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DEATH CLAIM APPLICATION. (04-2012) PART I. Please read the instructions at the back of the form before filling-up the application. Print information in capital letters and use black ink only. SS NUMBER.
Retirement Benefit. Retirement Claim Application. Member’s Claimant’s Photo & Signature Card Form. Affidavit of Separation from Employment/Cessation of Self-Employment with Undertaking. Application for representative payee (CLD 1.5) – In case guardian is other than parent/member.
AFFIDAVIT FOR DEATH BENEFIT CLAIM. I, ________________, of legal age, single/married and presently residing at _______________________________ having been sworn according to law, depose and say: That I am the __________ of the late ____________________, who died at ____________________________ on _____________________________________.
How to File an SSS Death Claim as a Non-Primary Beneficiary; Get to Know the SSS Survivor’s Benefit: Financial Support for Dependents of Deceased; How to Change and Update SSS Beneficiary using SSS Form E-4; SSS Death Claim Without a Beneficiary
Letter of explanation from the person whose name appears in the Official Receipt as to why such claimant is claiming the funeral benefit. TO EXPEDITE SETTLEMENT PLEASE FILE YOUR CLAIM AT THE BRANCH OR REPRESENTATIVE OFFICE NEAREST THE MEMBER’S PLACE OF DEATH.
This document is a form from the Social Security System of the Philippines for filing a death, disability, or retirement claim. The form requests information about the member such as their name, address, date and place of birth, civil status, and employment history.
DEATH CLAIM APPLICATION. (04-2012) PART I. Please read the instructions at the back of the form before filling-up the application. Print information in capital letters and use black ink only. SS NUMBER.
