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: 16 May 2024 J. RAY MCDERMOTT, S.A. |
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Name of Seaman/Landworker: |
Rigger Daniel G. Sta Ana |
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Address: |
JC Payumo Dinalupihan, Bataan |
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Mcdermott Crew Badge No.: |
24J99-55/DAY |
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Basic Pay |
US$ |
1,137.00 |
Fixed O.T. |
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341.10 |
Leave Pay |
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171.90 |
Others (Specify) |
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0.00 |
Total |
US$ |
1,650.00 |
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Name of Allottee |
Jhoyce G. Sta Ana |
Allottee # 1 |
Relationship |
Sister |
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Address |
Same as above |
Amount of (in Figures) |
$ 400.00 |
Allotment (in Words) |
Four Hundred Dollars and 00/100 |
Bank/Branch |
BDO - Olongapo Branch |
Account # (Peso) |
005830616794 |
Signature |
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Name of Allottee |
Sta Ana, Daniel G. |
Allottee # 2 |
Relationship |
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Address |
same as above |
Amount of (in Figures) |
$ 1,250.00 |
Allotment (in Words) |
One Thousand Two Hundred Fifty Dollars and 00/100 |
Bank/Branch |
BDO - SM City, Olongapo |
Account # (Peso) |
005830681030 |
Signature |
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Employees Signature | |
Vessel Assignment | Mcdermott Derrick Barge 32 |
Month of Effectivity | Apr 2024 |
S.S.S. # | 02-3912999-8 |
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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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