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SSS P.E.S.O Fund Enrollment Program
SSS application form for P.E.S.O fund program
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Republic of the Philippines
SOCIAL SECURITY SYSTEM
SSS P.E.S.O. FUND ENROLLMENT FORM
VPF-01216 (09-2015)
THIS FORM MAY BE REPRODUCED AND IS NOT FOR SALE. THIS CAN ALSO BE DOWNLOADED AT THE SSS WEBSITE AT www.sss.gov.ph.
PLEASE READ THE INSTRUCTIONS BELOW AND THE TERMS & CONDITIONS AT THE BACK BEFORE FILLING OUT THIS FORM. PRINT ALL
INFORMATION IN CAPITAL LETTERS AND USE BLACK INK ONLY.
PART I - TO BE FILLED OUT BY APPLICANT
A. PERSONAL DATA
SS NUMBER
COMMON REFERENCE NUMBER (CRN)
(LAST NAME)
NAME
GENDER
DATE OF BIRTH (MMDDYYYY)
(FIRST NAME)
TAX IDENTIFICATION NUMBER
(MIDDLE NAME)
(SUFFIX)
CIVIL STATUS
Male
Female
Single
ADDRESS IN THE PHILIPPINES
(SUBDIVISION)
Married
Widowed
(RM./FLR./UNIT NO. & BLDG. NAME)
(BARANGAY/DISTRICT/LOCALITY)
Legally Separated
Others _________________
(HOUSE/LOT & BLK. NO.)
(STREET NAME)
(CITY/MUNICIPALITY)
(PROVINCE)
FOREIGN ADDRESS (IF APPLICABLE)
ZIP CODE
COUNTRY
TEL. NO. (COUNTRY CODE + AREA CODE + TEL. NO.)
MOBILE/CELLPHONE NO.
E-MAIL ADDRESS
MEMBERSHIP TYPE
Employed
BANK NAME/BRANCH
Self-Employed
Voluntary
Non-Working Spouse
BANK ACCOUNT NO.
Overseas Filipino Worker (OFW)
B. BENEFICIARY/IES
NAME
(LAST NAME)
(FIRST NAME)
(MIDDLE NAME)
(SUFFIX)
RELATIONSHIP (To Applicant)
DATE OF BIRTH (MMDDYYYY)
1.
2.
3.
4.
5.
C. CERTIFICATION
I certify that the information provided in this form are true and correct and that I have
read, understood and accepted the TERMS AND CONDITIONS OF THE SSS P.E.S.O.
FUND PROGRAM indicated at the back of this form. (If applicant cannot sign, affix
fingerprints in the presence of an SSS authorized officer.)
RIGHT THUMB
SIGNATURE OF APPLICANT
RIGHT INDEX
DATE
PART II - TO BE FILLED OUT BY SSS
APPROVED
(ENROLLMENT DATE)
Remarks:
"With proof of payment"
RECEIVED / PROCESSED BY:
DISAPPROVED
Age is 55 years or older
SIGNATURE OVER PRINTED NAME
Did not meet contribution requirements
With SS final claim
Others __________________________
Indicate RECEIPT NO. and PAYMENT DATE
INSTRUCTIONS
1. Fill out this form in one (1) copy without erasures and alterations.
2. Place a checkmark on the applicable box.
3. Always indicate "N/A" or "Not Applicable" if the required data is not applicable.
4. Present Social Security (SS) Card or any two (2) valid IDs (both with signature and at least one (1) with photo).
5. Submit this form personally to the nearest SSS branch office.
DATE & TIME
TERMS & CONDITIONS
1. DEFINITION OF TERMS
The following terms, as used herein, shall mean as follows:
1.1 “SPF ENROLLEE” refers to an SSS member who has successfully enrolled in
the SPF Program but has yet to personally confirm the SPF Enrollment Form
and/or has yet to make an SPF contribution.
1.2 “SPF MEMBER” refers to an SSS member who has successfully enrolled in
the SPF Program, confirmed his/her SPF Enrollment Form and has made
his/her first valid SPF contribution. He/she shall remain an SPF MEMBER until
15.
the filing of his/her retirement, total disability or death claim.
1.3 “Working days”, for purposes of processing and crediting of investment
earnings, withdrawals and benefits, refer to regular SSS office hours (8:00 AM
– 5:00 PM) from Mondays to Fridays, except declared national holidays, and 16.
local holidays and work suspensions in the National Capital Region (NCR).
2.
3.
4.
5.
6.
7.
8.
1.4 “Valid contribution” is the contribution made in the SPF after successful
enrollment in the SPF Program, subject further to the rules on SPF
contributions.
CONFIRMATION OF SPF ENROLLMENT FORM
SSS member-applicant is required to confirm the accomplished SPF Enrollment
Form, whether submitted to the MSS Head of any SSS branch office or online thru
the My.SSS portal, by personally affixing his/her signature in the presence of an
SSS authorized officer. Non-confirmation of the SPF Enrollment Form shall prevent
the SPF ENROLLEE from making withdrawals and benefit claims and shall render
ineffective the designation of beneficiaries made. In the event that the SPF
ENROLLEE dies without having confirmed his/her SPF Enrollment Form,
beneficiaries shall be the same as those in the regular SSS program.
MEMBERSHIP
Membership in the SPF begins from payment of first valid contribution and
continues until the filing of a retirement, total disability or death claim. Early
termination of membership shall not be allowed. Once membership in the SPF has
ceased, renewal thereof shall no longer be allowed.
AMENDMENT
SPF MEMBER may amend, through an SPF Amendment Form, his/her listed
beneficiaries by adding more and/or deleting those listed in the confirmed SPF
Enrollment Form. SPF MEMBER shall amend all other membership details by
accomplishing and signing the E-4 Form.
CONFIRMATION OF SPF AMENDMENT FORM
SPF MEMBER is required to confirm the accomplished SPF Amendment Form,
whether submitted to the MSS Head of any SSS branch office or on-line thru the
My.SSS portal, by personally affixing his/her signature in the presence of an SSS
authorized officer. Non-confirmation of the SPF Amendment Form shall render
ineffective the amendments made.
PAYMENT OF CONTRIBUTIONS
SPF ENROLLEE/MEMBER, or his/her authorized representative, may pay
contributions anytime, provided that he/she has an SS contribution on the month
he/she makes a contribution to his/her SPF account. A Covered EE contribution for
a particular month in the regular SSS program may be based on any MSC while an
SE, VM and OFW contribution for a particular month in the regular SSS program
should be based on the maximum MSC. Both the SPF ENROLLEE/MEMBER or
his/her representative and SSS Branch Teller shall ensure that contributions to the
SPF are properly made through the use of an SPF Payment Form. No adjustments
for misclassified payments shall be made by the SSS.
AMOUNT OF CONTRIBUTIONS
The minimum contribution to the SPF is P1,000.00 per payment and the maximum
contribution is P100,000.00 per annum. Contributions in excess of the minimum
should be in multiples of P100.00. Any amount below the minimum, not in multiples
of P100.00, or in excess of the maximum, shall not earn interest and shall be
subject to automatic refund.
ALLOCATION OF CONTRIBUTIONS
Every SPF contribution shall be allocated to the following accounts based on an
assigned percentage distribution:
17.
18.
any time prior to the filing of a retirement or total disability claim thru an SPF
Withdrawal Form. Withdrawals are allowed only from the Medical and General
Purpose accounts with corresponding charges for management fee, and penalty if
made before the fifth (5th) year of membership in the SPF. Contributions in the
Retirement/Total Disability account and investment earnings in all accounts cannot be
withdrawn until the filing of a retirement or total disability claim. Approved withdrawn
amounts shall be credited to the SPF MEMBER’s enrolled bank account within three
(3) working days from date of transaction (T+3).
CONFIRMATION OF SPF WITHDRAWAL FORM
SPF MEMBER, or his/her authorized representative, is required to confirm the
accomplished SPF Withdrawal Form by personally affixing his/her signature in the
presence of an SSS authorized officer.
RETIREMENT AND TOTAL DISABILITY BENEFITS
SPF MEMBER, or his/her authorized representative, may file for SPF Retirement or
Total Disability benefit claim upon successful filing of a Retirement or Total Disability
benefit claim in the regular SSS program, by submitting the accomplished SPF
Retirement or Total Disability Benefit Claim Form to the MSS Head of any SSS branch
office. SPF MEMBER, or his/her authorized representative, is required to confirm the
accomplished SPF Retirement or Total Disability Benefit Claim Form by personally
affixing his/her signature in the presence of an SSS authorized officer. SPF Retirement
and Total Disability benefits shall be computed up to the date of successful filing of a
Retirement and Total Disability benefit claim in the regular SSS program and shall be
processed and released upon the settlement of the latter. However, for SPF
MEMBERS who have not filed any benefit claim and are sixty-five (65) years of age
with at least 120 monthly contributions in the regular SSS program, SPF Retirement
benefits shall be computed up to his/her 65th birthday and shall be processed and
released upon the successful filing of an SPF Retirement Benefit Claim. For SPF
MEMBERS who have not yet filed any benefit claim and are sixty-five (65) years of age
or older but has not yet obtained 120 contributions in the regular SSS program, SPF
Retirement benefits shall be computed up to the first day of the month following the
date of payment of his/her 120thmonthly contribution and shall be processed and
released upon the successful filing of an SPF Retirement Benefit Claim.
DEATH BENEFIT
SPF beneficiaries shall be as defined under the SS law and shall be limited to those
declared in the SPF Enrollment/Amendment Form. Declared SPF beneficiaries, or their
authorized representatives, individually, may file for a Death benefit claim directly in the
SPF Program by submitting the accomplished SPF Death Benefit Claim Form to the
MSS Head of any SSS branch office. The SPF Death benefit shall be computed up to
the date of successful filing of the first SPF Death Benefit Claim and may be processed
and released ahead of the filing and settlement of a Death/Funeral benefit claim in the
regular SSS program, provided that the rules on the conduct of “fact of death” shall be
followed.
