Scribd
Upload
840 views40 pages

SSS R1A Form

This document is an employment report submitted to the Social Security System of the Philippines. It contains information on up to 20 employees of a registered employer, including name, social security number, date of birth, position, monthly salary, and date of employment for each. The employer certifies the report is correct before submitting it to SSS for processing, review, and encoding of employee data. Instructions remind the employer to submit required registration forms and present identification if not already registered with SSS.

Uploaded by

Angela
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
840 views40 pages

SSS R1A Form

This document is an employment report submitted to the Social Security System of the Philippines. It contains information on up to 20 employees of a registered employer, including name, social security number, date of birth, position, monthly salary, and date of employment for each. The employer certifies the report is correct before submitting it to SSS for processing, review, and encoding of employee data. Instructions remind the employer to submit required registration forms and present identification if not already registered with SSS.

Uploaded by

Angela
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
You are on page 1/ 40

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

Republic of the Philippines

SOCIAL SECURITY SYSTEM

EMPLOYMENT REPORT

(Please read instructions/reminders at the back. Print all information in black ink.)
EMPLOYER ID NUMBER

REGISTERED EMPLOYER NAME

TELEPHONE NUMBER

ADDRESS
Name of Employee
(Surname)
(Given Name)

SS Number

(MI)

Date of Birth
(MMDDYYYY)

Position

Monthly Salary

Date of E
(MMD

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

CERTIFIED CORRECT:
TOTAL NO. OF
REPORTED
EMPLOYEES
Page

of

Page/s

FOR SSS USE


PROCESS BY/DATE:

Signature Over Printed Name


of Authorized Signature

REVIEW BY/DATE:

ENCODE BY/DATE:

Official Designation

Date

INSTRUCTIONS/REMINDERS
1. Submit in two (2) copies with properly accomplished SS Form R-1 (Employer Registration), if the
employer is not yet registered with the SSS.
2. Submit in two (2) copies to report newly hired/rehired employee/s and present SS Employer ID Card, if
the employer is already registered with the SSS.
3. The employer is obliged to report all its employees for coverage through this form regardless of the
actual amount of monthly earnings rounded off to the last peso.
4. The owner of a single proprietorship business is disqualified to be reported as employee thereof.
However, he may register as a self-employed, provided he is not over 60 years old and is currently not
an employee member.
5. Write "Nothing Follows" immediately after the last reported employee

R-1A
REV. 01-2001

TAXPAYER IDENTIFICATION NO.


POSTAL CODE
Date of Employment
(MMDDYYYY)

DE BY/DATE:

Remarks
FOR SSS USE

RECEIVED BY/DATE:

You might also like