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sss-r1

sss-r1

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Published by Vics Servando

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Published by: Vics Servando on Jun 27, 2011
Copyright:Attribution Non-commercial

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06/11/2014

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 RECEIVED BY/DATE:Transaction/SBR No.REVIEWED BY/DATE:
BUSINESS CODE
NAME OF BUSINESS/EMPLOYERNATURE OF BUSINESSI CERTIFY TO THE CORRECTNESS OF THE ABOVE INFORMATION.
Printed NameSignatureOfficial DesignationDate
FOR SSS USE
DATE OF COVERAGE
(mmyyyy)
EMPLOYER
NUMBER
PROCESSED BY/DATE:
FOR EMPLOYER REGISTRATION PLATE
LEGAL PERSONALITY
PARTNERSHIP
2
COOPERATIVE
4
SINGLE PROPRIETORSHIP
1
Republic of the Philippines
SOCIAL SECURITY SYSTEM
EMPLOYER REGISTRATION
Please read instructions at the back. Print all information in capital letters and use black ink.NUMBER OF EMPLOYEES
TOWN/DISTRICT CITY/PROVINCEBARANGAYNO. & STREET
E-MAIL ADDRESSTINAREA CODE FAX NUMBERBUSINESS ADDRESSBRANCH BUSINESS ADDRESS
TOWN/DISTRICTCITY/PROVINCENO. & STREETBARANGAY
START OF OPERATION
(mmddyyyy)
AREA CODE TELEPHONE NUMBER
CORPORATION
3
R-1
Validation/SBR Date
Signature Over Printed NameSignature Over Printed NameSignature Over Printed Name
ENCODED BY/DATE:APPROVED BY/DATE:
Signature Over Printed NamePOSTAL CODE
DATA CONTROLLED BY/DATE:
Signature Over Printed Name
NAME OF OWNER/MANAGING PARTNER/PRESIDENT/CHAIRMANNUMBER OF EMPLOYEESE-MAIL ADDRESSAREA CODE FAX NUMBERSTART OF OPERATIONAREA CODE TELEPHONE NUMBER
PART III - CERTIFICATION
NAME AND POSITION TITLE OF HIGHEST RANKED BRANCH OFFICIAL:NAME OF BUSINESS/EMPLOYER
PART II - EMPLOYER BRANCH OFFICE DATAPART I - EMPLOYER MAIN OFFICE DATA
SS NUMBEREMPLOYER NUMBER(03-2008)POSITION TITLE
(mmddyyyy)
DOCUMENT/S SUBMITTEDREMARKSSignature Over Printed Name
TIN

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