Republic of the Philippines SOCIAL SECURITY SYSTEM East Ave., Diliman, Quezon City Tel. Nos, (632) 920-6401 » (632) 920-6446 E-mail: member rolations@sss.gov.ch » Web site: http://waw.sss.gov.ph ss! 1 CIRCULAR No, 2018" °° mS ALL SSS MEMBERS SUBJECT LIST OF DOCUMENTARY REQUIREMENTS FOR DEATH BENEFIT To facilitate filing of death benefit claim application, simplification and revision of documentary requirements was done. In line with this, the following are hereby issued: 1. List of Documentary Requirements for Death Benefit; and 2. List of Identification (10) Cards/Decuments Please be guided accordingly. President afd CEO 11 JAN 2018 { Date ATTACHMENTS : Annex A —List of Documentary Requirements for Death Benefit Annex B — List of Identification (ID) Cards/Documents (Polley ~ Death)Annex A LIST OF DOCUMENTARY REQUIREMENTS FOR DEATH BENEFIT (Present original and submit photocopy of valid identification (ID) cards/documents for authentication purposes and subrnit originallcertified true copy of supporting documents} A BASIC DOCUNENTARY REQUIREMENTS 1, Death Cleim Application Form 2, Member's/Claimant’s Photo ard Signature Card 3, Death Ceriiicate of deceased member duly registered with the Looal Civil Regisiry (LCR) or issued by the Philippine Statistice Autrorty (PSA) member died abroad + Death Certificate of deceased member issued by the Vitel Slatistics OffceiCounty of Hoat Country or Its equivalent or Report of Death Issued by the Priippine Embassy or Consulate General 4, Single savings account _passbock/ATW/LUMIDidebit’ sash card enrolled ae ATM/eccompliched cach card eniolmert form/valideted initial deposit siproark cettiicate or statement duly signed by the bank's authorized signatory with dicated name of membericleimart, savings account number, bark branch and address (if cuslified for manthly pension and optional fer ump eum bonaft) ILATM card of femele claimant is sill under maiden name + Marriage Contrac/Certificate flaimart cannot open a savinas acount or apo. for adebiticash card + A wtitten request for exemption from the Pensioner’s Remittance Program stating reason for the exemption 8. Claimant's Identification (D) cardsiiecumerts (refer io the List of 10 Cards/Documents for Desth Benet) ADDITIONAL DOCUMENTARY REQUIRENENTS. {fled by Primory Beneficiervies (Dependent! Ee, ‘aid dependent child/ren 1. Marriage Cerificate of deceased member duy registered with the LCR or issued by the PSA {tdeceased member was married ebroad + Marriage Cortifete with English translation issued by foreign government or Report of Marriage issued by the Philppine Embassy or Consulate General 2. Birth Cerificate of dependent children duly registered with the LCR or issued by the PSA, i applicable (dependent chid is bom aproad + Birth Cerificate with English translation issued by foreign government or Report of Birth issued by Philippine Embassy 07 Consulate General Iffled by Secondary Beneficarviies (Dependent parents) 1. Birth Gerificate of deceased member duly registered with LGR or issued by he PSA 2. Death Certificate duly registered with LCR oriesued by the PSA of the following, whichever is applicable: a, Spouse, ifdeceased member is a widowinidewer at the time of death b. Dependent chiid/ren ©. Parent, f one of the parents is already deceased 3. Marriage Cerificate of parents duly registered with LCR of issued by the FSA, if date of death of member (spnorto 24 May 1997 4. Afidavt attesting to the parent's dependency for suppor from tne deceased member (Prescrived Form) Note: If the deceased mamber died at the age of sixty-five (85) years or above, death certificate of parents are no longer necessary. LUfiled by designated beneficaryes (any other person ‘desgnatec by the deceased member nnisirer Member's Record egal Heirs 41. Death Certificate culy registered with LCR or issued by the PSA of the following, whichever is applicable a, Spouse, deceased member is a widewswdower at the time of death b, Dependent chitvren Parents Note: Ifthe deceased memberdied atthe age of sxty- five (65) yeers o° above, death certificates of parents are no longer necessary 4. Other designated bonofcaryfis, if fled by designated beneficiary . Legal heirs (Should be in accordance with the lew of succession under the Civl Coce of the Philippines) if fled ay legal heirs Note: It deceased member is not yet 65 years cld at ihe time of deeth but Fisher parents are at east 85 years old, ceath certificates of the grandzarents sre ne longer necessary 2. Binh Ceniicate oftne deceased member. 3. Joint Affidavit (CLD-1.2) oreferebly by the relatives of the ¢eceased member 4, For fetal hers, bith certiicate of at ieast two (2) legal heirs. Fappicable Note: a) Documents issued in a foreign country should have English translation. ‘Autenticetion by the Philiopine Embassy or Consulate General is not required if said documents are duly received and signed by the SSS Foreign Representative, Foreign Office. b) For cleims fled abroad, photocopy of supporting documenvs with English transiation may be presented and subrritted in the ebsence of the originalcertfied true copy. to be duy received ard signed by the 88S Foreign Representative, Foraign Office, Additional documents iffiled by authorized representative nfthe claimants 1. Two @) valid ID cards/documents of the claimant and. representative 2, Latter of Authoriy (LOA) sigred by the claimant or Special Power of Attornoy (SPA) spocificaly stating the authotty to fle andlor sign for end in bekalf cf the amant Note: 2) LOASPA should have been made or executed, within six (6) menthsif inthe Philippines anc one (1) yeer if ebroed b) If calmant is abroad, LOA/SPA should be ccertied by the Phiippine Embassy’ Consulate General Refer to Supplemental List of Documentary Requirements for Death Benefit for the additional Supporting documents in special case Page Lot 1 LSUPPLEMENTAL LIST OF DOCUMENTARY REQUIREMENTS FOR DEATH BENEFIT (Present original and submit photocopy of valid identification (ID) carés/documents for authentication purposes and submit ‘orghalceriied rue copy of supporting docurnents) ‘SUPPORTING DOCUMENTS iS a semialdacieation 1. Inthe absence of the Death Cerificate ‘sefifcale ori equivalent & Certification of nor-ovallabilty issued by 4 PSALCR or issued by foreign goverment indicating mat death records of he offcevagency ‘concemed is intact btthere is no record of death {or the deceased member, and b._Any one (1) of he folowng = Cettiication of death sued by the panshichurch Cortfcation of burial seed by the carratory a. Certification of nor-avaliabilty from PSALCR or Issued by foreign government indicating that martiage records of the offica/agency concemied is intact but there ie no record of marrage for the requesting party; and b. Corifieate of marriage issued by the parishichurch/ministryicongregation/sectiother Teligous —organizaionsLGU/ether person authorized 19 adminisier mariage or Allen Certificate of Regstration stowing name of spout Inthe absence of the certificate of mariage: s ifeation of non-availabilty fron the ish/church/ministry/eongregation/secticth er felgious organizations; and b2 Any of the following: b21 AffdavivCettifeate of solemnizing officer stating the following together with authority ‘0 administer marriage, |" applicable ~ date of marriage = place of marriage = reascn for non-registration 22 Joint Affidavit of two (2) dsinterestec person who witnessed the marrage: ‘and b221 1 mith chien, bith Ccertitoate of at least Two (2) children wnerein under both documents the names o! parents and the dale anc place of merioge are indicates 3 Inthe absence of Birth Cerificate 8 Cerificaton of non-availability from PSA/LCR oF Issued by foreign government indicating that bith records of the offcs‘agency concerned is intact but there is no record of birth for the requesting party; and b. Baptismal/Dedication certificate or its equivalent fesued by the —_—parishichurch/ministy! ‘congregation’secYother religious (with date of pith of child and name ot parents) 1 Ceftifeation of non-availability trom the arsh/church/ministry/congregation/sect! ther religous organizations: and 82 Any of the following documents where the name of dependent, date of birth and the ame of the parents are indicated School cards/record of dependent ~ Educationalinsurance plans/neattn ‘card record + Employment records of member ~ Phiheath’GSIS/Pag BIG records ~ Income Tax Return of member = Member's record duly received by SSS ptior io May 1987 Note: '3) Baptismalidedicaton certificate or its aquivalent certificate must bear the original signature of the parish priesthead of churchiministy/congregation’sect/other religous organizations or his authorized signatory 'b) Dedication Certificate or its equivalent certificate issued bythe mnisty/congregation’ secVother religious Corgenizations in leu of baptismal certificate ‘must bear the date of bith and te name ot the parents. a. Cettiicate of finality of the judgment of annuimentinulity of mariage of annotated riarriage certiicate b. Certificate of naturalization prior to mariage abroad and decree of divorce after acquiring foreign citizenship, or its equivalent ‘Spouse Indicated in the death certificate 4 Certificate of No Martlage fiom PSA for the deceased member or joint affidavit of wo (2) persons preferably nearest relatives of the deceased member stating the marital ralationship between the deceased member and spouse per death certificate: bf spouse indicated in the Death Cortiicate is already decoased, death conificate of said spouse duly registered with LCR or issued by tie PSA or certfication of death of deceased member issued and signed by the authonzed signatory of the LCR and bearing the offical seal ‘© tf spouse ded abroad, death certificate of deceased member issued by the Vital ‘Statistics Office/County of Host County of its equivalent or Report of Death issued by the Philippine Embessy or Consulate General Page Lof36 8 ‘Additional_document_if_spouse_has_been ‘Separated in_facvleaally separated from the iocoased member (not living as husband and wife) a. Joint affidavit of two (2) persons preferably nearest relatives of the deceased member who have personal knowledge of the separaton tating the reason thereof and the fact of spouse's dependency for support upon the deceased member and thai the surviving spouse Must no! be the one who gave ground for the separation; or b, Affidavit of surviving spouse with undertaking stating that he/she has no knovmn relative of the ‘member oy that surviving spouse is not in good torms with the deceased member's relative; or © Cout declaration that the member-spouse should cortirue to eupport the surviving spouse ‘and that the surviving soouse musi not be the ‘one wine gave ground for the separation Adcitional documents for legally adopted shildren a. Decree of Adoption and Certiicate ef Finalty of Judgment Note: '2) Birth cerificate should bearthe annotation of the adepton bb) Date of adoption should be prior to date of death ‘Additional document if dependent child of the deceased member is incapacitated and under guardianship of the parent Medical certificate issued by the altending physician (with license number, contact number land address of cInic/attending physican) within three (2) months from the dete of fing of claim confirmedicettiied by the Medical Specialist of ‘SSS Physical Examination Centers (PECs) ‘Additional document if dependent child of the ‘deceased member is under auardianship (other than parent) a Application for Representative Payee and Guarentor's Bond Form b._ In-Trust for savings account 10. Additional _document_if_dependent_child_is incapacitated and under quardianship (other than aurviving legal epouss/common-law spouse] & Application for Representative Payee and ‘Guarantor’s Bond Form bb. In-Trust for savings account ¢ Medical certificate issued by the attending physician {wih license number, contact number land aderess of cinic/attending physician) within three (3) months from the dale of fling of claim confirmedicertiied by the Macical Speciaist of ‘SSS Physical Examination Centers (PECs) " 2 14 if dependent child is ilegitimats and is not acknowledsed by the deceased member in the ith certificate Any proof offilation, such as, but not limited to: a Will b. Statement made before any judicial or quasi- judicial proceedings © Any authente writing signed ky the father (2.9 letter, diay, or other document such as echost records, employment records and other pubkc records} 8. conceived prior to death, joint affidavit of two @) persons preferably nearest ‘elatives of the ‘ceceased member as proof of acknowledgment fe. Duly-recelved membership data record by other government agencies Ike Phihneali, Pag-IBIG, GSS ete Additions! documents __if __elsimant jcapacitated and under guardianship 2. Application for Representative Payee (SS Ferm GLD-18) end Guarantors Sond Form ($$ Form BPN 107) b. Member'siClaimant's Photo and Signature card (for the guardian); €_In-Trust fer savings account 4, Medical certificate iseued by tho claimant's attending physician (wth fcense number, contact number and address of clinic of attending physician) within three (3) months from the dale of fling of clam for quardianshia confirmedicertfied by the Mecical Specialist of 88S Physical Examination Centers (PECs); + Ifclaimant is abroad, Medical Certificate with letter head, contact number and address of vertiying physician Additional_document for_claimant other than primary bonefielary, and the euniving spouse hhas_abendoned te _deceased_member_or cohabited/remarry or entered into a_“live-in" ‘lationship bafore or after the death of the deceased member Joint affidavit of two (2) persons preferably nearest relatives who Nave knowledge of the ase stating the reason thereof and the fact