Scribd Logo
Upload

Welcome to Scribd!

  • 109 views

    Annex D - Affidavit On Inability To Pay Assessed Delinquencies

    Uploaded by

    Atty Tanglao
    This affidavit details the inability of a business owner to pay delinquent social security contributions. The owner received a statement of account showing delinquencies totaling a specific amount for a given time period. The owner acknowledges their obligations but states they were unable to pay due to financial difficulties the business experienced beyond their control. The owner swears the above details are true for legal purposes.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Annex D - Affidavit On Inability To Pay Assessed Delinquencies

    Uploaded by

    Atty Tanglao
    109 views1 page
    This affidavit details the inability of a business owner to pay delinquent social security contributions. The owner received a statement of account showing delinquencies totaling a specific amount for a given time period. The owner acknowledges their obligations but states they were unable to pay due to financial difficulties the business experienced beyond their control. The owner swears the above details are true for legal purposes.

    Original Description:

    SSS

    Original Title

    Annex D - Affidavit on Inability to Pay Assessed Delinquencies

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This affidavit details the inability of a business owner to pay delinquent social security contributions. The owner received a statement of account showing delinquencies totaling a specific amount for a given time period. The owner acknowledges their obligations but states they were unable to pay due to financial difficulties the business experienced beyond their control. The owner swears the above details are true for legal purposes.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    109 views1 page

    Annex D - Affidavit On Inability To Pay Assessed Delinquencies

    Uploaded by

    Atty Tanglao
    This affidavit details the inability of a business owner to pay delinquent social security contributions. The owner received a statement of account showing delinquencies totaling a specific amount for a given time period. The owner acknowledges their obligations but states they were unable to pay due to financial difficulties the business experienced beyond their control. The owner swears the above details are true for legal purposes.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    CON-01737 (08-2022) Annex D

    Republic of the Philippines )


    City of Borongan ) S.S.
    Province of Eastern Samar )

    AFFIDAVIT ON INABILITY TO PAY THE ASSESSED


    DELINQUENCIES ON SOCIAL SECURITY CONTRIBUTIONS
    Contribution Penalty Condonation, Delinquency Management and
    Restructuring Program for Business Employers

    I, _______________________ , of legal age, single/married, Filipino, with


    office/residential and postal address at _____________(address)___________ in
    accordance with law, do hereby depose and say – THAT:

    1. I am the owner of _________(business name)________ duly registered with


    Social Security System (SSS) with Employer ID Number ______________, with
    date of coverage in __(DD Month YYYY)__ and principal place of business at
    ______________________________.

    2. On __(DD Month YYYY)__, I received a Statement of Account from the SSS for the
    delinquencies incurred by my business in the amount of _______(amount in
    words)_______ pesos (Php _________) for the period from __(MM-YYYY)__ to
    __(MM-YYYY)__. The delinquencies represent the total amount of contributions
    plus penalties.

    3. I am aware of my obligations as an Employer with the SSS on the timely


    remittance of contributions on behalf of my employee/s.

    4. I was unable to pay/settle my obligations with the SSS because of the financial
    difficulties that my business has experience during the past years because of
    _______(reason/s of financial difficulty)________ , which is beyond my control.

    5. I am executing this affidavit in order to attest the truth of the above-mentioned


    facts for all legal intents and purposes it may serve.

    AFFIANT FURTHER SAYETH NAUGHT.

    ________________________
    Affiant

    SUBSCRIBED AND SWORN to before me this ____ day of ______________, 2022, affiant
    having shown to me his/her valid government issued identification card/s
    ____________________ issued on _____________________ at ___________________,
    Philippines.

    _______________________________
    Notary Public

    Doc. No. :______________


    Page No. :______________
    Book No. :______________
    Series of :______________

    You might also like