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    6 views1 page

    Solo Parent Form Editable

    Uploaded by

    rryc8425

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    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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