Sample Affidavit of Unemployment for Unemployment Insurance or Involuntary Separation Benefit under the Social Security Act of 2018

Sample Affidavit of Unemployment for Unemployment Insurance or Involuntary Separation Benefit under the Social Security Act of 2018

Affidavit of Termination (sample only) is provided here in support of the application for unemployment insurance or involuntary separation benefit with SSS.

Unemployment insurance or involuntary separation benefit under Section 14-B of the Social Security Act of 2018 (R.A. 11199) provides that an SSS member who is not over sixty (60) years of age who has paid at least thirty-six (36) months contributions the twelve (12) months of which should be in the eighteen-month period immediately preceding the involuntary unemployment or separation shall be paid benefits in the form of monthly cash payments equivalent to fifty percent (50%) of the average monthly salary credit for a maximum of two (2) months. (See Discussion on the Unemployment Insurance here)

In Section 6 of the SSS Circular No. 2019-011, one of the documentary requirements stated is the certification establishing the nature and date of involuntary separation from DOLE with either the Notice of Termination from Employer or Affidavit of Termination of Employment.

On July 29, 2019, the DOLE issued Department Circular 01, Series of 2019 on the Guidelines on the Issuance of DOLE Certification. This is a requirement for application for payment of unemployment insurance or separation benefit.

Applicants for certification shall be required to bring one (1) valid I.D. and a copy of the Notice of Termination issued by the employer. In the absence of Notice of Termination, an applicant may submit a duly notarized Affidavit of Termination of Employment to DOLE Field or Provincial Office, or Philippine Overseas Labor Office, as the case may be.

Below is the sample Affidavit of Termination of Employment under Article 298 or 299 of the Labor Code, as amended:

Republic of the Philippines )
City of _______________ ) S.S.

AFFIDAVIT OF TERMINATION
(Article 298 or 299)

I, TINA N. ANGGAL, Filipino, of legal age, and a resident of _____________, after having been duly sworn to, in accordance with law, do hereby depose and state, that:

  1. On _______________, I was issued a Notice of Termination of Employment by my employer, XYZ Company for the following reason (choose the appropriate option): installation of labor saving devices / Redundancy / Retrenchment or downsizing / Closure or cessation of operation / Disease/Illness
    1. Copy of my Notice of Termination is hereto attached as Annex “A”.
  2. The termination is not due to just cause or to my fault but occasioned by the above reason.
  3. I executed this Affidavit to attest to the truth of the foregoing statement and for purposes of securing DOLE Certification and availment of Unemployment Insurance or Involuntary Separation benefit from the SSS.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of ________, 20____.

TINA N. ANGGAL

Affiant
ID: _______________________

 

SUBSCRIBED AND SWORN TO, this ____ day of ________, 20___, the above personally appeared and presented to me the competent evidence of identity shown above.

 

 

 

 

Doc. No.: _______;
Page No.: _______;
Book No.: _______;
Series of 20______.

Below is the sample Affidavit of Termination of Employment under Article 300 of the Labor Code, as amended:

Republic of the Philippines )
City of _______________ ) S.S.

AFFIDAVIT OF TERMINATION
(Article 300)

I, TINA N. ANGGAL, Filipino, of legal age, and a resident of _____________, after having been duly sworn to, in accordance with law, do hereby depose and state, that:

  1. On _______________, I issued my employer, XYZ Company, a Notice of Termination of Employment for the following reason (choose the appropriate option): Serious insult / Inhuman and Unbearable Treatment / Commission of a crime or offense / Other causes analogous
    1. Copy of the Notice of Termination I submitted is hereto attached as Annex “A”.
  2. The reason behind my termination is that (e.g. I was demoted / my salary was severely diminished / there was diminution of my benefits etc.). The termination is not due to just cause or to my fault but occasioned by the above reason.
  3. I executed this Affidavit to attest to the truth of the foregoing statement and for purposes of securing DOLE Certification and availment of Unemployment Insurance or Involuntary Separation benefit from the SSS.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of ________, 20____.

TINA N. ANGGAL

Affiant
ID: _______________________

SUBSCRIBED AND SWORN TO, this ____ day of ________, 20___, the above personally appeared and presented to me the competent evidence of identity shown above.

 

 

 

 

Doc. No.: _______;
Page No.: _______;
Book No.: _______;
Series of 20______.

 

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