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Employer Contributions Payment Form R-5: Social Security System

This document is an Employer Contributions Payment Form from the Social Security System of the Philippines. It contains fields for the employer to provide identification information like their employer number, name, address, type of payor, and tax identification number. It also includes fields to itemize the social security and compensation contributions being remitted for each month, any applicable interest or penalties, and the total remittance. Instructions are provided on how to accurately complete the form in four copies and submit it along with supporting documents within deadlines to avoid penalties.

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Uncle Cheffy - Malate
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571 views2 pages

Employer Contributions Payment Form R-5: Social Security System

This document is an Employer Contributions Payment Form from the Social Security System of the Philippines. It contains fields for the employer to provide identification information like their employer number, name, address, type of payor, and tax identification number. It also includes fields to itemize the social security and compensation contributions being remitted for each month, any applicable interest or penalties, and the total remittance. Instructions are provided on how to accurately complete the form in four copies and submit it along with supporting documents within deadlines to avoid penalties.

Uploaded by

Uncle Cheffy - Malate
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

Republic of the Philippines

SOCIAL SECURITY SYSTEM


R-5 EMPLOYER CONTRIBUTIONS
CON- (03-2010) PAYMENT FORM
Please read instructions at the back before accomplishing this form.
Print all information in capital letters and use black ink only. (THIS IS YOUR OFFICIAL RECEIPT WHEN VALIDATED)

EMPLOYER NUMBER NAME OF EMPLOYER/REGISTERED BUSINESS

ADDRESS (NO. & STREET) (BARANGAY) (TOWN/DISTRICT) (CITY/PROVINCE) POSTAL CODE

TYPE OF PAYOR TIN TELEPHONE/MOBILE NUMBER


Regular Employer Household Employer
APPLICABLE PERIOD EMPLOYEES'
SOCIAL SECURITY COMPENSATION
MONTH YEAR CONTRIBUTION CONTRIBUTION TOTAL
JANUARY P P P
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
Sub-total P P P
PAYMENT
UNDER

INTEREST PENALTY
ADD

TOTAL REMITTANCE P P P
FORM OF PAYMENT AMOUNT IN FIGURES TOTAL AMOUNT IN WORDS
Cash P
Postal Money Order (PMO)
Check
Check Number CERTIFIED CORRECT
Date
Bank/Branch Name
TOTAL P SIGNATURE OVER PRINTED NAME DATE

Note: with approved installment - condonation


under RA 11199 / SS Act of 2018

/Revised Version 09/2009


INSTRUCTIONS

1. Fill out this form in four (4) copies.


2. Put a checkmark on the appropriate box of the type of payor.
3. Indicate the year for which payment is applicable.
4. Remit the monthly contributions of your employees/household helpers on or before the 10th day of the following month to
avoid 3% penalty per month for late payment.
- If the 10th day of the month falls on a Saturday, Sunday or holiday, the deadline shall be on the next working day.
5. Remit the monthly contributions of your employees/household helpers through any of the following:
a) SSS Branch with tellering facilities
b) accredited banks
c) authorized payment centers
6. Make all checks and postal money orders payable to SSS. Fill out properly the check details in the "Form of Payment"
portion.
7. Submit a copy of validated Employer Contributions Payment Form (SS Form R-5)/SS Form R-5 with Special Bank
Receipt (SBR), together with the corresponding Contributions Collection List (SS Form R-3) within ten (10) days after the
applicable quarter or R-3 in electronic media device within ten (10) days after the applicable month, to the SSS branch
nearest your office (if regular employee) or residence (if household employer).

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