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:
RECRUITMENT PARTNERS, L. P. |
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| Name of Seaman/Landworker: |
Assistant Derrickman Ergil L. Bautista |
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| Address: |
1075 Zone 8 Sta. Monica Hagonoy, Bulacan |
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| Basic Pay |
US$ |
1,540.00 |
| Fixed O.T. |
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1,155.00 |
| Leave Pay |
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385.00 |
| Others (Specify) |
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0.00 |
| Total |
US$ |
3,080.00 |
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| Name of Allottee |
Vea Anne C. Bautista |
Allottee # 1 |
| Relationship |
Wife |
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| Address |
1075 Zone 8 Sta. Monica Hagonoy, Bulacan
(90% of the Total Pay) |
| Amount of (in Figures) |
$ 2,278.95 |
| Allotment (in Words) |
Two Thousand Two Hundred Seventy Eight Dollars and 95/100 |
| Bank/Branch |
BDO - Malolos Bulacan Branch |
| Account # (Peso) |
010590090186 |
| Signature |
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| Name of Allottee |
Bautista, Ergil L. |
Allottee # 2 |
| Relationship |
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| Address |
1075 Zone 8 Sta. Monica Hagonoy, Bulacan
(10% of the Total Pay) |
| Amount of (in Figures) |
$ 801.05 |
| Allotment (in Words) |
Eight Hundred One Dollars and 05/100 |
| Bank/Branch |
BDO - Malolos Bulacan Branch |
| Account # (Peso) |
010590095331 |
| Signature |
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| Employees Signature | |
| Vessel Assignment | Noble Don Taylor |
| Month of Effectivity | |
| S.S.S. # | 34-1591313-2 |
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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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