Are you expecting? One of the most important steps when it comes to planning for your new arrival is filling out a maternity notification form with your employer. Notifying your workplace of an upcoming maternity leave is a critical step, allowing them time to plan and anticipate future staffing needs as well as giving you peace of mind that you’ll have job security upon returning from mat-leave. In this post, we’ll answer all your questions about how and when to fill out a maternity notification form so that everyone involved can be prepared for what lies ahead!
| Question | Answer |
|---|---|
| Form Name | Sss Maternity Notification Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | maternity notification form, sss maternity notification form, maternity notification, sss mat 1 form |
Republic of the Philippines
SOCIAL SECURITY SYSTEM
MATERNITY NOTIFICATION
Please read instructions and reminders below before filling up this form. Print all information in black ink only.
PART I - MEMBER'S INFORMATION
SS NUMBER
NAME OF MEMBER (SURNAME) |
(GIVEN NAME |
(MIDDLE NAME) |
ADDRESS (NUMBER, STREET AND SUBDIVISION) |
(BARANGAY) |
(TOWN/DISTRICT) |
(CITY/PROVINCE) |
POSTAL CODE
DATE OF BIRTH (MMDDYYYY) TIN
TELEPHONE/MOBILE NUMBER
MEMBER'S CERTIFICATION
I certify that this is my ________ pregnancy and my expected date of delivery is on ____________________.
I certify that the above information is true and correct.
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SIGNATURE OVER PRINTED NAME |
DATE |
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(If member cannot sign, fingerprints should be witnessed by two persons) |
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WITNESSES TO FINGERPRINTS |
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Please affix signature over printed name and indicate date |
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1) |
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2) |
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RIGHT THUMB |
RIGHT INDEX |
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PART II - EMPLOYER'S INFORMATION (FOR EMPLOYED)
EMPLOYER NUMBER
NAME OF EMPLOYER/REGISTERED BUSINESS NAME
ADDRESS |
(NUMBER, STREET AND SUBDIVISION) |
(BARANGAY) |
POSTAL CODE
(TOWN/DISTRICT) |
(CITY/PROVINCE) |
TELEPHONE/MOBILE NUMBER
EMPLOYER'S CERTIFICATION
I certify that the
I certify that the above information is true and correct.
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SIGNATURE OVER PRINTED NAME OF |
OFFICIAL DESIGNATION |
DATE |
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EMPLOYER/AUTHORIZED REPRESENTATIVE |
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PART III - FOR SSS USE |
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PROCESSED BY:
SIGNATURE OVER PRINTED NAME |
DATE |
RECEIVING BRANCH |
IDs presented
SS Card
Two (2) valid IDs No ID presented
INSTRUCTIONS AND REMINDERS
1.A member shall submit the Maternity Notification to her employer, if employed, or to the SSS branch nearest her residence, if separated from
2.The employer in turn, shall submit the Maternity Notification form to its servicing branch immediately after the receipt of notification from the employee.
3.Receipt of Maternity Notification form does not guarantee payment of the Maternity Benefit. Payment of benefit will be based on existing policies and guidelines.
4.Upon filing of the Maternity Benefit Application, the duly stamped "Received" Maternity Notification form shall be attached to the maternity benefit application form
5.If employed, full payment of the Maternity Benefit shall be advanced by the employer within thirty (30) days from the filing of maternity leave application.