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: 17 Jun 2024
J. RAY MCDERMOTT, S.A. |
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| Name of Seaman/Landworker: |
Quality Control Inspector* Ace Albert T. Ouano |
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| Address: |
B- 18 Lot 1 Bayswater Talisay City Cebu |
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| Mcdermott Crew Badge No.: |
24L91-295/da |
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| Basic Pay |
US$ |
6,103.00 |
| Fixed O.T. |
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1,830.90 |
| Leave Pay |
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916.10 |
| Others (Specify) |
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0.00 |
| Total |
US$ |
8,850.00 |
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| Name of Allottee |
Ouano, Ace Albert T. |
Allottee # 1 |
| Relationship |
Self Allotee |
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| Address |
Same as above |
| Amount of (in Figures) |
$ 3,050.00 |
| Allotment (in Words) |
Three Thousand Fifty Dollars and 00/100 |
| Bank/Branch |
BDO - Cebu-Insular Life Building BDO |
| Account # (Peso) |
002510285447 |
| Signature |
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| Name of Allottee |
Cherry Rose Valerie C. Racaza |
Allottee # 2 |
| Relationship |
Wife |
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| Address |
same as above |
| Amount of (in Figures) |
$ 5,300.00 |
| Allotment (in Words) |
Five Thousand Three Hundred Dollars and 00/100 |
| Bank/Branch |
BDO - SM Cebu Branch |
| Account # (Peso) |
010660071223 |
| Signature |
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| Name of Allottee |
Ouano, Ace Albert T. |
Allottee # 3 |
| Relationship |
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| Address |
Same as above |
| Amount of (in Figures) |
$ 500.00 |
| Allotment (in Words) |
Five Hundred Dollars and 00/100 |
| Bank/Branch |
BDO - SM Cebu Branch |
| Account # (Dollar) |
110660182076 |
| Signature |
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| Employees Signature | |
| Vessel Assignment | Mcdermott Derrick Barge 32 |
| Month of Effectivity | Jun 2024 |
| S.S.S. # | 06-2964-072-8 |
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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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