Gsis Umid Form Ecard Enrollment Form PDF Details

The GSIS Form No. ECRD-2010-02-001-B, revised on February 16, 2010, represents a crucial step for members of the Government Service Insurance System (GSIS) in the Philippines, including active members, old age pensioners, survivorship pensioners, and legal guardians, in obtaining their UMID-eCard Plus. This form, to be filled out with great care, requests comprehensive personal and contact information such as name, address, date of birth, marital status, and various identification numbers including GSIS ID and TIN. It also requires certification by the member or pensioner, as well as verification by authorized GSIS personnel. The instructions emphasize the use of block or uppercase letters, completion of all fields or marking them as not applicable, respectively, and the precise format for data such as date of birth and measurements. Additionally, the form outlines the need for appropriate identification during the enrollment process and accommodates those with physical impairments unable to provide biometrics. Through this form, members can access a range of services and benefits, signaling its importance in the broader context of government employee welfare in the Philippines.

QuestionAnswer
Form NameGsis Umid Form Ecard Enrollment Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesgsis umid application form, gsis enrollment form, gsis ecard customer information record form, how to apply gsis umid card online

Form Preview Example

GSIS Form No. ECRD-2010-02-001-B

Date Revised: 2010-02-16

PASEGURUHAN NG MGA NAGLILINGKOD SA PAMAHALAAN (GOVERNMENT SERVICE INSURANCE SYSTEM)

Financial Center, Roxas Boulevard, Pasay City 1308

GSIS UMID-eCARD ENROLLMENT FORM

(With GSIS eCARD PLUS)

PLEASE CHECK THE TYPE OF MEMBER

ACTIVE

OLD AGE PENSIONER

SURVIVORSHIP PENSIONER

LEGAL GUARDIAN

Read instructions at the back before accomplishing this form:

 

 

 

 

 

 

 

 

 

MEMBER’S INFORMATION

 

 

Personal Information

Mailing Address/Contact Information

 

 

First Name

Rm/Floor/Unit No. & Bldg. Name (if applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Middle Name

House or Lot and Block No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

Street Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suffix (i.e., Sr., Jr., III, etc.)

Subdivision

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Maiden Name (if married female employee)

Brgy/District/Locality

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth (DD-MM-YYYY)

Municipality/City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place of Birth-City

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place of Birth-Province

Postal Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place of Birth-Country (if born outside of the Philippines)

Cell Phone No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Marital Status

Home Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gender

Email Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*GSIS ID No. (the 11 digit number below your name in the eCard)

TIN No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Office Name

Office Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Certified By:

 

 

__________________________________________________________

_______________________________________

 

 

 

Signature of Member/Pensioner over Printed Name and Date

(For active Member) Signature of AAO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Please bring eCARD and Company ID)

 

 

 

 

 

 

 

 

 

 

 

GSIS PORTION

 

 

Validated by:

Enrolled by:

 

 

 

 

 

 

Date:

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANNOTATION

I hereby certify that the member/applicant named above is physically impaired and no biometrics can be captured.

_____________________________________

Printed Name of Enrolment Officer / Date

GUIDELINES ON FILLING OUT THE ENROLLMENT

FORM

1.Use BLOCK letters or UPPER CASE letters in filling out the form;

2.Fill-out all information indicated in the form (Please do not leave any field blank). For fields not applicable, please write N/A;

3.For married female member-enrollee, indicate your maiden name following the format: (First Name, Middle Name, Last Name)

4.For date of birth, follow the format indicated in the field. Example: Date

of Birth (dd-mm-yyyy) should be written as: 06-02-1965;

5.For field on Height: Report this in centimeters (cm.). Use these

conversion factors: 1 ft. = 12 in; 1 in. = 2.54 cm.

Example: five feet and 2 inches (5’2”) = (5 x 12 = 60 in. + 2 in.

=62 in. x 2.54 cm. = 157.48 cm.)

6.For field on Weight: Report this in kilograms (kg.). Use these

conversion factors: 1 kg. = 2.2 lbs.

Example: 162 lbs. = 162 / 2.2 = 73.63 kgs.

7.Distinguishing Features. Limit the distinguishing features to those that can be found on the face. Example: Birth marks, moles, dimples, etc.

Note: Please bring your Office/Agency/Company ID and your eCARD

Plus (if any) or any government issued ID (i.e., passport, driver’s license, etc.)

How to Edit Gsis Umid Form Ecard Enrollment Form Online for Free

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This PDF will need specific info to be filled out, hence be sure to take the time to type in precisely what is requested:

1. The gsis ecard customer information record will require particular details to be inserted. Be sure that the following blank fields are filled out:

gsis customer information record form writing process outlined (stage 1)

2. The next stage is usually to submit the next few blank fields: Place of BirthCountry if born, Cell Phone No, Marital Status, Gender, Home Phone, Email Address, GSIS ID No the digit number below, TIN No, Office Name, Additional Information, Office Address, Signature of MemberPensioner over, For active Member Signature of AAO, Please bring eCARD and Company ID, and Certified By.

Writing segment 2 in gsis customer information record form

As to For active Member Signature of AAO and Email Address, be certain that you don't make any errors in this current part. These two are viewed as the most important ones in the document.

Step 3: Be certain that the details are right and then click on "Done" to continue further. After registering afree trial account here, you will be able to download gsis ecard customer information record or send it through email right away. The PDF will also be accessible through your personal account page with your edits. FormsPal ensures your information confidentiality by having a protected method that in no way records or shares any type of private data used. Feel safe knowing your paperwork are kept safe each time you work with our service!

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