Cooperative Accreditation: Social Security System
Cooperative Accreditation: Social Security System
ACCREDITATION NUMBER
COOPERATIVE
ACCREDITATION
(06-2011)
Please read instructions at the back before accomplishing this form. Print all information in capital letters and use black ink only.
PART I - INFORMATION
EMPLOYER ID NUMBER
NAME OF COOPERATIVE
PRINCIPAL OFFICE ADDRESS (Room/Floor/Bldg No./Name)
(Street)
(Subdivision/Village)
(City/Municipality)
(Barangay/District/Locality)
(Province)
START
OF
O
PE
R
ATION (mm/dd
TYPE OF COOPERATIVE:
1__LJ____
AREAS OF OPERATION:
PRODU
CERS
E-MAIL ADDRESS
MARKET
ING
111111111
11 1 1 1CREDIT
1111
NUMBER OF
MEMBERS
CONSUMERS
yy
yy
)
POSTAL CODE
SERVICE
OTHERS: (Specify)
PART II - CERTIFICATION
MULTI PURPOSE
I certify that the information provided in this form are true and correct.
PART III - TO BE FILLED OUT BY SSS
A. RECEIVING BRANCH
RECEIVED BY:
SIGNATURE OVER PRINTED NAME
OFFICIAL DESIGNATION
DATE
EVALUATED BY:
REVIEWED BY: CONFIRMED BY:
REMARKS:
CAPITALIZATION:
CURRENT RATIO:
QUICK RATIO:
SIGNATURE OVER PRINTED NAME
DATE
3-YEAR PROFITABILITY NET INCOME (LOSS)
DATE
DATE
DATE
INTRUCTIONS
1.
2.
3.
a)
b)
c)
d)
e)
Fill out this form in two (2) copies and accomplish Parts I & II signed by the President/Chairman.
Submit this form to the nearest SSS Branch having jurisdiction over your operation with Cooperative Member List and the
required documents duly marked "a-m" below.
This application shall be submitted with the following documents:
Articles of Incorporation
By-Laws
Economic Survey
Certificate of Registration with the Cooperative Development Autority
A favorable endorsement, issued not earlier than six (6) months prior to the time of filing the application, from the proper
government agency in case of cooperatives engaged in the following activities:
Activity
Air Transport
Banking,Pawnshops, & other excersices with quasibanking
functions
Professional Boxing
Operation of games of chance
Educational Institution (College/Tertiary)
Educational Institution (Elementary/Secondary)
Educational Institution (Technical/Vocational)
Electric Power Plants
Hospitals
Insurance
Land Transport
Construction of water transport/vessel
Operation of Radio,Television, telephone
f)
Government Agency
Civil Aeronautics Board
Bangko Sentral ng Pilipinas
List of names and addresses of the present members of its Board of Directors
g) The board resolution, duly certified by the Cooperative Secretary, approving the Collection Agency Agreement (CAA) and
particularly naming the officer as the authorized signatory thereto.
h) Audited Financial Statements for the last three (3) years
i) Names and addresses of accountable officers to be bonded, and the estimated amount of coverage of the bond
j) Proposed nature of the bond to secure its performance under the CAA, and the estimated amount of
REMINDERS
1.
2.
Members of the cooperative who are self-employed members must be duly registered as such and must have submitted the
required registration form.
Members of the cooperative who are voluntary members should have been previously covered by the SSS as Employed,
Self-Employed, Overseas Filipino Worker or Non-Working spouse members. Otherwise, these members should register as
Self-Employed members.
CATEGORIES OF COOPERATIVES
Primary - the members of which are natural persons of legal age.
Secondary - the members of which are primaries.
Tertiary - the members of which are secondaries upward to one (1) or more apex organizations.