303 * CASTRO JAY MARK DELA CRUZ Oct-19 100
121021493049 * CASTRO JONIE BEJUCO Oct-19 100
121124534427 * CAY CHRISTONY MENDEZ Oct-19 100
121113574176 * CALICOY ARNEL LABIDE Oct-19 100
121213574176 * CELIRIDAD ROBIN LLANERA Oct-19 100
121054509186 * CENCILLA JAY AR TOLENTINO Oct-19 100
916312059981 * CENTINO ROGER QUILANTANG Oct-19 100
121102991554 * CIPRIANO ARCHIE NUAS Oct-19 100
121095519385 * CHAVEZ CHENNIE PATEÑO Oct-19 100
121092037785 * CHAVEZ JOHN LUKE SALISE Oct-19 100
919171807438 * CHIPAY ALEX LAGMAY Oct-19 100
121143407181 * CHIPAY CRISTIAN LAGMAY Oct-19 100
121132399067 * COLAPO RAYMOND MENGOTEX Oct-19 100
121028857642 * COMPLUMA CHRISTOPHER IAN MUÑOZ Oct-19 100
121231332128 * CONCEPCION ROSALIN BARICUATRO Oct-19 100
121109331298 * CONDIDO DANIEL ORO Oct-19 100
108000034494 * CORTEZ DANDEL CELAB Oct-19 100
121064992677 * CURAMENG ROWENA YBARRITA Oct-19 100
121216764565 * CUYOS MANUEL VILLEGAS Oct-19 100
121261113817 * DACUMOS RUEL ESTOLAS Oct-19 100
121128681581 * DALUMPINES ELOISA MENDOZA Oct-19 100
104002035832 * DANILA CHERRYLYN YUSO Oct-19 100
121103364469 * DAVO TOBIAS JR SULGAN Oct-19 100
121136443197 * DE GUZMAN LEAH VALEZA Oct-19 100
121084885956 * DE GUZMAN MARK ANTHONY PEREZ Oct-19 100
TOTAL FOR THIS PAGE 2,700
GRAND TOTAL ( If last page)
 EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge a
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
ER Total
SHARE
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
2,700 5,400
CERTIFICATION

made herein are true and corrct to the best of my knowledge and belief. I

DATE

ALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION

121162174586 * DELAMBACA MARTIN JONATHAN ANDIG Oct-19

121146855934 * DELANTE EFREN TARUCAN Oct-19
121145358345 * DE GUZMAN MARJORIE CORANTO Oct-19
121160747171 * DE LEON JAMES PLACIO Oct-19
121250783708 * DE MESA CHERRIE JAIZZER BACTOC Oct-19
004101571102 * DE VERA ROMAR VASQUEZ Oct-19
121121064885 * DEL FONZO JOHN ROBLES Oct-19
121228215821 * DEL RIO VIVIAN BUELA Oct-19
121118148380 * DELA CRUZ FLORENCE ARCA Oct-19
107002393358 * DELA CRUZ RODIN CRUZ Oct-19
121030137447 * DELA CRUZ VERCITO GUETERREZ Oct-19
121125841949 * DEMESA JAYSON SAGUIO Oct-19
121109580958 * DEVELOS JOHNNY CORTEZ Oct-19
121048506423 * DIAZ ALAN AGLIRON Oct-19
107000999193 * DIO DANILO INOCENCIO Oct-19
108002016399 * DIONISIO REMOND ALARCON Oct-19
121095313978 * DISCUTIDO CRISANTO GONDRA Oct-19
121126650705 * DISCUTIDO MOISES GONDRA Oct-19
121096690916 * DIZON PAUL RAY N/A Oct-19
121110474348 * DOLOGMANDIN PARYL MIQUIABAS Oct-19
121125938640 * DOMO ISIDRO BUSTARGA Oct-19
121231543355 * DONGHAO ROSLIN ACADEMIA Oct-19
108001961540 * DOROTEO RONELA BORJA Oct-19
121039218233 * DUMAYAS JAMAICA PARALES Oct-19
108002014100 * EBITA SOFIO JR DURANTE Oct-19
121250634938 * EDIAN ARCHIE DALINAN Oct-19
121112944825 * ENECILLO RAFFY CAMATCHO Oct-19
121165080612 * EREM LALYN DIOQUINO Oct-19
121084960113 * ESCALERA BERNIE GARRIDO Oct-19
TOTAL FOR THIS PAGE
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledg
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Lot No., Block No., Phase No. House No. Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
 2,900 2,900 5,800

