COMPLETE LIST OF DOCUMENTARY REQUIREMENTS

ADJUSTMENT OF MATERNITY BENEFIT APPLICATION

Case Required Documents Description

a. Qualified as Solo Parent
Solo Parent ID Any one of the following:
• Solo Parent ID issued within two (2) years
from date of delivery by the LGU and signed
by the Social Worker and the City/Municipal
Mayor; or
Certification of eligibility of the Solo Parent
issued by the LGU and signed by the Social
Worker/City/ Municipal Mayor, if the ID is not
yet available.

b. Qualified as Solo Parent Solo Parent ID; and For solo parent ID
and separated from Certificate of Separation
employment from Employment Any one of the following:
• Solo Parent ID issued within two (2) years
from date of delivery by the LGU and signed
by the Social Worker and the City/Municipal
Mayor; or
• Certification of eligibility of the Solo Parent
issued by the LGU and signed by the Social
Worker/City/ Municipal Mayor, if the ID is not
yet available.

Certificate of Separation from Employment

Any of the following:

• Certificate of Separation from Employment
indicating the effective date of separation and
that no advance payment was granted by the
Employer; or
Affidavit of undertaking indicating
effective date of separation from
employment and that no advance
payment was granted by the Employer
c. Correction of Type of • Hospital record Any ONE of these documents, whichever is
Claim – From Normal to indicating type of applicable:
Caesarian Section delivery
• Operating Room Record (ORR); or
Delivery
• Surgical Memorandum; or
• Discharge Summary Report; or
• Medical/Clinical Abstract; or Delivery Report;
or
• Detailed invoice showing caesarian delivery
charges, for deliveries abroad only; or
• Similar medical documents submitted which
indicate the type of contingency.

d. Correction of Type of Hospital record For hospital record indicating type of delivery:
Claim – From Normal to indicating type of
Any ONE of these documents, whichever is
Caesarian Section delivery; and Certificate
applicable:
Delivery and separated of Separation from
from employment Employment • Operating Room Record (ORR); or
• • Surgical Memorandum; or
• Discharge Summary Report; or
• Medical/Clinical Abstract; or Delivery Report;
or
• Detailed invoice showing caesarian delivery
charges, for deliveries abroad only; or
• Similar medical documents submitted which
indicate the type of contingency.

Certificate of Separation from Employment

Any of the following:

• Certificate of Separation from Employment
indicating the effective date of separation and
that no advance payment was granted by the
Employer; or
Affidavit of undertaking indicating effective date of
separation from employment and that no advance
payment was granted by the Employer
e. Correction of Type of • Hospital/medical • Certified true copy of hospital/medical
Claim – From records records stating how the condition was
Miscarriage to Ectopic managed;
Pregnancy with
Operation (for medical
approval)
f. Correction of Type of Hospital/medical For Hospital/medical records
Claim – From records; and Certificate • Certified true copy of hospital/medical
Miscarriage to Ectopic of Separation from records stating how the condition was
Pregnancy with Employment managed;
Operation and separated •
from employment Certificate of Separation from Employment

Any of the following:

• Certificate of Separation from Employment
indicating the effective date of separation and
that no advance payment was granted by the
Employer; or
• Affidavit of undertaking indicating effective
date of separation from employment and that
no advance payment was granted by the
Employer
g. Additional posted • No required N/A
contributions will documents
increase the amount of
maternity benefit
h. Additional posted Certificate of Separation Certificate of Separation from Employment
contributions will from Employment Any of the following:
increase the amount of • • Certificate of Separation from Employment
maternity benefit and indicating the effective date of separation and
separated from that no advance payment was granted by the
employment Employer; or
Affidavit of undertaking indicating effective
date of separation from employment and that
no advance payment was granted by the
Employer
i. SS computation is higher No required documents N/A
than employer’s
computation
j. SS computation is higher Certificate of Separation Certificate of Separation from Employment
than employer’s from Employment
computation and Any of the following:
separated from • Certificate of Separation from Employment
employment indicating the effective date of separation and
that no advance payment was granted by the
Employer; or
Affidavit of undertaking indicating effective
date of separation from employment and that
no advance payment was granted by the
Employer
k. Correction of approved • Proof of Child’s Birth Any ONE of the following, whichever is applicable:
number of days from 60
• Child’s Certificate of Live Birth duly registered
(normal delivery) or 78
with the Local Civil Registrar (LCR) or issued by
(CS) days to 105 days
the Philippine Statistics Authority (PSA); or
• Report of Child’s Birth issued abroad; or
• Child’s Certificate of Death duly registered
with the LCR or issued by the PSA or issued
abroad; or
• Child’s passport.
Note: Documents issued in a foreign
country shall be submitted with English
Translation, if applicable.

l. Correction of approved Proof of Child’s Birth; Proof of Child’s Birth

number of days from 60 and Certificate of
(normal delivery) or 78 Separation from Any ONE of the following, whichever is applicable:
(CS) days to 105 days Employment
• Child’s Certificate of Live Birth duly registered
and separated from •
with the Local Civil Registrar (LCR) or issued by
employment
the Philippine Statistics Authority (PSA); or
• Report of Child’s Birth issued abroad; or
• Child’s Certificate of Death duly registered
with the LCR or issued by the PSA or issued
abroad; or
• Child’s passport.
Note: Documents issued in a foreign country shall
be submitted with English Translation, if
applicable.

Certificate of Separation from Employment

Any of the following:

• Certificate of Separation from Employment
indicating the effective date of separation and
that no advance payment was granted by the
Employer; or
Affidavit of undertaking indicating effective
date of separation from employment and that
no advance payment was granted by the
Employer
m. Allocated leave credits • Certification from • Certification issued by the employer of
not used Employer of Child’s Child’s father or Qualified Alternate
Father/Alternate Caregiver stating that the child’s father or
Caregiver Qualified Alternate Caregiver is already
separated from employment and that the
allocated leave credits are not used.
n. Allocated leave credits Certification from • Certification issued by the employer of Child’s
not used and separated Employer of Child’s father or Qualified Alternate Caregiver stating
from employment Father/Alternate that the child’s father or Qualified Alternate
Caregiver and Certificate Caregiver is already separated from
of Separation from employment and that the allocated leave
Employment credits are not used.
•
Certificate of Separation from Employment

Any of the following:

• Certificate of Separation from Employment
indicating the effective date of separation and
that no advance payment was granted by the
Employer; or
• Affidavit of undertaking indicating effective
date of separation from employment and that
no advance payment was granted by the
Employer