HQP-PFF-002

EMPLOYER'S DATA
FORM (EDF)
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REGISTRATIONTRACKINGNUMBEf ~
INSTRUCTIONS
1. Accomplishthis f orminone(1) copy.
2. Type orprintallentries inBLOCK orCAPITAL LETTERS.
3. On the "CONTACTDETAILS"portion,indicate at least one (1) contact number.
4. Onthe "INDUSTRY"portion,indicateindustry based o n the Listof Industryf oundattheback of thef orm.
5. Submitdulyaccomplishedf ormandpresent required supportingdocuments basedonthe Checklistof Requirements f ound atthe backof thef orm.
6. Allf ields whicharemarkedwith asterisk (') are mandatory.
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*EMPLOYER/BUSINESS NAME
LotNo., Block No.. PhaseNo. HouseNo
i Business (DirectUne)
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-J Business (Fax)
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Business (Trllnk-L-In-e-)~ ~ ~ -
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'Cell Phone
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ZIPCode . 1 'Business EmailAddress
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Barangay
Street Name
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Subdivision
Municipality/City
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Local
Provi nce
CEIBULmllJ I 'INDUSTRY
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'BRANCH/OFFICE T'TYPE OF EMPLOYER
Head Of f ice i ." Private
Branch (Please Specify) I Government
For Private Employers
*LEGAL PERSONALITY
'WITH RETIREMENT PLAN PHILIPPINE BUSINESS
Yes 1REGISTRY No.
No
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DTI/SEC REGISTRATION
CERTIFICATE No.
I
DATE OF
ISSUANCE
Constitutional Office
Government-Owned and Controlled Corporation (GOCC)!
I-~ ~ G~o_vemment Finane/allnstitution (GFI)
PREVIOUS EMPLOYER/BUSINESS NAME (If applicable)
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TAXPAYERS IDENTIFICATION NUMBER (TIN}
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Sole Proprietorship Cooperative/Trade Association I For Private Employers
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'CLASSIFICATION I
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National Government
Local Government Unit (LGU)
m m d d
For Govemmeni Emp/oyers
GSIS BUSINESS PARTNER No.
COIl ! i I I] ] ]
AGENCY/BRANCH/DIVISION CODE
"Head of Of f icelAuthorized Representative
(Signature over Printed Name)
"Designation/Position Date
! HEREBY CERTIFY THAT THE INFORMATION GIVEN ANDALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT.
THIS FORM MAY BEREPRODUCEJ), NOT FOR SAI.t:.
(Rev. 02. 1112013)
Agriculture, Forestry and Fishing
Mining and Quarrying
Manuf acturing
Electricity, Gas, Steam and Air Conditioning Supply
Water Supply; Sewerage, Waste Management and Remediation Activities
Construction
Wholesale and Retail Trade; Repair of Motor Vehicles and Motorcycles
Transportation and Storage
Accommodation and Food Service Activities
Inf ormation and Communication
Financial and Insurance Activities
Real Estate Activities
Prof essional, Scientif ic and Technical Activities
Administrative and Support Service Activities
Public Administration and Def ense; Compulsory Social Security
Education
Human Health and Social Work Activities
Arts, Entertainment and Recreation
Other Service Activities
Activities of Households as Employers; Undif f erentiated Goods-and-Services-Producinq Activities of Households f or Own
Use
Activities of Extra-Territorial Organizations and Bodies

1. Employer's Data Form (EDF [ HQP-PFF-002] )

2. Specimen Signature Form (SSF [ HQP-PFF-003] )
3. Present the f ollowing as proof of business existence:
SSS Certif ication (if already registered with SSS)
Business Permit/Mayor's Permit
ForSole Proprietorship
Department of Trade and Industry (DTI) Certif icate of Registration
For Partnership/Corporation/Foreign-Owned Corporation
Securities and Exchange Commission (SEC) Certif icate of Partnership/lncorporation
Approved Articles of Partnership/Incorporation and By-Laws
ForCooperative
Cooperative Development Authority (CDA) Certif icate
Approved Articles of Cooperation
ForTrade Association
Securities and Exchange Commission (SEC) Certif icate of Incorporation
Articles of Incorporation and By-Laws