Cs Form 86 - Health Examination RecordFull description
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Women’s Health Men’s Health and Gender and Health ImplicationsDescrição completa
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all...
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all...
Descrição: Quantum Health
RF-1 REVISED JAN 2002
Republic of the Philippines PHILIPPINE HEALTH INSURANCE CORPORATION
F O R
EMPLOYER'S QUARTERLY REMITTANCE REPORT
Date Screened:
P H I L H E A L T H
Action Taken:
U S E
Date Screened:
Action Taken:
1
-
PHILHEALTH NO.
-
EMPLOYER TIN
-
By:
-
By: Signature over Printed Name
2
3 COMPLETE EMPLOYER NAME
Signature over Printed Name
EMPLOYER TYPE Regular
COMPLETE MAILING ADDRESS
-
Private
TELEPHONE NO.
4 EMPLOYER'S SSS NO.
Government
-
EMPLOYER'S SSS/GSIS POLICY NO.
5
TYPE OF REPORT
Quarter Ending Mar
200
Addition to previous RF-1
Quarter Ending Jun
200
Deduction to previous RF-1
Quarter Ending Sep
200
Quarter Ending Dec
200
Household 6
7
NAME OF EMPLOYEE/S Surname
PhilHealth ID No./SSS ID No./GSIS M.I. Policy No.
Given Name
9
8 MONTHLY COMPENSATION BRACKET 1st Month
2nd 3rd Month Month
NHIP PREMIUM CONTRIBUTIONS 2nd Month 3rd Month
1st Month PS
ES
PS
ES
PS
APPLICABLE QUARTER
Regular RF-1
10
ES
REMARKS S - Separated, NE - No Earning, NH - Newly Hired