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HQP-ITF-033 eSRS Employer Enrollment Form

Pag-Ibig eSRS enrollment form for employeer

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: HQP-PFF-002
(V05, 04/2018)
FOR Pag-IBIG Fund USE ONLY

EMPLOYER’S DATA
FORM (EDF)

Pag-IBIG EMPLOYER ID NUMBER

REGISTRATION TRACKING NUMBER

INSTRUCTIONS
1.
2.
3.
4.
5.
6.

Accomplish this form in one (1) copy.
Type or print all entries in BLOCK or CAPITAL LETTERS.
On the "CONTACT DETAILS" portion, indicate at least one (1) contact number.
All fields which are marked with asterisk (*) are mandatory.
On the “INDUSTRY” portion, indicate industry based on the List of Industry at the back of the form.
Submit duly accomplished form and present required supporting documents based on the Checklist of Requirements found at the back of the form.

*EMPLOYER/BUSINESS NAME

ADDRESS AND CONTACT DETAILS
*EMPLOYER/BUSINESS ADDRESS

AREA CODE

Unit/Room No., Floor

TELEPHONE NUMBER

Building Name

Business (Direct Line)
Lot No., Block No.,

Phase No.

House No

Street Name

Business (Fax)
Subdivision

Barangay

Business (Trunk Line)
Municipality/City

Local

Cell Phone

Province

ZIP Code

Business Email Address

EMPLOYER/BUSINESS DETAILS
*INDUSTRY

START OF BUSINESS OPERATION
m

m

d

d

y

y

y

*WITH RETIREMENT PLAN
 Yes
 No

y

*BRANCH/OFFICE
 Head Office
 Branch (Please Specify) ___________
For Private Employers
*LEGAL PERSONALITY

DATE OF
ISSUANCE

DTI/SEC/CDA REGISTRATION
CERTIFICATE No.

*TYPE OF EMPLOYER
 Private
 Government

PHILIPPINE BUSINESS
REGISTRY No.

DATE OF
ISSUANCE

*TAXPAYER IDENTIFICATION NUMBER (TIN)

 Sole Proprietorship
 Partnership
 Corporation
For Government Employers
*CLASSIFICATION

 Cooperative/Trade Association
 Foreign-owned Corporation

 National Government
 Local Government Unit (LGU)

 Constitutional Office
 Government-Owned and Controlled Corporation (GOCC)/
Government Financial Institution (GFI)

For Private Employers
SSS Employer Number
Date of Registration

PREVIOUS EMPLOYER/BUSINESS NAME (If applicable)

m

m

d

d

y

y

y

y

For Government Employers
GSIS BUSINESS PARTNER No.
AGENCY/BRANCH/DIVISION CODE

I HEREBY CERTIFY THAT THE INFORMATION GIVEN AND ALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT.
________________________________________
*Head of Office/Authorized Representative
(Signature over Printed Name)

____________________________
*Designation/Position

____________________
Date

FOR Pag-IBIG FUND USE ONLY
RECEIVED BY
_________________________________
Signature over Printed Name

DATE
________________________
Designation/Position

____________________
Branch/Unit

THIS FORM MAY BE REPRODUCED. NOT FOR SALE.

HQP-PFF-002
(V05, 04/2018)

LIST OF INDUSTRY






















Agriculture, Forestry and Fishing
Mining and Quarrying
Manufacturing
Electricity, Gas, Steam and Air Conditioning Supply
Water Supply; Sewerage, Waste Management and Remediation Activities
Construction
Wholesale and Retail Trade; Repair of Motor Vehicles and Motorcycles
Transportation and Storage
Accommodation and Food Service Activities
Information and Communication
Financial and Insurance Activities
Real Estate Activities
Professional, Scientific and Technical Activities
Administrative and Support Service Activities
Public Administration and Defense; Compulsory Social Security
Education
Human Health and Social Work Activities
Arts, Entertainment and Recreation
Other Service Activities
Activities of Households as Employers; Undifferentiated Goods-and-Services-Producing Activities of Households for
Own Use
Activities of Extra-Territorial Organizations and Bodies

CHECKLIST OF REQUIREMENTS
1. Employer’s Data Form (EDF [HQP-PFF-002])
2. Specimen Signature Form (SSF [HQP-PFF-003])
3. Present the following as proof of business existence:
 SSS Certification (if already registered with SSS)
 Business Permit/Mayor’s Permit
For Sole Proprietorship
 Department of Trade and Industry (DTI) Certificate of Registration
For Partnership/Corporation/Foreign-Owned Corporation
 Securities and Exchange Commission (SEC) Certificate of Partnership/Incorporation
 Approved Articles of Partnership/Incorporation and By-Laws
 Board Resolution concerning Authorized Signatory/ies
For Cooperative
 Cooperative Development Authority (CDA) Certificate
 Approved Articles of Cooperation
For Trade Association
 Securities and Exchange Commission (SEC) Certificate of Incorporation
 Articles of Incorporation and By-Laws
 
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