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This document is an accident/sickness report form from the Social Security System of the Republic of the Philippines. The form collects information such as the employee's name and social security number, the employer's name and identification number, the date and time of the accident or sickness, whether it occurred during regular or overtime hours, and a brief description of the incident. The employee's supervisor and personnel manager must also sign and date the completed form.
This document is an accident/sickness report form from the Social Security System of the Republic of the Philippines. The form collects information such as the employee's name and social security number, the employer's name and identification number, the date and time of the accident or sickness, whether it occurred during regular or overtime hours, and a brief description of the incident. The employee's supervisor and personnel manager must also sign and date the completed form.
This document is an accident/sickness report form from the Social Security System of the Republic of the Philippines. The form collects information such as the employee's name and social security number, the employer's name and identification number, the date and time of the accident or sickness, whether it occurred during regular or overtime hours, and a brief description of the incident. The employee's supervisor and personnel manager must also sign and date the completed form.
IMPORTANT ACCIDENT/SICKNESS REPORT IF VEHICULAR ACCIDENT SSS FORM B-309 (Revised 06/88) eeg ATTACH COPY OF POLICE RE- PORT NAME OF EMPLOYEE (Last, First, Middle) SS NUMBER
NAME OF EMPLOYER ADDRESS SS I.D. NUMBER
JOB DESCRIPTION OR OCCUPATION
DATE OF ACCIDENT/SICKNESS EXACT TIME PLACE
(Check applicable box)
REGULAR WORKING HOURS OVERTIME From To From To
DATE LAST REPORTED FOR WORK DATE RETURNED TO WORK
BRIEF DESCRIPTION OF ACCIDENT/SICKNESS
SIGNATURE OF IMMEDIATE SUPERVISOR SIGNATURE OF PERSONNEL MANAGER
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