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Get PH Member's / Claimant's Photo and Signature Card

(Surname) (Given Name) (M.I) . SS NUMBER . . NAME OF CLAIMANT (Surname) (Given Name) (M.I) SS NUMBER (If any) . . . . . . . . TYPE OF CLAIM : DEATH DISABILITY . SIGNATURE OF MEMBER/CLAIMANT . . . RETIREMENT (If member/claimant cannot sign, fingerprints should be witnessed by two persons) .. WITNESSES TO FINGERPRINTS . . . . . . . . . . . . . . . . . . . . Photo 1X1 DATE Please affix signature over printed name and indicate date 1 _____________________________ _____________ 2 .

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  1. Click the Get Form option to start modifying.
  2. Activate the Wizard mode on the top toolbar to get extra tips.
  3. Complete each fillable area.
  4. Ensure that the information you add to the PH Member's / Claimant's Photo and Signature Card is updated and correct.
  5. Add the date to the form using the Date feature.
  6. Click on the Sign icon and make a signature. You can find three available options; typing, drawing, or uploading one.
  7. Check each area has been filled in properly.
  8. Select Done in the top right corne to export the file. There are several options for getting the doc. As an instant download, an attachment in an email or through the mail as a hard copy.

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