ER CERTIFICATION

ts made herein are true and corrct to the best of my knowledge and belief. I

DATE

R SALE (V03,10/2016)
 Pag-IB

EMPLOYER / BUSINESS Name

Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY MEMBE
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION EE
SHARE
112109703483 * ESPAÑOLA LOILA RUPENTA Oct-19 100
121193175460 * ESPERA MARK KEVIN VELASQUEZ Oct-19 100
121121039283 * ESPINOSA ALLAN QUIJADA Oct-19 100
104001970473 * ESTRADA RONALD MAMUYAC Oct-19 100
109000365462 * ESTUESTA ROMEL NACAR Oct-19 100
121155515741 * FAJILAGOT JUDITH MAGRO Oct-19 100
121128284637 * FAZON JULIUS CESAR SANCIO Oct-19 100
121208925868 * FELASOL ARLENE PRILA Oct-19 100
121201045404 * FENANDEZ ANGEL ABELLAR Oct-19 100
121250434068 * FERNANDEZ ANTONETTE SUENO Oct-19 100
121126424713 * FERNANDEZ PRINCESS JOY NERY Oct-19 100
121102997147 * FETIL RANDY JUANILLAS Oct-19 100
107002050593 * FLORENDO BARBIE ANNE CENTINO Oct-19 100
121174422699 * FLORENTINO EDMAR PARAS Oct-19 100
121033444836 * FRIAS FELICITAS AFRICA Oct-19 100
121137230816 * GALANG GILBERT BITICON Oct-19 100
105026068315 * GALIN ARTYLOU DE GUZMAN Oct-19 100
121252126285 * GAMIS ARLENE PAHIMNAYAN Oct-19 100
121126547873 * GARAY JIGI FERNANDEZ Oct-19 100
121030137447 * GARCIA JAYSON PIAMONTE Oct-19 100
121120839902 * GARDON RHODERICK GARROTE Oct-19 100
121180267192 * GILLEGO MARY GEN GILLEGO Oct-19 100
121176029906 * GEROLAO ARJAN KEVIN GELLIGO Oct-19 100
121032645616 * GOJO CRUZ JEFFERSON ZAMORA Oct-19 100
101003255261 * GONDRA CRISCELITO BELISON Oct-19 100
121154800236 * GONDRA ERICK ALMADOVAR Oct-19 100
121245291308 * GONDRA KING RON FRANCIS RUBAYA Oct-19 100
121119929983 * GONZALES JEFFERSON BONGAR Oct-19 100
108002004298 * GONZALEZ MARIA LOURDES GALANG Oct-19 100
TOTAL FOR THIS PAGE 2,900
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge an
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
ER Total
SHARE
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
 100 200
2,900 5,800

CERTIFICATION

made herein are true and corrct to the best of my knowledge and belief. I

DATE

ALE (V03,10/2016)
 Pag-IBIG

EMPLOYER / BUSINESS Name

Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY MEMBER
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION EE
SHARE
104001968626 * GRACIANO AMELITA BIORE Oct-19 100
121114226053 * GRAJO REMEDIOS DE NEIVA Oct-19 100
104002022967 * GREGAS CONCISA MILLENDEZ Oct-19 100
121172054908 * GREGORIO GENALYN AGNO Oct-19 100
104000436513 * GRIO JONATHAN PIEL Oct-19 100
108001820152 * GUARDIANO SAMMY LUARDO Oct-19 100
121101617670 * GUEVARRA NOE ` ALIGAYA Oct-19 100
121126291588 * GUMBA LADEMHER RESIDUO Oct-19 100
004044655807 * GUZMAN ARNOLD BROA Oct-19 100
121140633373 * INTON AMELITA FERNANDEZ Oct-19 100
121218265268 * IGNACIO RAPHEL ESTEBAN Oct-19 100
121043570826 * ISAGON DOLORES DACILLO Oct-19 100
121084829081 * JALLORINA MOISES JR GABATAN Oct-19 100
121184878977 * JAUCIAN MARK ANTHONY ALORO Oct-19 100
121116030972 * JAVIER JHUNE EDWARD MAYCONG Oct-19 100
919301846486 * JAVIER ROLLY RELANO Oct-19 100
232226547873 * JAREÑO ROMNICK LOPEZ Oct-19 100
101002807129 * JIMENEZ GERALDO RONQUILLO Oct-19 100
121132418438 * JIMENEZ MARK ANTHONY MAYOR Oct-19 100
109004243069 * JUANILLO JONELL CUSTODIO Oct-19 100
121127369262 * LA MADRID RODRIGO FERNANDEZ Oct-19 100
004040793304 * LACHICA ALEXANDER DELIM Oct-19 100
121094640937 * LACMAN JEOFFREY PERALTA Oct-19 100
109002928434 * LALATA JOSELITO SORIANO Oct-19 100
121126174780 * LASAP RHEA BECHAYDA Oct-19 100
121178744839 * LATAP MARVIN BALMES Oct-19 100
TOTAL FOR THIS PAGE 2,600
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION
 I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge a
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
ER Total
SHARE
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
2,600 5,200

