Update February 10, 2016:

If you're separated from employment and your former employer refuses to issue you certificates, you can now use this SSS-created affidavit form AFFIDAVIT OF UNDERTAKING to complete your requirements for your SSS maternity benefit claim.

Gamitin na yong bagong form ng SSS na Affidavit of Undertaking; huwag na itong sample ko below.  :)

Here's a sample Affidavit of Non-Advancement of SSS Maternity Benefit

Before you obtain this affidavit, ask first your SSS branch if you can submit an Affidavit of Separation from Employment and an Affidavit of Non-Advancement of Maternity Benefit.
Usually, these affidavits are accepted if your company closed down. SSS will verify if indeed your company closed down.


I, __________, of legal age, single (or married), Filipino, with SSS No. _______ and presently residing at __________________, after having been sworn to in accordance with law hereby depose and state:

1.  That I was separated from my last employer, ________, with address at _________ on __________ .

2.  That my last employer ________ did not advance any SSS maternity benefit to me, and that I did not receive any advance SSS maternity benefit from this employer.

3.  That I cannot secure a Certificate of Non-advancement of Maternity Benefit, Certificate of Separation from Employment, and L501 form from my last employer because ________________________.

4.  That I am executing this affidavit to attest to the truth of the foregoing facts and to support my claim for my SSS maternity benefit.


SUBSCRIBED AND SWORN TO BEFORE ME this _____________ day of _____ 20___ in _____City, Philippines, affiant having exhibited to me his/her Residence Certificate No. ___________________ _______________ issued in _________________________ on ________

                                                                Notary Public
                                                                Until December 31, ___
                                                                PTR No. _______
                                                                Issued at _______
                                                                Issued on _______

DOC NO. ____________ 
PAGE NO. ____________
BOOK NO. ____________
SERIES OF ____________