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    Affidavit of Retirement-Sss

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    SORITA LAW
    This document is an affidavit for separation from employment or cessation of self-employment for the purpose of applying for SSS retirement benefits. It states that the affiant was separated from their last employer on a specific date and has not been re-employed since. It also acknowledges the legal liabilities for providing false information. The affiant undertakes to notify SSS if they become re-employed and signs the affidavit to attest to the truth of the statements in support of their retirement benefit application.

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    Affidavit of Retirement-Sss

    Uploaded by

    SORITA LAW
    2K views2 pages
    This document is an affidavit for separation from employment or cessation of self-employment for the purpose of applying for SSS retirement benefits. It states that the affiant was separated from their last employer on a specific date and has not been re-employed since. It also acknowledges the legal liabilities for providing false information. The affiant undertakes to notify SSS if they become re-employed and signs the affidavit to attest to the truth of the statements in support of their retirement benefit application.

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    Affidavit of Retirement-sss

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    This document is an affidavit for separation from employment or cessation of self-employment for the purpose of applying for SSS retirement benefits. It states that the affiant was separated from their last employer on a specific date and has not been re-employed since. It also acknowledges the legal liabilities for providing false information. The affiant undertakes to notify SSS if they become re-employed and signs the affidavit to attest to the truth of the statements in support of their retirement benefit application.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    2K views2 pages

    Affidavit of Retirement-Sss

    Uploaded by

    SORITA LAW
    This document is an affidavit for separation from employment or cessation of self-employment for the purpose of applying for SSS retirement benefits. It states that the affiant was separated from their last employer on a specific date and has not been re-employed since. It also acknowledges the legal liabilities for providing false information. The affiant undertakes to notify SSS if they become re-employed and signs the affidavit to attest to the truth of the statements in support of their retirement benefit application.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    RDF-01275 (08-2016)

    Republic of the Philippines )


    Province/City/Municipality of ____________) S.S.

    AFFIDAVIT OF SEPARATION FROM EMPLOYMENT/


    CESSATION OF SELF-EMPLOYMENT
    WITH UNDERTAKING
    (re SSS Retirement Benefit)

    I, ________________________________, a Filipino, of legal age, single/married, with


    residence/postal address at _______________________________________________after having been
    sworn in accordance with law, hereby depose and state that:

    1. I am a bona fide member of the Social Security System (SSS) with assigned SS Number/Common
    Reference Number ________________________________________;

    2. I was separated from my last employer/s __________________________________with office


    address/es at ____________________________________________________ on
    _______________________, or has ceased to be engaged in the business of
    ___________________________, or practice of profession as ____________________ with
    office address at _____________________________________________________ on
    _______________; and was never again re-employed/re-engaged in self-employment;

    3. I cannot secure a certification and/or proofs from my last employment/self-employment


    because_________________________________________________________________;

    4. I am aware of the nature, consequences and incurring liabilities (criminal/civil/administrative)


    for any falsity, deceit, fraud, misrepresentation or non-disclosure made in connection with my
    claim/application for retirement benefits under the SS Law and other applicable laws, rules and
    regulations;

    5. I hereby undertake to inform/notify SSS on the fact of my re-employment/re-engagement in


    self-employment after availing of retirement benefits; and

    6. I am executing this affidavit to attest to the truth and veracity of the foregoing statements and
    to support my claim/application for retirement benefits.

    Affiant further sayeth naught.

    In witness/truth whereof, I hereby set my hand and affix my signature this _________________
    at _______________________________.

    ________________________________
    AFFIANT
    Signature over Printed Name of Affiant

    SUBCRIBED AND SWORN TO before me this ____________at ____________ affiant exhibiting to me


    his/her Community Tax Certificate No. ___________ issued on ___________at ________ and/or Identification
    card No. _____________issued on/by _________________ at________________________ and valid until
    ______________.

    Doc No.__________
    Page No. _________
    Book No. _________ NOTARY PUBLIC
    RDF-01275 (08-2016)

    Series of _________

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