CERTIFICATION
ts made herein are true and corrct to the best of my knowledge and belief. I

DATE

SALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION

109003186387 * LEGASPI FABIAN III OLIQUINO Oct-19

916113550793 * LEPALAM ROSEMARIE SALVALLON Oct-19
121120029423 * LERITA DRENNO LUZON Oct-19
101002556016 * LEYES JEAN CASTETE Oct-19
121048541454 * LIBRADILLA EDUARD ALEGADOO Oct-19
108076519301 * LINGO LORILYN DE LUNA Oct-19
121125814650 * LLANERA APRIL JOY DELOS ANGELES Oct-19
109000995977 * LLORIN GILBERT CELAJE Oct-19
121148541454 * LOBO JUDITH MELO Oct-19
104001297237 * LOBREDO JASON SOL FLORALDE Oct-19
121181648209 * LOGROSA ALDIN AÑORA Oct-19
108001969853 * LONGCOB AIRAF UNABIA Oct-19
121142418025 * LOPEZ ARVIN DELA CRUZ Oct-19
121133802636 * LOPEZ DANIEL BOBIS Oct-19
108001961539 * LOPEZ LUNAR DANGLE Oct-19
121128985845 * LOPEZ MICHELLE CORREA Oct-19
121118083024 * LORENA MARYAN LACHICA Oct-19
121125930826 * LOYOLA ANA MARIE MACHETE Oct-19
121200175225 * LUSTADO JOHN RICK SABUITO Oct-19
121118393443 * MACABATA IRENE DABLO Oct-19
104001968672 * MACASIEB ROGER SAMBRANO Oct-19
102001964863 * MAGNAYE ABELARDO JR DELA CRUZ Oct-19
* MAGSISI JAY ANN Oct-19
121090509892 * MAGYAWE JOHN ANGIELO ALBINDO Oct-19
121211468133 * MAHILUM PRINCESS ABELIDA Oct-19
108002015890 * MALCO ALEX LUCI Oct-19
121163355925 * MALLARI LOVELLA AGATHA JEREMIAS Oct-19
104001970538 * MANAGBANAG LEONARD MAGALLANES Oct-19
TOTAL FOR THIS PAGE
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Lot No., Block No., Phase No. House No. Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
2,800 2,800 5,600
R CERTIFICATION

s made herein are true and corrct to the best of my knowledge and belief. I

DATE

R SALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION

104002013164 * MANCAO DEXTER SALLIMA Oct-19

121127081437 * MANCERA ALLAN JOHN NARCISO Oct-19
104001968694 * MANCILLA WINSTON VILLANUEVA Oct-19
121250777001 * MANDIA ANNELET PEÑA Oct-19
121225508305 * MANDRAS REGGIE ORIAS Oct-19
104001968703 * MANJARES GERALD VASQUEZ Oct-19
121148013002 * MANLANGIT ANNA LASANAS Oct-19
121131185268 * MANZANO JENNIFER VELASCO Oct-19
121164930533 * MARQUITO RAMIL CABERIO Oct-19
121190484018 * MARQUITO ZALDY ODQUIN Oct-19
121250432215 * MATILAC ROSELYN MALIGA Oct-19
121020831998 * MEJIA NORMAN CRUZ Sep-19
104001967584 * MEJIA SALOME DENIEGA Oct-19
121186781829 * MERANO JR GALINDEZ Oct-19
121227195105 * MILA KENNETH N/A Oct-19
104001982195 * MILA ROMMEL FLORES Oct-19
121114066727 * MIZON JHESSA LYN MIRAAFLOR Oct-19
121080151810 * MOCAM RONALD ONGCOY Oct-19
104001968737 * MONTECASTRO ROMEO PELOVILLO Oct-19
121129005168 * MORADO ALMIN DELOS REYES Oct-19
121126863855 * MORALES ALBERT ALFONSO Oct-19
916187187601 * MORALES ARNOLD POSADAS Oct-19
121217385475 * MORENTE MARK VINCENT PRADO Oct-19
101002556050 * MORONG ANGELES PORNOBI Oct-19
121243903894 * MOSQUITE BRYAN DUAN Oct-19
121153499167 * MOSTOLES ROMMEL DATIN Oct-19
121243814216 * NAMION MILDRED POPOY Oct-19
TOTAL FOR THIS PAGE
GRAND TOTAL ( If last page)
 EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowled
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Lot No., Block No., Phase No. House No. Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
2,700 2,700 5,400
ER CERTIFICATION

