SSS E1 Editable Form

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Republic of the Philippines

SOCIAL SECURITY SYSTEM


SPECIMEN SIGNATURE CARD
SSS Form L - 501 (07-94)
Registered Employer Name (Print in full) I.D. No.

Address (Print in full) Tel. No.

Authority to certify or sign documents on all social security matters is hereby delegated to the following officials of the company.

Printed Name Official Designation Initial Signature

Name and official capacity of person granting authority: Date authority granted:
(Please sign over printed name.)

Internet Edition (7/2000)

Republic of the Philippines


SOCIAL SECURITY SYSTEM
SPECIMEN SIGNATURE CARD
SSS Form L - 501 (07-94)
Registered Employer Name (Print in full) I.D. No.

Address (Print in full) Tel. No.

Authority to certify or sign documents on all social security matters is hereby delegated to the following officials of the company.

Printed Name Official Designation Initial Signature

Name and official capacity of person granting authority: Date authority granted:
(Please sign over printed name.)

Internet Edition (7/2000)


IMPORTANT INFORMATION/INSTRUCTIONS ABOUT YOUR
SPECIMEN CARD

1. This form (SSS Form L-501) should be accomplished in two (2)


copies by the responsible officials authorized by the employer to
certify and/or sign documents on the Social Security System (SSS).

2. Any signature in the space for “Employer’s Representative” in


salary and calamity application forms shall not be honored unless
signatures appear in this form and are filed with the SSS.

3. The SSS should be notified of any change/revocation or addition in


authorized representative through the submission of a new
specimen signature card to replace or supplement that on file with
the SSS.

4. The registered name, ID number and address of the employer


should be correctly indicated in this form.

IMPORTANT INFORMATION/INSTRUCTIONS ABOUT


YOUR SPECIMEN CARD

1. This form (SSS Form L-501) should be accomplished in two (2)


copies by the responsible officials authorized by the employer to
certify and/or sign documents on the Social Security System (SSS).

2. Any signature in the space for “Employer’s Representative” in


salary and calamity application forms shall not be honored unless
signatures appear in this form and are filed with the SSS.

3. The SSS should be notified of any change/revocation or addition in


authorized representative through the submission of a new
specimen signature card to replace or supplement that on file with
the SSS.

4. The registered name, ID number and address of the employer


should be correctly indicated in this form.

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