Sinumpaang Salaysay Form PDF Details

In the heart of the Philippines' administrative and legal framework lies the Sinumpaang Salaysay form, a crucial document for Filipinos handling various legal matters. Predominantly used for the declaration and attestation of facts under oath, it ensures that individuals provide truthful information in a formal, legally binding manner. The form is commonly required in situations involving declarations of death, as it meticulously records essential details such as the deceased's identity, the circumstances of death, burial arrangements, and the informant's identity verified through specific identification numbers from recognized sources like the SSS (Social Security System) or COMELEC (Commission on Elections). Additionally, it caters to situations requiring formal acknowledgment about funeral claims with the SSS, ensuring that no duplicated claims are made. It mandates the declarant's thumbprints and attached photograph as a means of identity confirmation, reinforcing the document's integrity. The act of signing and swearing in front of an administering officer not only solidifies the commitment to truth but also aligns with the country's legal requirements for document verification, marking a profound step in the process of legal documentation and proceedings in the Philippines.

QuestionAnswer
Form NameSinumpaang Salaysay Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namessss death claim form sinumpaang salaysay, sinumpaang salaysay sample, sinumpaang salaysay, sinumpaang salaysay sss death claim sample

Form Preview Example

REPUBLIC OF THE PHILIPPINES ) City/Municipality of ________________ ) S.S.

________________________________ )

Province of ______________________ )

SINUMPAANG SALAYSAY

Ako si __________________________________, may sapat na gulang, mamamayang ____________________,

may/walang asawa at kasalukuyang naninirahan sa ________________________________________________,

pagkatapos manumpa ng ayon sa batas ay malayang nagsasabi at nagsasalaysay ng buong katotohanan ng mga sumusunod:

1.Na batid kong namatay si ______________________________________________________ noong

_________________________ sapagkat siya ay aking ____________________________________.

2.Na ang nabanggit na namatay ay ililibing/inilibing sa _________________________________ noong

_________________________.

3.Na ang katotohanan ang nagbayad/magbabayad sa pagpapalibing sa nabanggit na namatay ay si ___________________________________.

4.Na ang aking pagkatao ay makikilala sa pamamagitan ng aking ipinakitang (kung alin ang mayroon):

a.SSS/COMELEC ID NO. ________________ na ibinigay noong ___________________________

ng ___________________________________

b.EMPLOYMENT ID NO. ________________ na ibinigay noong ___________________________

ng ___________________________________

5.Na kung nanaisin ng SSS na kumuha ng karagdagang impormasyon tungkol sa akin at sa alinmang nabanggit na namatay ay maaaring puntahan sina:

Pangalan

Trabaho

Tirahan

a. __________________________

__________________________

_________________________

b. __________________________

__________________________

_________________________

6.Na pinagtibay ko na ako o sino man ay walang nag-file ng Funeral Claim sa alinmang tanggapan ng SSS maliban dito sa _________________________________.

7.Na idinimpil ko ang aking kaliwa at kanang hinlalaki at idinikit ko ang aking larawan sa salaysay na ito bilang pagpapatunay ng aking pagkakaintindi sa isinasaad nito.

Idikit ang

Kaliwang

Kanang

larawan

Hinlalaki

Hinlalaki

 

 

______________________

 

 

LAGDA

Lumagda at nanumpa sa aking harapan ngayong ika-___________ ng _____________________ 19____ dito sa

___________________________ at ipinakita sa akin ang kanyang sedula BILANG A & B ___________________

na ibinigay noong ika-_______ ng ____________________ 19____ sa _________________________________.

______________________

ADMINISTERING OFFICER

Internet Edition (4/1999)

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As for the fields of this specific PDF, here's what you should consider:

1. Whenever filling in the sinumpaang salaysay sss death claim sample with answer, make certain to include all important blanks in the corresponding area. It will help to speed up the work, making it possible for your details to be processed promptly and appropriately.

The right way to fill out sinumpaang salaysay stage 1

2. Soon after filling in this step, head on to the subsequent stage and complete the necessary particulars in these blank fields - b EMPLOYMENT ID NO na ibinigay, Na kung nanaisin ng SSS na kumuha, Pangalan, Trabaho, Tirahan, Na pinagtibay ko na ako o sino man, Na idinimpil ko ang aking kaliwa, Idikit ang larawan, Kaliwang Hinlalaki, and Kanang Hinlalaki.

Na pinagtibay ko na ako o sino man, Kaliwang Hinlalaki, and Pangalan in sinumpaang salaysay

3. In this specific stage, take a look at Idikit ang larawan, Kaliwang Hinlalaki, Kanang Hinlalaki, LAGDA, Lumagda at nanumpa sa aking, Internet Edition, and ADMINISTERING OFFICER. All these need to be filled out with utmost attention to detail.

Completing segment 3 of sinumpaang salaysay

It's very easy to make errors while filling out the Idikit ang larawan, hence make sure you take a second look before you decide to finalize the form.

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