ents made herein are true and corrct to the best of my knowledge and belief. I

DATE

OR SALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. Last Name First Name Extension Middle Name COVERED COMPENSATION

104001968748 * NATIVIDAD VICTOR GADOT Oct-19

121160722893 * NAVAJA JOHN PAUL ALANO Oct-19
121258562971 * NAVAREZ CECILE SAGAYNO Oct-19
104001977642 * NAVAREZ DANTE MANAGING Oct-19
121117768635 * NAVARRO THELMA ESPIRITU Oct-19
121087841004 * NAVICES KEVIN CHRISTOPHER VIDUYA Oct-19
104001968759 * NAZAL MARIA GLORY OBARRA Oct-19
104001977642 * NAZARETA ALBERTO JR BAÑAS Oct-19
121111333850 * NICOLAS JOANNE SEBASTIAN Oct-19
121080639670 * NILLASCA ANDREA YARANON Oct-19
121085821391 * NUÑEZ LIZA HAGANAS Oct-19
121134949375 * OBIERNA JAYRANN BARONA Oct-19
109002729219 * OLAYRES AJERICO JR MAGNO Oct-19
121255375791 * OLESCO CRIS IVAN CANTUBA Oct-19
108001993200 * OLIQUNO ALAN ORAYE Oct-19
121047149894 * OLIVEROS JARMAINE SARMIENTO Oct-19
121097216363 * OPSIMA EDNA JANE GARCIA Oct-19
121166279558 * ORCIGA ZALDY BERMAL Oct-19
104001968761 * PACIA EDWIN VIDALLON Oct-19
121070794614 * PADECIO JINNYBEE AYUBAN Oct-19
121080771734 * PAGAL IMELDA ROXAS Oct-19
121225796201 * PAGUIO DENNIS LOPEZ Oct-19
121188260430 * PALACIO WENDELL FERRE Oct-19
121156234443 * PALMA JOANNA ALVERO Oct-19
121227190291 * PANANGANAN MARIO ROSA-OT Oct-19
121261321835 * PANAGANAN RUBEN CASTILLO Oct-19
121010148718 * PANGATIHAN JO-ANNA MARIE LIMPIN Oct-19
108001800392 * PANOY ARMANDO VILLEGAS Oct-19
121055030629 * PANTILLA JAN TREMBEVILLA Oct-19
121067981086 * PAPA RONELL ABUNDANCIA Oct-19
TOTAL FOR THIS PAGE
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledg
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Lot No., Block No., Phase No. House No. Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
 3,000 3,000 6,000