of the spcuse’ depardency for support upon the docoased member It claimant _is_fiing_pursuant_to_an_existing Bilateral Social Security Aareement (SSA) a. Liaison forms as. provided for under the Administrative Agraement of the Bilzteral SSA ‘with the following information: = claim application detais; and ~ insurance periods under the 8S Lew of other country b, Photocopies of two (2) valid IDs of cleimant certified by counterpart lialson agencies. as provided (OF under the Bilateral SSA, in leu of the caiman's photo and signature Page2of316, Additional docu: 1. Additional document if claim was filed for more than seven (7) years from date of death and claimant is the surviving spouse 2. Joint affidavit of two (2) persons preferaby Felatves attesting to the fact of dependency for Support and present martal status of the claimant; or b. Affidavit of dependency with undertaking if cause of death is work gonnected ‘a, Report of Death (@PN-105) 8, Any of the following documents as proof that cceuse of death is work connected. + Pre-empoyment medical records, if cause of death is due to jiness * Statement of duties and responsiblites duly signed by the employer = MissioniJob or Travel order duly signed by the empioyer, f applicable © Photocopy of page in company legbookitecord of accident signed by the employerlprintout of electronic file + Police investigation report or employers report of injury, death or casualty spot roport if applicable Wi company was already closed, joint affidavit of two (2) co-workore of deceacod member who have personal knowledge of the accident or Injury and attesting that said accident or injury which caused the death of the memoer was work-related U1 with dependent legitimate children, int affidavit oftwo (2) persons preferably relatives of the deceased member that the decezsed member end the comman-law spcuse have no legal impediment to marry Page 3 of 3Annex B LIST OF IDENTIFICATION (iD) CARDS/DOCUMENTS FOR DEATH BENEFIT CLAIM APPLICATION (Present criginal and submit photocopy of valid identification (ID) carcs/documents for authertication purposes) A. Primary ID cardsidocuments Any ene (1) ofthe following ‘Social Securty (SS) card Unified Multi-Purpose ID (UMID) card Professional Regulation Commission (PRC) care Passport Drivers License Seaman's Book (Sealsters Identfication & Record 80k) Secondary ID cardsidocuments In the absence of the primary 1D cards/documents present any wo (2) ofthe flowing tom with signature and at least ore (1) wih photo, 4. Postal 2 Company 10 caro 3. School ID card 4 Overseas Worker Wetfare Administration (OWWA) card Senier Citzen card Phiippine National Police (PNP)-Firearm License 0 1, Taupayers Identitcation Number (TIN) cara 8D cardissued by Local Goverment Unis (LGUs) (49. barangayimunicpaltylcty) 9, 1D card issued by protessional assaciators ‘ecogrized by PRC 10. Pag.ig(D/Mempe’s Data Farm 11, Philippine Heath insurance Corp. (PHIC) ‘cardMembe’s Data Record 12 Voters ID o Voters AfidaviiCentfcste of Registration 13. Government Service Instrance System (GSIS Membe’s Record/Certficate of Membershia 14 Creat card win name end signature) 15 Fish Workers License Card issued by Bureau of Fisheries and Aquatic Resources (BFAR) 16. Heath of Medical Card 17. Resdency cardiwork permit issued by foreign ‘governments, 418 Marnage CortractiCertficate 19. Seafarers Registration Certificate issued by the Philgpine Oversees Employment Authority (FOEA) 20. Allen Cerificate of Registration 21, Certficate of Confirmation issued by National Commission on indigenous Peooles (formerly Offic of the Southern Cultural Community anc Office of Norther Cultural Community) 22, Certficate of Mealim Filipino Tribal affiiaton ‘issued by National Commission on Muslim Fipinos 23. Certticate of Licensure/Quaitication Documents ‘rom Mantime Industry Authonty 24. Certficate of Naturalization issued by the Bureau ‘at immigratan 25. National Bureau of Investigation (NB) Clearance 28. Police Clearance 27. Cour Order granting pettion for change of name (or date of bith 28. Lfe Insurance Policy 29 Stucent Permit issued by Land Transporation Office (LTO) Note: a) Expred IOs shail bo accepted as ‘dertification, provided It has signature and photo ) Equivalent ID cards/documenss should have English transiation i issued by foreign government ‘Married female claimants may use primary or ‘secondary ID cardeidecumerts that are stil under their maiden name, provided that copy of Marriage ContacyCerificate duly registered win PSALCR or Report of Mariage issued by the Philppine Embassy 1 Corsutste General, is presented Q