Sss Form Rs 5 PDF Details

Sss Form Rs 5, also known as the takaful certificate, is an insurance policy that offers protection against loss or damage to property. The policy is designed to provide coverage for both Muslims and non-Muslims, and it can be used to protect a variety of assets, including homes, businesses, and vehicles. If you're looking for reliable property insurance coverage, Sss Form Rs 5 may be a good option for you.

The table offers information about the sss form rs 5. It's worth finding the time to read through this before starting filling in your document.

QuestionAnswer
Form NameSss Form Rs 5
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namessss voluntary contribution form, sss voluntary payment form, sss form rs5, sss voluntary form

Form Preview Example

Payment Deadline
(following the applicable month or quarter)
10th day of the month 15th day of the month 20th day of the month 25th day of the month Last day of the month

Republic of the Philippines

RS-5 SOCIAL SECURITY SYSTEM

(06-2012)

CONTRIBUTIONS

PAYMENT RETURN

Please read the instructions below before accomplishing this form.

 

Print all information in capital letters and use black ink only.

(THIS IS YOUR OFFICIAL RECEIPT WHEN VALIDATED)

SS NUMBER

NAME

(SURNAME)

(GIVEN NAME)

(MIDDLE NAME)

ADDRESS

(NO. & STREET)

(BARANGAY)

E-MAIL ADDRESS (If any)

(TOWN/DISTRICT)

(CITY/PROVINCE)

POSTAL CODE

TELEPHONE/MOBILE NUMBER

TYPE OF PAYOR (Check the appropriate box)

 

Self-Employed

Voluntary

Overseas Filipino Worker

Farmer/Fisherman

Non-Working Spouse

(Foreign Address-City, Country __________________________________ )

INSTRUCTIONS

1.Fill out this form in three (3) copies.

2.Remit your contributions following the payment deadlines below:

For Self-Employed, Voluntary, Non-Working Spouse, Farmer/Fisherman:

If 10th digit of the

SS number ends in:

1 or 2

3 or 4

5 or 6

7 or 8

9 or 0

For OFW-members:

-Contributions for January to December of a given year may be paid until 31 December of the same year

-Contributions for October to December of a given year may be paid until

31 January of the succeeding year

In case the payment deadline falls on a Saturday, Sunday or holiday, payment may be made on the next working day. Otherwise, late contribution payments of self-employed and voluntary members shall be applied prospectively.

3.Make all checks payable to SSS and fill out properly the "Details of Check Payment" portion of the form.

4.Fill out the Declaration of Earnings if you desire to change your monthly salary credit (MSC) to more than two salary brackets or if the change will result to an MSC of lower than P5,000. Please note that if you are 55 years old or older and present MSC is more than P10,000, your allowed increase is only one salary bracket.

 

APPLICABLE PERIOD

 

SOCIAL SECURITY

 

Month

 

 

Year

 

CONTRIBUTION

 

JANUARY

 

 

 

 

 

P

FEBRUARY

 

 

 

 

 

 

 

 

 

 

 

MARCH

 

 

 

 

 

 

 

 

 

 

 

APRIL

 

 

 

 

 

 

 

 

 

 

 

MAY

 

 

 

 

 

 

 

 

 

 

 

JUNE

 

 

 

 

 

 

 

 

 

 

 

JULY

 

 

 

 

 

 

 

 

 

 

 

AUGUST

 

 

 

 

 

 

 

 

 

 

SEPTEMBER

 

 

 

 

 

 

 

 

 

 

 

OCTOBER

 

 

 

 

 

 

 

 

 

 

NOVEMBER

 

 

 

 

 

 

 

 

 

 

DECEMBER

 

 

 

 

 

 

 

 

 

 

TOTAL REMITTANCE

 

 

 

P

 

 

 

 

 

 

 

 

 

 

TOTAL AMOUNT IN WORDS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CERTIFIED CORRECT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OVER PRINTED NAME

 

 

DATE

DETAILS OF CHECK PAYMENT

 

 

 

 

 

Check No.

 

 

 

 

Date

 

 

Bank/Branch Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Declaration of Earnings

I hereby declare, for purposes of Sec. 19-A of the Social Security Law , the amount of ________________________________________

(P ______________) as my monthly earnings, which shall be the basis of my monthly salary credit to be effective until revised in my next

declaration.

I affirm under the penalties of perjury, that this declaration has been made in good faith, and to the best of my knowledge and belief, is true and correct.

SIGNATURE OVER PRINTED NAME

DATE

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