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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE 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 Date of Birth Date of Em

SS Number Position Monthly Salary
(Surname) (Given Name) (MI) (MMDDYYYY) (MMD
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CERTIFIED CORRECT: FOR SSS USE
TOTAL NO. OF PROCESS BY/DATE: REVIEW BY/DATE: ENCODE BY/DATE:
REPORTED
EMPLOYEES Signature Over Printed Name
of Authorized Signature
Page of Page/s
 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 Remarks

(MMDDYYYY) FOR SSS USE

RECEIVED BY/DATE:
DE BY/DATE: