JEASOON TIMANONO

Experienced Assembler knowledgeable about general warehouse operations. Works quickly and stays focused under strict deadlines. Skilled in managing multiple tasks with frequently changing priorities. Continuously projects positive attitude and seeks opportunities to help team members.

• MOTHER'S MAIDEN NAME (LAST NAME)

• /IES(If without spouse & child and parents are both deseased) (LAST NAME) (FIRST NAME) (MIDDLE NAME) (SUFFIX) RELATIONSHIP DATE OF BIRTH (MMDDYYYY) 1 TIMANONO ROSEVELYN BUTALID Foster parent 01021974
• /OVERSEAS FILIPINO WORKER/NON-WORKING SPOUSE
• (SE) OVERSEAS FILIPINO WORKER (OFW) NON-WORKING SPOUSE (NWS) Profession/Business Foreign Address SS No./Common Reference No. of Working Spouse Year Prof./Business Started Monthly Income of Working Spouse (P) Monthly Earnings Monthly Earnings Are you applying for membership in the Flexi-Fund Program? YES NO PURPOSE OF APPLICATION PURPOSE FOR EMPLOYMENT / PRIOR REGISTRANT PROFESSION/BUSINESS ESTIMATED MONTHLY SALARY UMID CARD APPLICATION WITH ATM OPTION UMID CARD AS ATM CARD (BANK NAME) (BANK BRANCH) CERTIFICATION, DATA PRIVACY CONSENT AND AUTHORIZATION 1. I certify that the information provided are true and correct. 2. I hereby consent to: the collection, data capture, storage, biometric matching and the retention of my personal data for the generation/updating of my CRN, card production and delivery, further processing and payment of my loans and SSS benefits; sharing of these data with SSS service providers to carry out the purposes stated above; and disposal of this application in the manner consistent with the Data Privacy Act. 3. I trust that all these data shall be kept confidential by SSS and its service providers and my bank. 4. I further give my consent to SSS to share necessary data with my chosen bank for the generation of bank account number, crediting of loan and benefit proceeds to the account number and payment of said loan and benefit proceeds. For this purpose, I consent for the sharing of my bank account number with SSS. INSTRUCTIONS 1. Fill out this form in one (1) copy. 2. Erasures/alterations are not encouraged. However, if necessary, such will be limited up to two (2) erasures/alterations only. Always affix initials on all erasures/alterations of this form. 3. Place a checkmark on the applicable box. 4. Always indicate "N/A" or "Not Applicable", if the required data is not applicable. 5. Indicate the home address. If permanent home address is in the province but working in Metro Manila during weekdays or working abroad, indicate the provincial address instead of the Metro Manila address. 6. Write the "HEIGHT" in centimeters and "WEIGHT" in kilograms. To convert: 1 ft = 30.48 cm 1 in = 2.54 cm 1 lb = 0.4536 kg 7. Limit the distinguishing features to those that can be found on the face such as "mole under the right eye" and "mole or birth mark on the left cheek/forehead". 8. Always indicate the following mandatory information: Country of place of birth, if born outside the Philippines Mobile number, if applied locally Email address, if applied abroad if card applicant cannot provide the required mobile number/email address, indicate the card applicant's immediate family member's mobile number/email address where SSS can communicate with the card applicant. 9. For all types of card replacement, pay the required fee at any SSS branch office/accredited bank/collecting agent. Write the Special Bank Receipt (SBR)/Receipt Number/Transaction Reference Number on the field provided and submit this form together with the required document/s and proof of payment to the nearest SSS branch office. 10. For card replacement due to unclaimed UMID cards beyond five (5) years, a replacement fee and biometric data re-capture is required. 11. Submit this form to the nearest SSS branch with the following required documents (use the table Documentary Requirements Guide). DOCUMENTARY REQUIREMENTS GUIDE IDENTIFICATION REQUIREMENTS (Present the original) A. Primary ID card/document [any one (1) of the following]: 1. Unified Multi-Purpose ID Card 2. Social Security Card 3. Alien Certificate of Registration 4. Driver's License 5. Firearm Registration 6. License to Own and Possess Firearms 7. National Bureau of Investigation (NBI) Clearance 8. Passport 9. Permit to Carry Firearms Outside of Residence 10. Postal Identity Card 11. Seafarer's Identification & Record Book (Seaman's Book) 12. Voter's ID Card B. Any two (2) other ID cards/documents, both with signature and at least one (1) with photo (In absence of a primary card). Please specify. _________________________________________ _________________________________________ IDENTIFICATION REQUIREMENTS (Present the original) A. For card replacement due to amendment of data/authenticating finger Previously issued SS digitized ID or UMID card of the card applicant Proof of payment B. For card replacement due to lost SS digitized ID or UMID Card Duly notarized Affidavit of Loss Proof of payment C. For card replacement due to non-receipt of UMID Card Duly notarized Affidavit of Non-Receipt of Card Notice/Email from Identity Management Department (IMD) that the courier lost/was not able to deliver the UMID Card Proof of payment C. For card replacement due to damaged UMID Card, UMID Card as ATM Card and other reason/s Proof of payment 12. Observe proper attire when applying for a UMID card. DOs DONTs Collared shirt/blouse is encouraged Face and neck should be free from bandage or accessories Wearing of the following: a. For Male - undershirt/"sando" and/or earrings d. Metal piercing in any part of the face b. For Female - dangling or overstated earrings e. Head gear c. Eyeglasses and/or colored contact lenses f. Sunglasses Unified Multi-Purpose ID (UMID) Card Application Page 2 REMINDERS 1. Card applicants who chose to enroll their UMID Card as ATM card at point of card application shall claim the same at the specified bank's branch or kiosk within thirty (30) days upon receipt of SMS notification from SSS. 2. For regular UMID Card, the default mode of issuance is pick-up at the SSS branch office where card application was made. 3. UMID Cards for pick-up at SSS Offices where card application was filed, shall be claimed within sixty (60) days from receipt of SMS notification from SSS. Otherwise, unclaimed UMID Cards within the 60-days claiming period shall be verified thru IMD or SSS hotline. Unclaimed UMID Cards beyond five (5) years shall be shredded or destroyed. 4. To verify the status of your UMID Card application, you may reach us at 920-6401 local 5714 or email at sss_id@sss.gov.ph. 5. Card applicants shall be required to verify the status/availability of their UMID Cards if with change of mobile number after the card application was made or non-receipt of SMS notification from SSS within thirty (30) days from card application. 6. Unsuccessfully delivered UMID Cards (RTS) will be sent to the SSS branch office where biometric data capture was made.