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COV-01185 Flexi Fund Enrollment Form

SSS application form for flexi - fund of OFWs with existing SS numbers.

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SOCIAL SECURITY SYSTEM

FLEXI-FUND ENROLLMENT FORM
FOR OVERSEAS FILIPINO WORKER (OFW) MEMBERS

COV-01185 (07-2014)

THIS FORM MAY BE REPRODUCED AND IS NOT FOR SALE. THIS CAN ALSO BE DOWNLOADED THRU THE SSS WEBSITE AT www.sss.gov.ph.
PLEASE READ INSTRUCTIONS, REMINDERS & PROGRAM FEATURES AT THE BACK BEFORE FILLING OUT THIS FORM. PRINT ALL INFORMATION IN CAPITAL LETTERS & USE BLACK
INK ONLY.

PART I - TO BE FILLED OUT BY THE MEMBER
SS NUMBER

COMMON REFERENCE NUMBER (IF ANY)

(LAST NAME)

NAME

ADDRESS IN THE PHILIPPINES

DATE OF BIRTH (MMDDYYYY)

(FIRST NAME)

(RM./FLR./UNIT NO. & BLDG. NAME)

(MIDDLE NAME)

(HOUSE/LOT & BLK. NO.)

(BARANGAY/DISTRICT/LOCALITY)

TAX IDENTIFICATION NUMBER (IF ANY)

(SUFFIX)

(STREET NAME)

(CITY/MUNICIPALITY)

(SUBDIVISION)

(PROVINCE)

FOREIGN ADDRESS

ZIP CODE

COUNTRY

TELEPHONE NUMBER (COUNTRY + AREA CODE + TEL. NO.)

MOBILE/CELLPHONE NUMBER

HAVE YOU BEEN PREVIOUSLY ENROLLED IN THE FLEXI-FUND PROGRAM?

E-MAIL ADDRESS

Yes

No

CERTIFICATION

Member is required to affix fingerprints.

I certify that the information provided in this form are true and correct and that I have read and understood the
FEATURES OF THE FLEXI-FUND PROGRAM indicated at the back of this form. (If member cannot sign, affix
fingerprints in front of an SSS personnel.)

PRINTED NAME

SIGNATURE

DATE

RIGHT THUMB

RIGHT INDEX

PART II - TO BE FILLED OUT BY SSS
LATEST MONTHLY SALARY CREDIT (MSC)

RECEIVED BY

PROCESSED BY

FLEXI-FUND APPLICATION

Approved

Disapproved

DOCUMENTS SUBMITTED (FOR LOCAL ENROLLMENT)

SIGNATURE OVER PRINTED NAME
DATE & TIME

SIGNATURE OVER PRINTED NAME
DATE & TIME

INSTRUCTIONS
1. Fill out this form and submit to the nearest SSS branch/service office/representative office (local/foreign).
2. Present UMID/SS ID card or valid passport for proper identification.
3. In case of local enrollment, present original and submit photocopy of valid Overseas Employment Certificate (OEC) or E-receipt issued by
POEA as proof of pending deployment.
4. Present validated proof of payment if latest maximum contribution is not yet posted.

REMINDERS
1. This form shall be used for the Flexi-fund enrollment of OFWs with existing SS numbers. Application for an SS number as an OFW shall be
thru the Personal Record Form.
2. Change/s or correction/s in personal data, including new/additional child/ren or other beneficiary/ies, shall be reported through the Member
Data Change Request form, to be submitted together with the required supporting documents.
FEATURES OF THE FLEXI-FUND PROGRAM
1. Membership. Membership in the Flexi-fund Program is open to all OFW-members who are: (i) recruited in the Philippines by a foreignbased employer for work abroad; (ii) with source of income in a foreign country; or (iii) residing permanently abroad; and who are
paying/shall pay the maximum contribution under the regular SSS program. Membership shall take effect upon payment of first Flexi-fund
contribution.
2. Contributions. An OFW-member may pay his Flexi-fund contributions anytime, provided that, at the time of payment, he pays/has paid the
maximum regular SSS contribution. Any amount paid (not lower than P200) in excess of the required maximum contribution for the
applicable period shall be automatically credited to the member's individual Flexi-fund account to earn interest.
3. Interest Earnings. Earnings on Flexi-fund contributions are guaranteed. Interest rates shall be based on the average rates of SSS' shortterm peso placements or 91-day Treasury bills (T-bills), whichever is higher. This is subject to quarterly re-pricing (i.e., rate for current
calendar quarter is based on rates in previous calendar quarter). Earnings shall be computed based on actual date of payment of Flexifund contributions, and shall be credited to the member's individual Flexi-fund account every month-end.
4. Management Fees. The SSS charges a fixed annual management fee equivalent to 1% of individual accumulated funds (contributions
plus interest earnings) to cover the cost of investing and managing the Flexi-fund. Management Fees shall be deducted from the member's
individual Flexi-fund account every month-end.
5. Option to continue paying. An OFW-member may continue paying his Flexi-fund contributions even after the termination of his
employment abroad, provided that he continues to pay the required maximum monthly contribution. Payment of contributions shall cease
upon filing of a final claim under the regular SSS program.
6. Benefits. The amount of Flexi-fund benefit shall be the accumulated contributions plus interest earnings less management fees, to be
provided tax-free. A member is entitled to receive his benefits upon retirement (i.e., has reached age 60) or in the event of total disability either in lump sum, pension or combination. Upon death of a member/pensioner, his beneficiary/ies shall receive a lump sum
equivalent to the benefit amount/cash value of the remaining pension (contingency date same as in regular program). A member
may opt for early withdrawal of his Flexi-fund contributions in lump sum, including net interest earnings, anytime. Annual Incentive Benefits
may be granted to members who have no benefit/withdrawal claims filed within the year. The individual AIB shall be automatically credited
to the member's Flexi-fund account and shall form part of his accumulated funds.
 
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