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    Template 2 - Spouse Dependency

    Uploaded by

    Jerome Formalejo
    Petitioner is seeking a declaration of dependency on the deceased Social Security System member for support and resumption of surviving spouse pension benefits. The petition provides details of the petitioner and deceased member, including their marriage and the member's death. It indicates the petitioner previously filed a claim with SSS, which was denied, and requests the court declare petitioner's entitlement as the dependent legitimate spouse. The petition is supported by documents establishing the marriage and member's death.

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    Template 2 - Spouse Dependency

    Uploaded by

    Jerome Formalejo
    70 views5 pages
    Petitioner is seeking a declaration of dependency on the deceased Social Security System member for support and resumption of surviving spouse pension benefits. The petition provides details of the petitioner and deceased member, including their marriage and the member's death. It indicates the petitioner previously filed a claim with SSS, which was denied, and requests the court declare petitioner's entitlement as the dependent legitimate spouse. The petition is supported by documents establishing the marriage and member's death.

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    Petitioner is seeking a declaration of dependency on the deceased Social Security System member for support and resumption of surviving spouse pension benefits. The petition provides details of the petitioner and deceased member, including their marriage and the member's death. It indicates the petitioner previously filed a claim with SSS, which was denied, and requests the court declare petitioner's entitlement as the dependent legitimate spouse. The petition is supported by documents establishing the marriage and member's death.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    70 views5 pages

    Template 2 - Spouse Dependency

    Uploaded by

    Jerome Formalejo
    Petitioner is seeking a declaration of dependency on the deceased Social Security System member for support and resumption of surviving spouse pension benefits. The petition provides details of the petitioner and deceased member, including their marriage and the member's death. It indicates the petitioner previously filed a claim with SSS, which was denied, and requests the court declare petitioner's entitlement as the dependent legitimate spouse. The petition is supported by documents establishing the marriage and member's death.

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    © All Rights Reserved
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    Template 2.

    Petition for Declaration of Spouse’s Dependency for Support Upon


    Deceased Member or Petition for Resumption of the Surviving
    Spouse’s Pension Benefit

    Republic of the Philippines


    SOCIAL SECURITY COMMISSION
    Makati City

    ___________________________,
    Petitioner,

    - versus - SSC CASE NO. _________

    SOCIAL SECURITY SYSTEM,


    Respondent.
    x--------------------------------x

    PETITION
    COMES NOW Petitioner (full name of petitioner), by counsel, and unto this
    Honorable Court, most respectfully states that:

    1. PERSONAL CIRCUMSTANCES OF THE PARTIES:

    1.1. PETITIONER

    Name of Petitioner __________________________________________________


    Sex ____ Age ____ Civil Status _________

    Petitioner’s home address


    City ______________________________________________________________
    ______________________________________________ Zip Code ___________

    Province, if applicable_______________________________________________
    ______________________________________________ Zip Code ___________

    Telephone No. ____________________ Cellphone No. _________________

    Place of Work _____________________________________________________

    Telephone No. ____________________ Cellphone No. _________________

    If petitioner is assisted by counsel or law student pursuant to the


    requirements under this Commission’s Revised Rules of Procedure

    Petitioner’s Counsel or assisting law student


    Name ____________________________________________________________

    Firm Name/Law school clinical legal education program


    _________________________________________________________________

    Mailing Address ____________________________________________________


    __________________________________________________________________
    Page 2 of 5

    Email Address ________________________________________


    Tel/Cel/Fax Nos. _____________________________________
    PTR No. _________________ Date/Place of Issue________________
    Roll No. _________________
    IBP No. _________________ Lifetime
    Date/Chapter _________________
    MCLE Compliance No. ______________
    Exemption _________________

    Other Compliances ________________________________________

    1.2. RESPONDENT

    Respondent Social Security System is a corporate body created by law pursuant to


    RA 1161, as amended, with principal office located on East Avenue, Diliman,
    Quezon City, Metro Manila

    2. STATEMENT OF FACTS AND OTHER CAUSE/S OF ACTION

    2.1. Petitioner is the legitimate surviving spouse of deceased SS member


    (name of deceased member) with SS No. _____________________, entitled to
    the SS death benefit under Section 12-B (d)1 or Section 132 of the Social Security
    Act of 1997 both in relation to 8 (e) (1) and (k)3 thereof. Further, in accordance
    with Art. 68 and 195 (1) of the Family Code4, petitioner is considered as
    dependent upon deceased member for support.