R CERTIFICATION

ts made herein are true and corrct to the best of my knowledge and belief. I

DATE

R SALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION

104001968772 * PASMA TERESA ATIENZA Oct-19

121128353710 * PEDRIGOSA IRISH CERVANTES Aug-19
121136182926 * PENILLA EDMAR BAHIAN Oct-19
121083113221 * PEREGRIN MARY ANN GA Oct-19
121101618480 * PEREZ ALLAN LOGMAO Oct-19
000917147601 * PEREZ MARCELINO DOMINGUEZ Oct-19
121135112698 * PESTANO JOHN DENVER ESPIRITU Oct-19
121206059636 * PIEDAD FERDINAND POMENTO Oct-19
121250825426 * PILAR JOSEFINA JIMENEZ Oct-19
103022592111 * POLENIO CRISANTA BALDASAN Aug-19
121074121082 * PONCE LUNINGNING QUIÑONES Oct-19
104001967649 * PORTEZA GRACE RIVERA Oct-19
121257527343 * POSADAS CAMILLE RAYMUNDO Oct-19
121139501622 * POSADAS CLAUDINE RAYMUNDO Oct-19
121239289099 * PRADES ROBY ALIJANDRE Oct-19
004130795711 * QUILLA RICHARD NACAR Oct-19
121007207256 * RABOY PAMELA ATIENZA Oct-19
121074059680 * RACOMA MARY ANN BUENAVISTA Oct-19
121177263373 * RAJEL EMMA FRIAZ Oct-19
121177263495 * RAMIREZ ALMA PABIONA Oct-19
121248307625 * RAMIREZ HANSEL RAFOL Oct-19
108002004298 * RAMOS MARIA LOURDES BANDA Oct-19
121012030445 * RAMOS RICHARD MAHUSAY Oct-19
104003345651 * RAQUEM WILSON BERNAS Oct-19
121185316356 * RAYMUNDO MARIA CARMEN BUENAVENTURA Oct-19
121162076625 * REGAÑA ADRIAN JAMES PARAGUA Oct-19
121258486035 * RELLAMA CARL IVAN VILLAREAL Oct-19
101000256913 * RELLAMA JERWIN MALICDEM Oct-19
TOTAL FOR THIS PAGE
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
2,800 2,800 5,600
R CERTIFICATION

made herein are true and corrct to the best of my knowledge and belief. I

DATE

R SALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION

121180869903 * RESULLAR GINALYN ABELLA Oct-19

190900545324 * RETAZO ALONA ATLAS Oct-19
104001544908 * REYES CHARLIE DE LEON Oct-19
121133048039 * REYES MARCELO DILLERA Oct-19
121141212565 * RIBON JOHN MICHAEL BERGANIO Oct-19
121124414010 * RIUFRER RONALD BACALLA Oct-19
121250481741 * ROBRIGADO MAE SAZON Oct-19
121193025966 * RODNY AMAHIT BANOR Oct-19
108001940736 * ROLDAN NOLY DOMINE Oct-19
121086253632 * ROMERO JACKQUELINE ANTIPOLO Oct-19
104001968848 * ROSALES WILLIAM BERISO Oct-19
121166982489 * ROSELLO MELCHOR N/A Oct-19
142000504606 * ROSETE DARWIN ESPIRITU Oct-19
104001967704 * SABADO DONECIA JAGOS Oct-19
121189744094 * SABICO JONEL SEMILLA Oct-19
121140569837 * SABIJON MARK LESTER MACABIDANG Oct-19
121127292520 * SABLAN JOVELYN PASCO Oct-19
* SABUETO JOY MARIE Oct-19
121020470348 * SALAZAR RAFAEL AVILA Oct-19
121097418363 * SALVO LEO REYES Oct-19
121216765597 * SAMSON LEVI REYES Oct-19
121141748527 * SAN JUAN AURELIO III MARCELO Oct-19
109000845039 * SANCHEZ GIENO ALUDO Oct-19
* SANGCO JOSE JAZTIN Oct-19
109004150017 * SANTIAGO ANNALY ROCA Oct-19
121246544287 * SANTIAGO MYLA VILLAREAL Oct-19
121188714075 * SANTOS MA. JOANNE RACHEL CAMANTIGUE Oct-19
121137150732 * SARANZA KRISTIAN PAUL CAJETAS Oct-19
121105570280 * SAURE ROGELIO FLORENTINO Oct-19
TOTAL FOR THIS PAGE
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
2,900 2,900 5,800
R CERTIFICATION

