Agency Name: deped cabuyao Agency BP Number: 1000001143

FOR AGENCY REMITTANCE ADVICE

FORM A. List of employees with life and retirement premium remittance but without existing record in the GSIS Database.
Cellular Phone no.
9398021088 9227271346 9265353978 9178375770 9184429679 9469672192 9258685892 9108621292 9199479431 9487020229 9334067980 9392683366 9198557724 9493755209 9465663490 9487023009 9273763542 9398179230

Last Name
Cabagyo Nipas Tingnan Montera Salinas Rosales Mendoza Castillo Maralli Marcial Orbista Formento Munda Bautista Cabungcal Gaygay Lapidario Valderama

First Name
Cecilia Je Je Liza Rosalinda April Joy Melanie Hydee Jessivel Tito Mariane Ginalyn Mutya Noel Maricel Chem Jayder Raynette Mary Anne Marie Ann

Suffix

Middle Name
Tandado Pabayos Andawe Maraa Jaro DeLuna P. Buenaobra Areola Sollestre Panotes Palomaria Pojas Camacho Masilang Carandang Abad Abril

Mailing Address / Zip Code

221 Mamatid Cabuyao Laguna 4025 Lot 62 Blk.12 Ph2 Ext.Mabuhay City Subd. Mamatid Cabuyao Laguna 137 Banlic CabuyaoLaguna Sitio 2 Brgy. Bian Pagsanjan Laguna BanaybanayCabuyao Laguna 152 San Isidro Cabuyao Laguna Blk. 22 L.13 Ph 1 Mabuhay City Baclaran Cabuyao Laguna 4025 Jp Rizal St. Pagsanjan Laguna Ph 5 Mamatid City Of Cabuyao Mamatid CabuyaoLaguna Mamatid CabuyaoLaguna MaravillaNagcarlan Laguna Mamatid CabuyaoLaguna Liliw Laguna 232 A. Bonifacio St. Brgy Bagong Pook Santa Maria, Laguna 4022 302 Brgy. San Isidro Bay, Laguna 4033 262 Brgy. Mamatid Cabuyao, Laguna 4025 Purok 6 Brgy. San Francisco Nagcarlan, Laguna 4002

Email Address Sex CS Cabagyocecilia@yahoo.com F Married nipas.jeje@yahoo.com F Married liza_tingnan@yahoo.com F Single rose_montera@yahoo.com F Single salinas_jaszzy@yahoo.com F Single mhiles_0918@yahoo.com F Married mendoza_hydee@yahoo.com F Single jessivelbuenaobra@yahoo.com F Married titomaralli@yahoo.com M Single mariane_marcial@yahoo.com.ph F Married ginalyn_orbista@yahoo.com.ph F Single rin2x_28@yahoo.com F Married mundanoel@gmail.com M Married maricel_bautista@yahoo.com F Married pisces_221986@yahoo.com M Married raynettegaygay@yahoo.com F Single mhean.abad@yahoo.com F Married valderama_marieann@yahoo.com F Married

Date of Birth

Place of Birth

Basic Monthly Effectivity Salary Date

5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013 5/15/2013

December 29, 1982 Calamba City 18, 549php January 15, 1982 Mindoro 18, 549php September 6, 1986 Sindangan,Zambo.Norte 18, 549php November 5, 1982 HilongosLeyte 18, 549php April 29, 1984 Himamaylan Negros18, Occ. 549php September 18, 1981 Sta.Cruz Marinduque 18, 549php March 24,1980 Pakil, Laguna 18, 549php December 25, 1974 Lumban Laguna 18, 549php July 14,1979 Negros Oc. 18, 549php May 8,1983 Siniloan Laguna 18, 549php February 7,1987 Camarines Norte 18, 549php October 28,1986 Sta.Cruz Laguna 18, 549php August 29,1987 St. Bernard Leyte 18, 549php October 23,1977 LiliwLaguna 18, 549php February 22,1986 Santa Maria, Laguna18, 549php August 24,1990 San Pablo City Laguna 18, 549php September 3,1985 Mandaluyong City 18, 549php May 28,1987 San Pablo City Laguna 18, 549php

If any or all of the employees listed above are transferees, please provide the information required in Form B below opposite their name.

FORM B. List of Transferees

Member BP Number Date of Transfer Employment status

Last Name

First Name

Suffix

MI

Salary

Position

FORM C. List of employees with salary adjustments for confirmation as to correct amount of monthly salary and effectivity date to be supplied below.
Member BP Number Employment status

Last Name

First Name

Suffix

MI

Salary

Effectivity Date

Position

FORM D. List of employees with no premium remittance for 2 consecutive months.

Member BP Number

Last Name

First Name

Suffix

MI

Reason 1

Effectivity Date

Remarks 2

1 Reason: please specify whether transferred to other office / resigned / retired / deceased / dismissed / laid-off / end of term / end of contract / dropped from the rolls / suspended / on Leave without pay, etc. 2 Remarks: in case transferred to other office, please indicate new office (if available)

Status of Position Employment REMARKS

Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Teacher 1 Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent