1'!
/';j SOCIAL SECURITY SYSTEM
Republic of the Philippine s
SSS WEB REGISTRATION FOR EMPLOYER
Employer ID: Branch Code:
Employer Name: __.--- DCCS CONSTRUCTION SERVICES
Date of Coverage: r--
Business Address:_____..- MALIGAYA ST BRGY CAUT LAPAZ TARLAC
Postal Code----- 2314
Landline Number: ___.-
Mobile Number:..--- 09105158912
Company Email Address: -
[email protected]EMPLOYER AUTHORIZED SIGNATORY
SSS Number;-- ----
First Name:- - DAVE MARK
Middle Name:..,.- --- DIZON
Last Name:
,-- QUIAMBAO
Email Address~
[email protected]EMPLOYER lOG-IN DETAILS
Preferred User ID:
Note: Your User 10 must be properly patterned after the Business Name. Length must be 8-20 characters. First characters
must be alphabetic. No special characters
except underscore. (Ex. LardoftheWeblnc_12).
DAVE MARK D. QUIAMBAO
Signature over printed name of the Signature over printed name of the
Employer Authorized Signatory in Form L-501 Person Granting Authority in Form L-501
Date Signed: Date Signed:
Position Title: Position Title:
55 Number: SS Number:
Contact N u m b e r : - - - - - - - - - - Contact N u m b e r : - - - - - - - - - -
Email Address: Email Address: