Pacific Seamen Services, Inc. 
						3F Unit 33, 34 & 35 Columbia Tower, Ortigas Avenue Mandaluyong City 
						 Telephone Nos.: (632) 7444546 * (632) 7268927						 Fax Nos.: (632) 7444548								
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			  |   Allotment Instruction Form |   | ETD: 29 Apr 2025  Tschudi Shipmanagement A.S |   			   				
			   
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						| Name of Seaman/Landworker: | 
						Motorman Shielo A. Elisan												 | 
				 
				 
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						| Address: | 
						Juarez Residence Purok Mabinuligon Octavio Village Cannery Site Polomoloc South Cotobato | 
				 
				 
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						| Basic Pay | 
						US$ | 
						1,103.00 | 
				 
				
						| Fixed O.T. | 
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						330.90 | 
				 
				
						| Leave Pay | 
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						166.10 | 
				 
				
						| Others (Specify) | 
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						0.00 | 
				 
				
						| Total | 
						US$ | 
						1,600.00 | 
				 
				 
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						| Name of Allottee | 
						Wennie J. Elisan | 
						Allottee # 1 | 						
			 
						
     				| Relationship | 
						Wife | 
						
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						| Address | 
						same as above | 
			 
						
     				| Amount of (in Figures) | 
						$ 800.00 | 
			 
						
						| Allotment (in Words) | 
						Eight Hundred  Dollars and 00/100 | 
			 
						
						| Bank/Branch | 
						BDO - Gen. Santos | 
			 
						
						| Account # (Peso) | 
						3290159153 | 
			 			
						
						| Signature | 
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						| Name of Allottee | 
						Elisan, Shielo A. | 
						Allottee # 2 | 						
			 
						
     				| Relationship | 
						Self Allottee | 
						
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						| Address | 
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     				| Amount of (in Figures) | 
						$ 800.00 | 
			 
						
						| Allotment (in Words) | 
						Eight Hundred  Dollars and 00/100 | 
			 
						
						| Bank/Branch | 
						BDO - Gen. Santos | 
			 
						
						| Account # (Peso) | 
						6230085126 | 
			 			
						
						| Signature | 
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			 | Employees Signature |  |  
			 | Vessel Assignment | SAGA X |  
			 | Month of Effectivity |  Apr 2025 |  
			 | S.S.S. # | 09-1984478-4 |  			 
			  
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			 | File Copies |  Master Crewmember Principal 201 File Accounting |  
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			| Rev. 2.1 May 2003 | OPS/GEN-007 |  
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				I,   , pursuant to Section 8 of the Standard Terms 
				and Conditions Governing the Employment of Filipino Seafarers, hereby instructs Pacific Seamen Services, Inc. to  deposit at least 
				80% of my basic salary to any authorized Philippine Bank.
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			Employee's signature over printed Name | 
		 
	 
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