SOP Exhibits
Title
:
Statement of Account (Fidelity Bond)
SOP Number :
HR-PA01
EXHIBIT 4
REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF FINANCE
BUREAU OF TREASURY
FIDELITY BOND DIVISION
STATEMENT OF ACCOUNT FOR ______SEMESTER, 19___
NAME OF
BONDED
OFFICER
DESIGNATION
STATION
RISK NO.
EFFECTIVITY
DATE
AMOUNT OF
BOND
PREMIUM
TOTAL BOND AMOUNT __________
TOTAL PREMIUMS DUE:
FOR THE SEMESTER ___________