DISTRIBUTION OF DEATH BENEFITS
The SPF Death benefit shall be equally distributed among declared SPF beneficiaries.
In case of death of an SPF beneficiary, the following rules shall apply:
18.1 If the SPF beneficiary died prior to the death of the SPF MEMBER, his/her share
in the SPF Death benefit shall be equally distributed to the remaining declared
SPF beneficiaries or, in case of a sole beneficiary, to the beneficiaries of the SPF
MEMBER under the regular SSS program.
18.2 If the SPF beneficiary died after the death of the SPF MEMBER, his/her share in
the SPF Death benefit shall be given to his/her legal heirs, as may be determined
by the SSS.
19. CONFIRMATION OF SPF BENEFIT CLAIM FORMS
Declared SPF beneficiaries, or their authorized representatives, individually, are
required to confirm their respective accomplished SPF Death Benefit Claim Form by
personally affixing their signature in the presence of an SSS authorized officer.
20. CREDITING OF BENEFIT CLAIMS
SPF Retirement, Total Disability and Death benefits shall be credited to the bank
account of the SPF MEMBER/beneficiary within three (3) working days from approval
of said benefit claim.
Percentage
Distribution
65%
25%
10%
21. EVIDENCE OF PARTICIPATION
Enrollment, amendment, withdrawals and benefit claims in the SPF shall be evidenced
by a validated copy of the corresponding SPF Forms.
1. Retirement/ Total Disability
22. VERIFICATION OF ACCOUNT
2. Medical
SPF ENROLLEE/MEMBER, at any time, may access his/her SPF account information
3. General Purpose - education, housing,
through any of the following: My.SSS portal, Self-Service Information Terminal (SSIT),
livelihood, unemployment, etc.
and with the assistance of the MSS Head at any SSS branch office.
9. VALUE DATE OF CONTRIBUTIONS
23. COMMUNICATIONS AND NOTICES
SPF contributions shall start earning on the second working day from the day
SPF ENROLLEE/MEMBER shall certify that all contact information provided in the SPF
contribution was made (T+2) and shall continue to earn until the filing of a
Enrollment Form are valid and active and shall be deemed to have been informed of all
retirement, total disability or death claim.
communications and notices regarding his/her SPF account after successful
transmission of the communication/notice to his/her enrolled e-mail address and/or
10. INVESTMENT INSTRUMENTS
Investment of the SPF shall be made only in sovereign-guaranteed instruments
mobile number via SMS/text message.
(government securities).
24. ANNUAL STATEMENT
Account
11. RATE OF GUARANTEED EARNINGS
All contributions are guaranteed to earn based on the following rates, by type of
account:
Account Guaranteed
1. Retirement/Total Disability
2. Medical
3. General Purpose
Rate
Five (5)-year T-bond
364-year T-bill
364-year T-bill
* Philippine Dealing System Treasury Reference Rate P.M.
Interest
Reference
Rate
PDST-R2
An annual statement consisting of the SPF MEMBER’s summary of contributions,
withdrawals and earnings during the calendar year will be sent via e-mail within the first
quarter of the succeeding year.
25. RESERVE FUND
The SSS shall establish an SPF reserve fund to be taken as a percentage of the net
investment earnings (actual earnings less guaranteed earnings and fees/charges), if
any. The same shall be used to cover interest variabilities that may occur in the future
in relation to the SPF.
26. ADMINISTRATION AND MANAGEMENT
The SSS shall exercise absolute control, direction, and management of the SPF
Program. A Management Fee of 1% per annum of the accumulated fund shall be
deducted from the SPF ENROLLEE’S/MEMBER’S account every month-end upon
crediting of guaranteed earnings. The Management Fee may be changed through the
recommendation of the SSS, subject to the approval of the Social Security
Commission (SSC) without prior notice.
12. CREDITING OF GUARANTEED EARNINGS
Guaranteed earnings shall be computed based on the SPF MEMBER account’s
total Average Daily Balance (ADB). The interest/reference rate to be used will be
based on the gross daily average as stated in the PDST-R2 for the past three (3)
months immediately prior to the month of crediting. The same shall be credited to
27. CONSEQUENCE OF FORCE MAJEURE
the SPF ENROLLEE’S/MEMBER’S account every month-end.
13. CREDITING OF EXCESS EARNINGS
The SSS shall be relieved from carrying out its obligations on the SPF if it is prevented
from doing so due to Force Majeure (an event beyond the control of the SSS such as,
Actual fund earnings in excess of the guaranteed earnings, if any, after deducting all
but not limited to; fires, explosions, earthquakes, storms, floods, war, disorder,
fees and charges, shall be distributed to all active SPF ENROLLEES/MEMBERS
terrorism, etc).
based on their respective shares to the total ADB of the SPF and shall be credited
to their respective accounts every year-end.
28. MODIFICATIONS OF POLICIES
14. WITHDRAWALS
Policies, including this terms and conditions, governing the SPF Program are subject to
change as may be determined by the SSS and without prior notice.
SPF MEMBER, or his/her authorized representative, may file a withdrawal claim at
any
time
