NAME: OFFICE: ___________________________________________ POSITION: ________________________

CHECKLIST OF REQUIREMENTS FOR STAFF MEMBERS

PART I
FOR PROCESSING OF APPOINTMENT PAPERS (Please submit/accomplish the following) :
RECEIVED BY HRMS:
1. Endorsement Letter/ List of Staff 2 copies
2. CS Form No. 33-A, Revised 2018 (Appointment Paper)
3 copies
* Entries should be typewritten, printed back to back
3. DBM-CSC Form No. 1, Revised 2017 (Position Description Form) duly signed by House Member 2 copies
4. CS Form No. 212, Revised 2017 (Personal Data Sheet) with two (2) colored 4.5 cm X 3.5 cm (passport size) 2 copies
*Photos must be taken in appropriate office attire and in front of a white background.
NOTE: Information entered into the forms/documents should be consistent with the information in your birth certificate (i.e. name, birthdate)/ Service
Record (if applicable)
4.a Philippine Statistics Authority (PSA) copy of employee's birth certificate (1 original copy for 201 File and 2 photocopies for PDWG) 3 copies
4.b PSA copy of Marriage Contract for married employees (1 original for 201 File and 2 photocopies for PDWG) 3 copies
5. Duly accomplished Identification Information Sheet with two (2) colored 2 X 3 pictures 1 copy
*Photos must be taken in appropriate office attire and in front of a white background.
6. CS Form No. 4, Revised 2018 (Certificate of Assumption to Duty) duly signed by the House Member 3 copies
7. CS Form No. 32, Revised 2018 (Oath of Office) duly signed by the Appointee 3 copies
IMPORTANT: Pursuant to Sec. 19 Rule VI of the Civil Service Commission 2017 Omnibus Rules on Appointments and Other Human Resource Actions, an appointment shall be
submitted to the Commission within thirty (30) calendar days from the date of issuance.The responsible official/person who caused the delay in the submission of the appointment
may be held administratively liable for neglect of duty.
Ex. If effectivity date is 01 July 2019, the appointment paper must be submitted to the Civil Service Field Office on or before 30 July 2019, otherwise said appointment paper will
be considered lapsed.
(Please give the Human Resource Management Service (HRMS) at least ONE (1) WEEK to process the appointment papers prior to submission to the Civil Service
Field Office).

I HAVE BEEN DULY INFORMED BY HRMS OF THE PROVISIONS OF CSC OMNIBUS RULES ON APPOINTMENTS. I UNDERSTAND THAT THE RESPONSIBLE OFFICIAL/PERSON WHO
CAUSED THE DELAY IN THE SUBMISSION OF THE APPOINTMENT PAPERS WILL BE HELD ADMINISTRATIVELY LIABLE FOR NEGLECT OF DUTY.

ACKNOWLEDGED BY/ DATE:

PART II
FOR PROCESSING OF INITIAL SALARY:
A. FOR NEW EMPLOYEE (ORIGINAL APPOINTMENT):
RECEIVED BY HRMS:
8. Duly sworn Statement of Assets, Liabilities and Networth (HRep SALN Form 2019) duly signed by the House Member and stamped received by the Records 3 copies*
Management Service (As of Date of Assumption)
*One copy for each: Human Resource Management Service, Records Management Service and personal file
9. Certificate of Attendance with complete names of staff members and duly signed by the House Member 2 copies
10. Photocopy of appropriate validated BIR form/s (Downloadable at www.bir.gov.ph) 3 copies
Must be initially submitted in three (3) copies to the Tax Unit, Accounting Service for validation. Validated forms should be submitted to HRMS:
a. For new employees without TIN: (Tax Unit, Accounting Service will generate the TIN from BIR online Portal)
Note: Due to the implementation of TRAIN LAW, provision for Personal and Additional Exemption are no longer applied.
- Duly accomplished Form 1902, attach a photocopy of ANY of the ff:
- Valid government-issued ID such as: GSIS, PhilHealth, Pag-ibig, postal, voter's ID, etc.
- Philippine Statistics Authority copy of Employee's Birth Certificate
- Passport
- Driver's License
b. For new employees with TIN: (Without business or purely compensation income earner)
- If registered with Revenue District Office (RDO) 28, secure validation slip from RDO 28
- If not registered, request transfer to RDO 28 using form 1905, duly stamped received by the previous RDO
c. For new employees with TIN: (With business or mixed income earner)
- Copy of Certificate of Registration (BIR Form 2303)
d.
All employees with previous employer during the taxable year must submit in addition to the above-mentioned forms applicable to them, a photocopy
of BIR form 2316 from previous employer. (To be submitted to Tax Unit, Accounting Service for consolidation of income for the taxable year)
B. FOR REAPPOINTMENT/REEMPLOYMENT (In addition to item Nos. 1-10)
RECEIVED BY HRMS:
11. Service Record ( 2 original or 2 certified photocopies) 2 copies
12. Certificate of Last Salary Received (2 original or 2 certified photocopies) 2 copies
13. Duly Approved Accountability Clearance (2 original or 2 certified photocopies) 2 copies
C. FOR TRANSFEREE (In addition to item Nos. 1-13), if applicable.
14. Certificate of Earned Leave Credits (Original and one photocopy) 2 copies
PART III
Please proceed to GSIS, PhilHealth, Pag-IBIG desks for processing of your membership.
Kindly submit two (2) copies each of the duly accomplished appropriate forms, together with attachments.
15. Government Service Insurance System (GSIS) 2 copies
a. GSIS Membership Information Sheet
16. Philippine Health Insurance Corporation (PhilHealth) 2 copies
a. For newly hired or reappointed employees, with or without PhilHealth Identification Number (PIN)
PhilHealth Member Registration Form (PMRF)
PhilHealth Identification Number (PIN) ______________________
b. For declaration of new and additional dependents
Birth Certificate of new dependents below 21 years old;
Court Decision on Adoption or Foster Parental Authority issued by the Department of Social Welfare and
Development (DSWD), in case of adopted child/children; or
Medical Certificate of parents below 60 years old,or of children above 21 years old with permanent disability.
c. For updating of records, to reflect the following (Please check):
Correction of Name; Change of Name; Correction of Date of Birth;
Change of Civil Status; Change and correction of Information of Declared Dependents.
PhilHealth Member Registration Form (PMRF)
Photocopy of any of the following:
PSA Birth Certification Barangay Certificate
2 valid IDs with correct name and date of birth PSA Certificate with annotation or correction
CSC Resolution Death Certificate
Annulment or Court Decision
17. Pag-IBIG Home Development Mutual Fund (Pag-IBIG) 2 copies
a. For newly-hired or reappointed employees, with or without Pag-IBIG Member Identification Number (MID)
Pag-IBIG Membership Data Form (MDF)
Pag-IBIG Member Identification Number (MID) _____________________
Registration Tracking Number (RTN) ______________________
b. For updating of records
Pag-IBIG Member's Change of Information Form (MCIF)
Pag-IBIG Member Identification Number (MID) _____________________
Registration Tracking Number (RTN) ______________________
Photocopy of two (2) valid IDs with correct date of birth and signature
Request for Consolidation/Merging of Member's Record Form
LEGEND: ü(CHECK) - SUBMITTED m(ENCIRCLED NUMBER) - NOT YET SUBMITTED — - NOT APPLICABLE
Note: Appointment Requirements except BIR forms are downloadable from www.congress.gov.ph.