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Solo Parent Form Editable

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358 views1 page

Solo Parent Form Editable

Uploaded by

rryc8425
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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S

REPUBLIKA NG PILIPINAS
PAMAHALAANG LUNGSOD NG MUNTINLUPA

TANGGAPAN NG PANLIPUNANG PAGLILINGKOD


SOCIAL SERVICES DEPARTMENT

Requirements for Solo Parent ID Application


SOLO PARENT FORM For NEW Application:
Application No.: _______ 1. Get application form at the SSD Office front desk and fill out
2. Photocopy of Care Card or Voter’s ID/Verification (if available)
3. Barangay Certificate
I. BASIC INFORMATION
4. Certificate of Employment (if employed)
5. Photocopy of ITR or photocopy of 1 month payslip (if employed)
Name: _______________________________________________
Surname Given Name Middle Name Ext. 6. Certificate of Non-filing of Income Tax Return (not employed)
7. Photocopy of Business Permit (for business owner)
Civil Status: Single Annulled Separated Widow/Widower
8. Affidavit of Being a Solo Parent (Legal Office – 3F Annex Bldg., City
Sex: ________ Age: _______ Date of Birth: _______________ Hall)
Place of Birth: ________________ Religion: ________________ 9. Photocopy of Birth Certificate of child/children, 22 years old and
Present Address: _______________________________________ below
_____________________________________________________ 10. Photocopy of PWD ID (for PWD Child/ren)
Mobile No.: __________________ Landline No.: _____________ 11. Photocopy of Death Certificate (if widow/widower)
Educational Attainment: _________________________________ 12. Latest 1x1 picture
Profession: _________________ Occupation: ________________ For RENEWAL:
Monthly Income: _______________________________________ 1. Surrender old Solo Parent ID
Name of Employer: _____________________________________ 2. Get application form at the SSD Office front desk and fill out
Employer/Company Address: _____________________________ 3. Photocopy of Care Card or Voter’s ID/Verification
_____________________________ Contact No.: _____________ 4. (if available)
5. Barangay Certificate
6. Photocopy of ITR or photocopy of 1 month payslip
7. (if employed)
8. Affidavit of Non-filing of ITR (not employed)
9. Photocopy of Business Permit (for business owner)
10. Affidavit of Being a Solo Parent (Legal Office – 3F Annex Bldg.,
II. FAMILY COMPOSITION City Hall)

Name Age Sex Relationship Status Educational Occupation Monthly


Attainment Income
1.
2.
3.
4.
5.
 Please include other members of the household aside from family members. Use the back portion of this form if necessary.

III. REASONS/CIRCUMSTANCES OF BEING A SOLO PARENT


__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
 You may use the back portion of this form for other details.

I have read this form, understood its contents and consent to the processing of my personal data. I understand that my consen t
does not preclude the existence of other criteria for lawful processing of personal data, and does not waive any of my rights under the
Data Privacy Act of 2012 and other applicable laws.

________________________________________ Right Thumbmark


Signature Over Printed Name of Applicant / Date

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