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phil health excel format 2010 - 100ees

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EMP NAME ADDRESS PEN EMPLOYER TYPE TEL # YEAR INCHARGE MONTH POSITION TYPE OF REPORT # OF EE'S LAST NAME SUFFIX FIRST NAME 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43

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Page 1: Phil Health Excel Format 2010 - 100ees

EMP NAME

ADDRESS

PEN EMPLOYER TYPETEL # YEARINCHARGE MONTHPOSITION TYPE OF REPORT# OF EE'S LAST NAME SUFFIX FIRST NAME

123456789

10111213141516171819202122232425262728293031323334353637383940414243

C7
SUFFIX JR SR III IV
Page 2: Phil Health Excel Format 2010 - 100ees

4445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293

Page 3: Phil Health Excel Format 2010 - 100ees

949596979899

100

Page 4: Phil Health Excel Format 2010 - 100ees

EMPLOYEE COUNT 100 SSS NUMBER ME-5 # / OR # AMOUNT PAID

PRIVATE TIN DATE PAID2010 APPLICABLE MONTH JANUARY

1 ALLOTED GS TOTAL RF-1 0.00 R OVER/UNDER 0.00

MIDDLE NAME PHILHEALTH NO SALARY SB PS ES0 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.00

F7
ALWAYS INDICATE: (PIN) PHILHEALTH IDENTIFICATION NUMBER CONVERT TO TEXT 12 CHARCTERS ONLY
Page 5: Phil Health Excel Format 2010 - 100ees

0 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.00

Page 6: Phil Health Excel Format 2010 - 100ees

0 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.000 0.00 0.00

Page 7: Phil Health Excel Format 2010 - 100ees

TOTAL PS 0.00 LINKSTOTAL ES 0.00NO ALLOTED GS 0.00TOTAL ARREARS 0.00TOTAL PS & TOTAL ES 0.00TOTAL PS + NO ALLOTED GS 0.00

ALLOTED REMARKS DATE0.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00

PRINT OUT RF1SAVE TXT

PRINT OUT RF1aSAVE TXTa

Page 8: Phil Health Excel Format 2010 - 100ees

0.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00

Page 9: Phil Health Excel Format 2010 - 100ees

0.000.000.000.000.000.000.00

Page 10: Phil Health Excel Format 2010 - 100ees

REMITTANCE REPORT

000000 12010RMEMBERS 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000

Page 11: Phil Health Excel Format 2010 - 100ees

00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000

Page 12: Phil Health Excel Format 2010 - 100ees

00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 00000000 000000 000000 000000 000000 000000 000000 M5-SUMMARY100000000 00000000 12301899 100GRAND TOTAL0000000000

Page 13: Phil Health Excel Format 2010 - 100ees

marc punzalan PLEASE READ INSTRUCTIONS (FOR EACH NUMBERED BOX) AT THE BACK BEFORE ACCOMPLISHING THIS FORM | 14 | PAGE 13 OF 15 PAGES

Republic of the PhilippinesF O R P H I L H E A L T H U S E

PHILIPPINE HEALTH INSURANCE CORPORATION

EMPLOYER'S QUARTERLY Date Screened: Action Taken:

REMITTANCE REPORT By:

PHILHEALTH NO. 00-000000000-0EMPLOYER TIN 000-000-000-000 Signature Over Printed Name

EMPLOYER NAMEEMPLOYER TYPE REPORT TYPE APPPLICABLE PERIOD

MAILING ADDRESSJANUARY 2010

TELEPHONE # 0

NAME OF EMPLOYEE/SPHILHEALTH NO.

MEMBER STATUS

SURNAME GIVEN NAME MIDDLE NAME PS ES STATUS1 0 2 ### 0 3 ### 0 4 ### 0 5 ### 0 6 ### 0 7 ### 0 8 ### 0 9 ### 0 10 ### 0 11 ### 0 12 ### 0 13 ### 0 14 ### 0 15 ### 0 16 ### 0 17 ### 0 18 ### 0 19 ### 0 20 ### 0 21 ### 0 22 ### 0 23 ### 0 24 ### 0 25 ### 0 26 ### 0 27 ### 0 28 ### 0 29 ### 0 30 ### 0 31 ### 0 32 ### 0 33 ### 0 34 ### 0 35 ### 0 36 ### 0 37 ### 0 38 ### 0 39 ### 0

RF-1 REVISED JAN 2008 EXCEL FILE

MONTHLY SALARY

BRACKET (MSB)

