Philippine Government Forms All in One Location
Request for GSIS Retirement Certification (For Availment of PhilHealth Benefits)
GSIS request form for GSIS retirement certificate
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: GOVEftNMENT SERV.ICE:.INS,-,RAN«;E SYSTEM
Ng Mga Nagli/ing/(od sI! Pamaha/aan
GSIS RETIREMENT CERTIFICA'l"E
. l am requesting for a retirement
availing. of Philllealth benefits.'
from the OSIS for the purpose
Below are necessary information on the retiree:
1. Full Name of Retiree
2. Retirement No.
3. Date of Retirement
4. Retire under RNPD-
5. Present Address
6. Former Employer
and Office Address
7. Date of Birth
8.' Retiree's Present Age
9. No. ofyrs. in service
certificate is issued to it GSIS retiree / legal spouse for the purpose 'of
availing PhilHealth benefits pursuant to PD#408 dated ~1arch~, 1974...However,
the retiree should be at least 60 years old upon hospitalization.