made herein are true and corrct to the best of my knowledge and belief. I

DATE

R SALE (V03,10/2016)
 Pag-IBI

EMPLOYER / BUSINESS Name

Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY MEMBE
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION EE
SHARE
121255389710 * SEMBLANTE SANDY PEPITO Oct-19 100
121078699142 * SERRANO DANILO BUCAL Oct-19 100
121140660037 * SIBAYAN JERIC JUNIO Oct-19 100
121171170590 * SIMBA MARK RICHARD DELA CRUZ Oct-19 100
108001994455 * SIMON NANCY GUTIERREZ Oct-19 100
121199094062 * SINFUEGO IVAN FAJARDO Oct-19 100
101002492442 * SISIT CELERINA DE LEMOS Oct-19 100
105002025157 * SOLLANO ALBERTO SISBAS Oct-19 100
104002013206 * SORIANO CHONA PIMENTEL Oct-19 100
121136418904 * SORIANO FLORENCE CAGUIN Oct-19 100
121093767401 * TABASAN LORELIE TOQUIB Oct-19 100
* TANEDO RAQUEL Oct-19 100
121142989873 * TANYAG RYAN JERSON CALIWAN Oct-19 100
103000416897 * TAPAWAN ELSIE MONZON Oct-19 1,000
121062883138 * TATUALLA JENNIFER VISTA Oct-19 100
121041872528 * TAYO MYRNA REGALADO Oct-19 100
121156726812 * TAYO ROBERT OROLA Oct-19 100
121127012830 * TEJADA MARICOR HUMALATAG Oct-19 100
121169181592 * TEODORO KENNETH CHRISTOPHER GROMET Oct-19 100
104001971261 * TEOXON MICHAEL TOLERO Oct-19 100
101002168801 * TOLENTINO IMEE ARCEO Oct-19 100
121174564028 * TRIVELES ARCILYN MAGSAYO Oct-19 100
109004168756 * TROSO HENRY OJERIO Oct-19 100
121169480027 * TUPAS JEYCEN PAR Oct-19 100
121080250800 * URBANA RAHYAN BRIÑA Oct-19 100
109000783206 * URBINO NYMPA DEUNA Oct-19 100
121210217629 * VALDEZ MA. THERESA TAGUIBAO Oct-19 100
121208399896 * VALDEZ MARK KYLE ANGELO N/A Oct-19 100
121102943105 * VALENCIA MERRY CHRISTMA-D BUENACOSA Oct-19 100
121094951000 * VALILA ARIEL GANGCAYCO Oct-19 100
TOTAL FOR THIS PAGE 3,900
GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowledge an
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
ER Total
SHARE
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 1,100
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
100 200
 3,000 6,900

CERTIFICATION

made herein are true and corrct to the best of my knowledge and belief. I

DATE

ALE (V03,10/2016)
EMPLOYER / BUSINESS Name
Kalinisan Workers Service Cooperative
EMPLOYER / BUSINESS ADDRESS
Unit No. , Floor Building Name Lot No., Block No., Phase No. House No.
# 10 Manggahan Street
Subdivision Barangay Municipality/City Province / State/country (If Abroad)
Bagumbayan Quezon City
Pa-IBIG ACCOUNT MEMBEERSHIP NAME OF MEMBERS PERIOD MONTYLY
Name
MID No. NO. PROGRAM Last Name First Name Extension Middle Name COVERED COMPENSATION

121177138924 * VALLEJOS CABLEE Oct-19

104002023007 * VARGAS DANILO BASAS Oct-19
121171337362 * VELASCO HILARION PERALTA Oct-19
121064783948 * VERSOZA JOCELYN MORANO Oct-19
108001989502 * VICTORINO JAY-PEE FAJARDO Oct-19
121101091487 * VILAR JEAN GANSAEN Oct-19
121112890131 * VILLAMOR JESSICA CABIGTING Oct-19
121158800057 * VILLARUZ GEOVER JEAN GENESIRAN Oct-19
108001933074 * VIRTUDES NORMAN JANE SAAVEDRA Oct-19
121181246706 * YANGCO JOSEPHINE NOLLORA Oct-19
121141404716 * YATAR TADEO TUAZON Oct-19
121001933502 * YGOT RYAN MARCOJOS Oct-19
121159467395 * ZERNA MARY JOY POON Oct-19
109001911640 * ZAMORA ELSA SOMBE Oct-19
121160955254 * ZERNA SHIENA POON Oct-19

TOTAL FOR THIS PAGE

GRAND TOTAL ( If last page)
EMPLOYER CERTIFICATION

I hereby certifby under pain of perjury thath the information given and all statements made herein are true and corrct to the best of my knowled
further certify that my signature appearing herein is genuine and authentic

Ma. Lourdes G. Gonzalez

HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE DESIGNATION/ POSITION
(Signature Over Printed Name)

THIS FORM MAY REPRODUCED. NOT FOR SALE

77,300 77,500
 HQP-PFF-053
Pag-IBIG EMPLOYER'S ID NUMBER

Street Name

ZIP Code
1110
MEMBERSHIP SAVINGS
Remarks
EE ER Total
SHARE SHARE
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200
100 100 200

1,500 1,500 3,000

ER CERTIFICATION

made herein are true and corrct to the best of my knowledge and belief. I

DATE

R SALE (V03,10/2016)