Template for Affidavit of Non-Receipt of SSS UMID

If it so happen that you applied for an SSS UMID before and you did not receive it for some reason, one of the requirements that you need to prepare to file for an UMID Replacement is an Affidavit of Non-Receipt of SSS UMID. Some Notary places will prepare this Affidavit of Loss for an additional charge. You can save money if you will prepare and print your own affidavit of Non Receipt and just bring it to the notary place for their seal.

Here is an Affidavit of Non Receipt, just put your details on the details, double check and print.

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REPUBLIC OF THE PHILIPPINES)
_______) S.S.

AFFIDAVIT OF NON-RECEIPT OF SSS UMID

That I, __________________________ of legal age, Filipino citizen,
single with residence and postal address at _______________________________
__________________________________________________, after having duly
sworn to in accordance with the law do hereby depose and say:

• That I applied for an SSS UMID last _______ on SSS Branch _____.
• But to this date, I have not received the SSS UMID.
• That I have neither received, endorsed, assigned nor appointed anybody to receive the SSS UMID.
• That I am executing this affidavit to attest to the truth of foregoing facts and support my request for SSS UMID replacement.

IN WITNESS WHEREOF, I hereunto set my hand on this _____ day of , 20_______, in
the City of ____________.

_________________________

(PRINTED NAME AND SIGNATURE)
Affiant

SUBSCRIBED AND SWORN to before me on this this _ day of 20__, in the City
of _________.

Doc. No.___________
Page No. __________

Notary Public _________
Book No. ________
Series of Year _______

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