SSS Unified Multi-Purpose ID (UMID) Card Application Form

Other SSS Forms

Request/Verification Form

Kasambahay Unified Registration Form

SSS # Application Form

SOCIAL SECURITY SYSTEM – Unified Multi-Purpose ID (UMID) Card Application Form

INSTRUCTIONS

1. Fill out this form in one (1)  copy.
2. Erasures/alterations are not encouraged. However, if necessary, susch will be limited up to two (2) erasures/alterations only. Always affix initials on all erasures alterations of this form.
3.  Place a check mark on the application box.
4.  Always indicate “N/A” or “Not Applicable”, if the required data is not applicable.
5. Indicate the home address. If permanent home address is in the province but working in Metro Manila during weekdays or working abroad, indicate the provincial address instead of the Metro Manila address.
6. Write the “HEIGHT” in centimeters and “WEIGHT” in kilograms.

To convert: 1 feet = 30.48 cm   1 in = 2.54 cm 1 lb= 0.4 536 kg.

7. Limit the distinguishing features is to those that can be found on the face such as “a mole under the right eye” and “mole or birthmark on the left cheek/forehead”.
8. Always indicate the following mandatory information:

• Country of place of birth, if born outside the philippines
• Mobile number, if applied locally*
• Email address, if applied abroad*

*If card applicant cannot provide the required mobile number/email address. Indicate the card applicant’s immediate family member’s mobile number/email address where SSS can communicate with the card applicant.

9. For all types of card replacement, pay the required fee at any SSS branch office/accredited bank/collecting agent. Write the Special Bank Receipt (SBR)/Receipt Number/Transaction Reference Number on the field on the field provided and submit this form together with a required document/s and proof of payment to the nearest SSS branch office.
10. For card replacement due to unclaimed UMID cards beyond five (5) years, a replacement fee and biometric data re-capture is required.
11. Submit this form to the nearest SSS branch with the following required documents (use the table Documentary Requirements Guide).