NHIP PREMIUM CONTRIBUTION SP-Separated, NE-No Earnings, NH-Newly Hired

DATE OF EFFECTIVITY

1

2 3 5

6 7 8 9 10

4

REGULAR RF-1

ADDITION TO PREVIOUS RF-1

DEDUCTION TO PREVIOUS RF-1HOUSEHOLD

PRIVATEGOVERNMENT

Page 14: Phil Health Excel Format 2010 - 100ees

marc punzalan PLEASE READ INSTRUCTIONS (FOR EACH NUMBERED BOX) AT THE BACK BEFORE ACCOMPLISHING THIS FORM | 14 | PAGE 14 OF 15 PAGES

Republic of the PhilippinesF O R P H I L H E A L T H U S E

PHILIPPINE HEALTH INSURANCE CORPORATION

EMPLOYER'S QUARTERLY Date Screened: Action Taken:

REMITTANCE REPORT By:

PHILHEALTH NO. 00-000000000-0EMPLOYER TIN 000-000-000-000 Signature Over Printed Name

EMPLOYER NAMEEMPLOYER TYPE REPORT TYPE APPPLICABLE PERIOD

MAILING ADDRESSJANUARY 2010

TELEPHONE # 0

NAME OF EMPLOYEE/SPHILHEALTH NO.

MEMBER STATUS

SURNAME GIVEN NAME MIDDLE NAME PS ES STATUS

RF-1 REVISED JAN 2008 EXCEL FILE

MONTHLY SALARY

BRACKET (MSB)

NHIP PREMIUM CONTRIBUTION SP-Separated, NE-No Earnings, NH-Newly Hired

DATE OF EFFECTIVITY

1

2 3 5

6 7 8 9 10

4

REGULAR RF-1

ADDITION TO PREVIOUS RF-1

DEDUCTION TO PREVIOUS RF-1HOUSEHOLD

PRIVATEGOVERNMENT

40 ### 0 41 ### 0 42 ### 0 43 ### 0 44 ### 0 45 ### 0 46 ### 0 47 ### 0 48 ### 0 49 ### 0 50 ### 0 51 ### 0 52 ### 0 53 ### 0 54 ### 0 55 ### 0 56 ### 0 57 ### 0 58 ### 0 59 ### 0 60 ### 0 61 ### 0 62 ### 0 63 ### 0 64 ### 0 65 ### 0 66 ### 0 67 ### 0 68 ### 0 69 ### 0 70 ### 0 71 ### 0 72 ### 0 73 ### 0 74 ### 0 75 ### 0 76 ### 0 77 ### 0 78 ### 0

Page 15: Phil Health Excel Format 2010 - 100ees

marc punzalan PLEASE READ INSTRUCTIONS (FOR EACH NUMBERED BOX) AT THE BACK BEFORE ACCOMPLISHING THIS FORM | 14 | PAGE 15 OF 15 PAGES

Republic of the PhilippinesF O R P H I L H E A L T H U S E

PHILIPPINE HEALTH INSURANCE CORPORATION

EMPLOYER'S QUARTERLY Date Screened: Action Taken:

REMITTANCE REPORT By:

PHILHEALTH NO. 00-000000000-0EMPLOYER TIN 000-000-000-000 Signature Over Printed Name

EMPLOYER NAMEEMPLOYER TYPE REPORT TYPE APPPLICABLE PERIOD

MAILING ADDRESSJANUARY 2010

TELEPHONE # 0

NAME OF EMPLOYEE/SPHILHEALTH NO.

MEMBER STATUS

SURNAME GIVEN NAME MIDDLE NAME PS ES STATUS

RF-1 REVISED JAN 2008 EXCEL FILE

MONTHLY SALARY

BRACKET (MSB)

NHIP PREMIUM CONTRIBUTION SP-Separated, NE-No Earnings, NH-Newly Hired

DATE OF EFFECTIVITY

1

2 3 5

6 7 8 9 10

4

REGULAR RF-1

ADDITION TO PREVIOUS RF-1

DEDUCTION TO PREVIOUS RF-1HOUSEHOLD

PRIVATEGOVERNMENT

79 ### 0 80 ### 0 81 ### 0 82 ### 0 83 ### 0 84 ### 0 85 ### 0 86 ### 0 87 ### 0 88 ### 0 89 ### 0 90 ### 0 91 ### 0 92 ### 0 93 ### 0 94 ### 0 95 ### 0 96 ### 0 97 ### 0 98 ### 0 99 ### 0

100 ### 0

ACKNOWLEDGEMENT RECEIPT (ME-5/POR/OR/PAR)GRAND TOTAL 0.00 0.00

CERTIFIED CORRECT:

REMITTED AMOUNT TRANSACTION DATE NO. OF EMPLOYEES

JANUARY 0.00 0 12/30/1899 100 (To be accomplished on the last page) 0.00

SIGNATURE OVER PRINTED NAME

APPLICABLE PERIOD

ACKNOWLEDGEMENT RECEIPT NO

11 12 13


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