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Request for GSIS Retirement Certification (For Availment of PhilHealth Benefits)
GSIS request form for GSIS retirement certificate
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: GOVEftNMENT SERV.ICE:.INS,-,RAN«;E SYSTEM
Paseguruhan
cusrosrsa
Ng Mga Nagli/ing/(od sI! Pamaha/aan
RELATIONS &'MONITORING
DEPARTMENT.
REQUEST FORM
for
GSIS RETIREMENT CERTIFICA'l"E
Date:
. l am requesting for a retirement
availing. of Philllealth benefits.'
certificate'
from the OSIS for the purpose
.
of
Below are necessary information on the retiree:
1. Full Name of Retiree
2. Retirement No.
3. Date of Retirement
4. Retire under RNPD-
5. Present Address
6. Former Employer
and Office Address
7. Date of Birth
8.' Retiree's Present Age
9. No. ofyrs. in service
certificate is issued to it GSIS retiree / legal spouse for the purpose 'of
availing PhilHealth benefits pursuant to PD#408 dated ~1arch~, 1974...However,
the retiree should be at least 60 years old upon hospitalization.
A retirement
