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ER3 Employer Data Amendment Form

PhilHealth amendment form for employer data

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An employer requesting for data amendment which was previously presented to the Corporation, must fill-out this
form in duplicate copies together with the following supporting documents whichever is applicable:
1.

CHANGE OF BUSINESS NAME
a.
b.
c.
d.

2.

CORRECTION OF BUSINESS NAME
a.
b.
c.

3.

b.

Single Proprietorship to Corporation
Article of Incorporation duly received by SEC; and
Approved application for Business Retirement as Single Proprietor
Partnership to Corporation
Article of Incorporation duly received by SEC; and
Deed of Dissolution of Partnership approved by SEC

TEMPORARY SUSPENSION OF OPERATION
a.

b.
c.
d.
5.

Single Proprietorship
Certificate of Registration of Business Name from Department of Trade and Industry (DTI)
Partnership and Corporation
Certificate of Registration from Securities and Exchange Commission (SEC); or
Articles of Partnership/incorporation duly received by SEC
Cooperative
Certificate of Registration from Cooperative Development Authority (CDA); and
Articles of Cooperation duly received by CDA

CHANGE OF LEGAL PERSONALITY
a.

4.

Single Proprietorship
Certificate of Registration of Business Name from Department of Trade and Industry (DTI)
Partnership
Amended Articles of Partnership duly received by Securities and Exchange Commission (SEC)
Corporation
Amended Article of Incorporation duly received by Securities and Exchange Commission (SEC)
Cooperative
Amended Article of Cooperation duly received by Cooperative Development Authority (CDA)

Bankruptcy
Financial Statement or
Income Tax Return (ITR) for the year showing non-operation/no earnings or
Board Resolution
Separation of employee/s
Report on the Separation of the last employee/s and
Separation paper of last employee
Fire / Demolition / Flood
Certification from the Fire Department of the municipality, or
Certification from City Hall
Strike
Notice of Strike duly license by DOLE

Termination / dissolution
a.
b.

c.

d.

For single proprietorship
Approved Application of Business Retirement by the Municipal Treasurer's Office.
Certification of Non-Operational of Business from the Municipal Treasurer’s Office / BIR
For Partnership or Corporation
Deed of Dissolution approved by the Securities and Exchange Commission (SEC) or
Certification of Non-Operational of Business from SEC/BIR or
Minutes of Meeting certified by the Corporate Secretary.
Cooperative
Dissolution of Cooperative duly received by Cooperative Development Authority (CDA) or
Minutes of the meeting duly certified by the Secretary; or
Certification of Non-Operational of Business from CDA/BIR
Death of Owner
Death Certificate

6.

MERGER / CONSOLIDATION
Deed of Merger/Merger Agreement duly certified by SEC
Memorandum of Agreement filed with SEC.

7.

CHANGE OF OWNERSHIP
a.
b.

8.
Note:

Sale

Deed of Sale/Transfer/Assignment signed by both parties, or
In its absence, Certification from the Registry of Deeds, if applicable
Death of Managing Owner (family business)
Death Certificate of the managing owner and waiver from the other legal heirs

RESUMPTION OF OPERATION
Notice of Resumption of Operation from the employer, and
List of Employees

The registrant may submit a photocopy of any of the above-mentioned documents but the original or
Certified True Copy (CTC) of the document should be presented to PhilHealth for cross checking.
 
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