Here's a photo of a Bayad Center Transaction Form:
Here are the details of the form:
BAYAD CENTER TRANSACTION FORM
Please provide all required information below
Account Name (Surname, Given Name, Middle Name)
____________________________________________
Present Address _______________________________
__________________________Contact No. ________
TRANSACTION DETAILS
( ) Bills Payment ( ) Others _______
Biller _______ Date _______
Amount Due _______ Due Date _______
SOA/Invoice No. _______ Statement Date _______
Account Number _______
FOR GOVERNMENT TRANSACTIONS ONLY
ID Number _______
Payment Type ( ) Contribution ( ) Short Term Loan ( ) Real Estate
Payor Type ( ) SE ( ) VM ( ) )OFW ( ) Others_______
Loan Acct No. _______ Loan Type _______
Applicable Month(s) From _______ To _______ Year_______
Contribution/Month _______ Total Amount_______
PAYMENT DETAILS
( ) Cash ( ) Check ( ) Cash & Check ( ) Credit Card
Cash Php _______ Check No._______
Check Php _______ Bank_______
Total Php _______ Branch _______
Credit Card No. _______ Expiry Date _______
DECLARATION: The information provided above and documents hereby submitted have been made in good faith, verified correct to the best of my knowledge, pursuant to any Laws and Regulations applicable. I fully understand that CIS BAYAD CENTER INC. is authorized to accept and process payments and documents submitted through its branches.
_______________________________
Signature over printed name
____________________________________________
Machine Validation
This will serve as your receipt when machine validated
____________________________________________
If you're paying your SSS Loan, fill up the following:
Account Name:
Present Address:
Contact No.:
Biller: SSS
Date: Aug 20, 2014
Amount Due: 1,080.00
ID Number: SSS No. 04-800804004
Payment Type: VM
Loan Acct. No. SSS No. 04-800804004
Loan Type: Salary
Applicable Month(s): August 2014
Total Amount: 1,080.00
( ) Cash
Cash Php: 1,080.00
Total Php: 1,080.00
Signature over printed name
Note: Many Bayad Centers do not accept payments for the previous month, even if you're still within your payment deadline based on the last digit of your SSS No.
