PH SSS CLD-9N 1974-2024 free printable template

SICKNESS NOTIFICATION SSS Form CLD-9N Rev. 10/74 CONFINED MEMBER S NOTIFICATION PART I Date This Block to be accomplished by confined member. His/her confinement 2. Sickness Notification was received by us on 19 thru Phone rec d by Handcarried by Mail Date 3. In such cases the 5day period for the employer to notify the SSS shall start on the day immediately following the 1st day of sickness or injury. The foregoing prescription period of NOTIFICATION does not apply to HOSPITAL confinement....

How to fill out sickness notification form

To fill out the sss form sickness, follow these steps:

1. First, obtain a copy of the form from the Social Security System (SSS) office or their website.
2. Fill out your personal details accurately, including your full name, SSS number, and contact information.
3. Provide information about your employer, such as their name, address, and SSS number.
4. Indicate the start and end dates of your sickness, as well as the total number of days you were unable to work.
5. Describe the nature of your sickness or injury in detail.
6. Sign and date the form.

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What is sss form sickness?

SSS Form SSS-Sickness is the Social Security System's form for reporting sickness benefits for its members. This is a form that must be completed whenever a member is unable to work due to illness or injury. The form requires information such as the date of the illness or injury, the type of illness or injury, and the number of days of work missed due to the illness or injury. The form must be signed by both the employer and employee.

Who is required to file sss form sickness?

The employer is required to file the SSS sickness benefit form for the employee, if the employee is unable to work due to sickness or injury.

How to fill out sss form sickness?

1. Fill out the SSS Sickness Notification Form (SNS Form). Enter your Social Security System (SSS) number and the date you became ill. 2. Enter the name of the attending physician and the hospital where you were confined. 3. Indicate the start and end dates of your confinement or the start and end dates of your medical treatment. 4. List the medical diagnosis. 5. Enter the amount you have already paid for medical expenses. 6. Enter the amount of additional medical expenses you are expecting to pay. 7. Sign and date the form. 8. Submit the form with the required documents to the nearest SSS office. The documents required are a copy of your SSS card, a certified medical certificate from your attending physician, and copies of receipts for the medical expenses you have already paid.

What information must be reported on sss form sickness?

The information that must be reported on SSS Form SSS-Sickness includes: the employee's name, address, date of birth, SSS number, the date the illness began, the details of the illness or injury, and the employee's attending physician's name, address, and telephone number.

What is the penalty for the late filing of sss form sickness?

The penalty for late filing of the SSS Form R3 (Sickness) is a penalty of PHP 200 for each day of delay, or a minimum of PHP 10,000.

Can I create an electronic signature for signing my sickness notification form in Gmail?

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