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Webbinitial list (attach to philhealth form er1) subsequent list address: e-mail address: employer no. total no. listed above: page ___ of ___ sheets signature over printed name to be accomplished in duplicate philhealth sss/gsis number name of employee position salary date of employ-ment (do not fill) eff. date of coverage previous employer ( if any) WebbFor the Declaration of Dependents, fill-out the names of the living spouse, children and parents in items 2.1, 2.2 and 2.3 following the same format above. Put a mark in the box for item 2.2 if child has disability. Put a mark in the box for item 2.3 if parent has disability. Please indicate FULL MOTHERS MAIDEN NAME for item 2.3. 7. how is long beach arena seated
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