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: 24 Sep 2024
J. RAY MCDERMOTT, S.A. |
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| Name of Seaman/Landworker: |
Storekeeper Mark Anthony T. Rodriguez |
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| Address: |
#300 Filtration Road Sta. Rita Olangapo City |
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| Mcdermott Crew Badge No.: |
24J90- 100/d |
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| Basic Pay |
US$ |
2,068.00 |
| Fixed O.T. |
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620.40 |
| Leave Pay |
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311.60 |
| Others (Specify) |
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0.00 |
| Total |
US$ |
3,000.00 |
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| Name of Allottee |
Anna Remedios S. Rodriguez |
Allottee # 1 |
| Relationship |
wife |
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| Address |
300 - B Filtration . Rd. Sta. Rita , Olongapo City |
| Amount of (in Figures) |
$ 1,354.00 |
| Allotment (in Words) |
One Thousand Three Hundred Fifty Four Dollars and 00/100 |
| Bank/Branch |
BDO - SM City Branch, Olongapo City |
| Account # (Peso) |
007700058889 |
| Signature |
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| Name of Allottee |
Anna Remedios S. Rodriguez |
Allottee # 2 |
| Relationship |
wife |
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| Address |
same as above |
| Amount of (in Figures) |
$ 1,346.00 |
| Allotment (in Words) |
One Thousand Three Hundred Forty Six Dollars and 00/100 |
| Bank/Branch |
BDO - Subic |
| Account # (Dollar) |
5830-12589-8 |
| Signature |
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| Name of Allottee |
Mark Anthony T. Rodriguez |
Allottee # 3 |
| Relationship |
Self-Allottee |
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| Address |
59-D Otero Ave., Mabayuan, Olongapo Vity
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| Amount of (in Figures) |
$ 300.00 |
| Allotment (in Words) |
Three Hundred Dollars and 00/100 |
| Bank/Branch |
BDO - Rizal Avenue, Olongapo City |
| Account # (Peso) |
5830430852 |
| Signature |
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| Employees Signature | |
| Vessel Assignment | Mcdermott Derrick Barge 32 |
| Month of Effectivity | Oct 2024 |
| S.S.S. # | 02-1238854-9 |
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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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