Electronic R-3 File Generator

r3filegen2021

 

Printable Forms

Penalty Condonation Program for Housing Loans (PCPHL)

  Annex A – Application for Penalty Condonation Program for Housing Loans
  Annex B – Affidavit of Legal Heir/s of Decedent Housing Loan Borrower with Settled Estate (Single Account)
  Annex C – Affidavit of Legal Heir/s of Decedent Housing Loan Borrower with Settled Estate (Duplex Account)
  Annex D – Affidavit of Successor/s-in-interest (Single Account)
  Annex E -Affidavit of Successor/s-in-interest (Duplex Account)
  Annex F – Affidavit of Housing Loan Borrower (Duplex Account)
  Annex D – Penalty Condonation Program for Housing Loans (PCPHL) Promissory Note

Contribution Penalty Condonation, Delinquency Management and Restructuring Program for Business Employers

  Annex C1 – Application for Contribution Penalty Condonation, Delinquency Management and Restructuring Program Form
  Annex C2 – Checklist of Documentary Requirements
  Annex C3 – Undertaking
  Annex C4 – Affidavit of Inability to Pay
  Annex C5 – Installment Proposal
  Annex C6 – Promissory Note
  Annex C7 – Joint Undertaking
  Annex C8 – Undertaking for ER with No PDCs

Contribution Penalty Condonation and Restructuring Program for Household Employers

  Annex C1 – Application for Contribution Penalty Condonation, Delinquency Management and Restructuring Program Form for Household Employers
  Annex C2 – Checklist of Documentary Requirements for Household Applicant
  Annex C3 – Affidavit of Two Disinterested Persons
  Annex C4 – Certification by Homeowners/Condo
  Annex C5 – Installment Proposal
  Annex C6 – Promissory Note
  Annex C7 – Joint Undertaking
  Annex C8 – Undertaking

Housing Loan Penalty Condonation Program

  Application for Housing Loan Penalty Condonation Program
  Affidavit of Legal Heirs of Decedent HL Borrowers with Settled Estate (single account)
  Affidavit of Legal Heirs of Decedent HL Borrowers with Settled Estate (duplex account)
  Affidavit of Successor-in-Interest (single account)
  Affidavit of Successor-in-Interest (duplex account)
  Affidavit of Housing Loan Borrower (duplex account)

Pandemic Relief and Restructuring Program 3 – Enhanced Installment Payment Program

Annex A – Application for installment payment
Annex B – Installment Payment (Regular ER with PDCs)
Annex B – Installment Payment ( Regular ER with PDCs issued by Third Party)
Annex B – Installment Payment ( Regular ER without PDCs)
Annex B – Installment Payment (Houehold ER without PDCs)
Annex B – Installment Payment (Household ER with PDCs issued by Third Party)
Annex B – Installment Payment (Household ER with PDCs)
Annex B – 1 Installment Payment Schedule
Annex C – Notice of Conditional Approval
Annex D – Notice of Denial
Annex E – Undertaking
Annex F – Joint Undertaking
Annex G – Notice of Default
Annex H – Notice of Termination

 

Registration and Membership

Member Forms

Personal Data Record
Member’s Data Change Request
Unified Multi-Purpose ID (UMID) Card Application Form
Kasambahay Unified Registration Form
Request/Verification Form

Employer-Member Forms

Employer Registration Form
Employment Report
Employer Data Change Request
Household Employer Unified Registration Form
Household Employment Unified Report Form

Application for Special Programs

Cooperative Accreditation as Servicing/Collecting Agent
Sickness and Maternity Benefits Payment thru the Bank Form

Contributions

Contribution Collection List
Contributions Payment Return
Contributions Payment Form
Miscellaneous Payment Return
Auto-Debit Arrangement Enrollment Form
Auto-Debit Arrangement Amendment Form
Contribution Penalty Condonation Form – Installment Proposal
Contribution Penalty Condonation Form – Promissory Note

Member Loans

Member Loan Application
Member Loan Payment Return
Real Estate Loan Payment Return
Educational Assistance Loan Program
Application for Direct House Repair and/or Improvement Loan

Application for Option to Sell Shares of Stock (SILP/PFLP)

  • Special Power of Attorney-Option to Sell Shares of Stock (SILP/PFLP)
Loan Restructuring Program (LRP) with penalty condonation

Calamity Loan Assistance Application Form

Benefit Applications

DDR Application Form under Portability Law
Certification

Sickness Benefit

Sickness Notification Form
Sickness Reimbursement Form
Sickness Benefit Application Form (for Unemployed/Self-Employed/Voluntary)
Medical Certificate
EC Medical Reimbursement Application Form 1
EC Medical Reimbursement Application Form 2
ECMED Evaluation Sheet
Employer Transmittal List (Sickness Benefit Reimbursement Application)
Transmittal List(Sickness Benefit Application)
Affidavit of Undertaking (English)
Affidavit of Undertaking (Tagalog)
Affidavit of Undertaking (Visayan Version)

Maternity Benefit

Maternity Benefit Application
Maternity Notification
Allocation of Maternity Leave Credits Form
Maternity Reimbursement
Transmittal List (Maternity Benefit Application)
Employer Transmittal List (Maternity Benefit Reimbursement Application)
Affidavit of Undertaking (English)
Affidavit of Undertaking (Tagalog)
Affidavit of Undertaking (Visayan Version)

Retirement Benefit

Retirement Claim
Affidavit of Separation from Employment

Disability Benefit

Disability Claim
Employment Data Form
Medical Certificate

Death Benefit

Death Claim
Affidavit for Death Claim Benefits

Funeral Benefit

Funeral Claim
Affidavit of Funeral Expenses
Sinumpaang Salaysay (Pinagbayaran sa Pagpapalibing)
Waiver (SS Funeral Benefit)
Pagpapaubaya (SSS Funeral Benefit)

Annual Confirmation of Pensioners

ACOP Form (Pensioner’s Reply)
Pensioner’s Data Change Request Form
Self-Declaration Form of Survivor Pensioner on Non-Remarriage/Non-Cohabitation

EC Benefits

EC Claim for Temporary Total Disability or Sickness
EC Medical Reimbursement Benefit Application
EC Accident/Sickness Report

Flexi Fund Program

Flexi Fund Enrollment Form
Early Withdrawal Claim Form
P.E.S.O. Fund Program
SSS P.E.S.O. Fund Enrollment Form
SSS P.E.S.O. Fund Payment Form
SSS P.E.S.O. Fund Amendment Form
SSS P.E.S.O. Fund Withdrawal Form
SSS P.E.S.O. Fund Retirement Benefit Claim Form
SSS P.E.S.O. Fund Total Disability Benefit Claim Form
SSS P.E.S.O. Fund Death Benefit Claim Form

Supplementary Forms

Specimen Signature Card
Sinumpaang Salaysay
Member’s/Claimants Photo and Signature Card

Freedom of Information

FOI Request Form

Member Concern

Sinumpaang Salaysay For Authorized Representative (mca-01620)
Sinumpaang Salaysay para sa Miyembro (mca-01619)
Sinumpaang Salaysay For Authorized Representative (mca-01618)
Customer Information Form (mca-01616)
Sinumpaang Salaysay (mca-01617)