    Evidencing the fact of petitioner’s marriage with deceased member are the
    following:

    Marriage Contract (Annex “__”)


    Petitioner’s Advisory on Marriages issued by the Philippine Statistics
    Authority (PSA) (Annex “__”)
    Member’s Advisory on Marriages issued by the PSA (Annex “__”

    1
    SEC. 12-B. Retirement Benefits. – (d) Upon the death of the retired member, his primary beneficiaries as
    of the date of his retirement shall be entitled to receive the monthly pension: xxx
    2
    SEC. 13. Death Benefits. – Upon the death of a member who paid at least thirty-six (36) monthly
    contributions prior to the semester of his death, his primary beneficiaries shall be entitled to the monthly
    pension: Provided, That if he has no primary beneficiaries, his secondary beneficiaries shall be entitled to a
    lump sum benefit equivalent to thirty-six (36) times the monthly pension. If he has not paid the required
    thirty-six (36) monthly contributions, his primary or secondary beneficiaries shall be entitled to a lump sum
    benefit equivalent to the monthly pension times the number of monthly contributions paid to the SSS or
    twelve (12) times the monthly pension, whichever is higher (Social Security Act of 1997)
    3
    SEC. 8. Terms Defined. – For the purpose of this Act, the following terms shall, unless the context
    indicates otherwise, have the following meanings:
    xxx
    (e) Dependents – The dependents shall be the following:
    “(1) The legal spouse entitled by law to receive support from the member;
    xxx
    (k) Beneficiaries – The dependent spouse until he or she remarries, the dependent legitimate,
    legitimated or legally adopted, and illegitimate children, who shall be the primary beneficiaries of
    the member: xxx

    4
    Art. 68. The husband and wife are obliged to live together, observe mutual love, respect and fidelity, and
    render mutual help and support.

    Art. 195. Subject to the provisions of the succeeding articles, the following are obliged to support each
    other to the whole extent set forth in the preceding articles:
    (1) Spouses; xxx (Family Code of the Philippines)
    Page 3 of 5

    Others, specify_______________________________________________
    ____________________________________________________________
    ____________________________________________________________
    ____________________________________________________________

    2.2. SSS member (name of deceased member) died on (date of death), as


    shown in the attached:

    Death Certificate (Annex “__”)


    Court Order on the Declaration of Presumptive Death, if member
    is presumed dead (Annex “__”)
    Others, specify _______________________________________________
    ____________________________________________________________
    ____________________________________________________________
    ____________________________________________________________

    2.3.1. Did you file a death claim on account of member’s death or a


    reconsideration of the revocation/suspension of monthly pension with the SSS?

    Yes No

    2.3.2. If NO, why did you file a case with this Commission without first filing a
    claim with the SSS? (State reason/s below)
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________

    2.3.3. If YES, what is the action taken by the SSS? (Please attach letter of
    denial/revocation/suspension of pension)

    granted
    denied
    still pending

    on the ground/s of:

    remarriage of petitioner when member was still alive or after the


    member’s death
    Cohabitation of petitioner with another man/woman when member was
    still alive or after the member’s death
    Petitioner’s alleged abandonment of the member
    Petitioner’s alleged attempt on member’s life
    Being separated from the member since (date of separation)
    Others, specify _______________________________________________
    ____________________________________________________________
    ____________________________________________________________
    ____________________________________________________________

    2.3.4. What is the SSS’ written action in denying your claim for member’s death
    benefit or your reconsideration of the revocation/suspension of monthly pension?

    denial by the SSS President


    denial by the Manager or Officer-in-Charge or authorized personnel of the
    SSS Department/Branch/Representative Office concerned
    Certification from the Benefit Appeals Review Committee
    Page 4 of 5

    2.3.5. Is there truth on the ground of the SSS in the denial of your claim or
    revocation/suspension of your monthly pension?

    YES, but I am still entitled to member’s death benefit as his/her dependent


    legitimate spouse based on the following: (State reason/s with attached
    documents to prove the same)
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________

    NO, as shown in the following attached documents, I remained the


    dependent legitimate spouse of deceased member during his/her lifetime and even
    after his/her death because I did not:

    remarry another during the lifetime of member, as shown in the

    Advisory on Marriage issued by the PSA


    others, specify ___________________________________
    _______________________________________________
    _______________________________________________

    cohabit with another man/woman when member was alive and


    until the present, as supported by the

    Affidavit of Disinterested Persons of no cohabitation


    others, specify ___________________________________
    ________________________________________________
    ________________________________________________

    abandon the member, as supported by the

    Affidavit of Disinterested Persons of no abandonment


    others, specify ___________________________________
    ________________________________________________
    ________________________________________________

    attempt on member’s life, as supported by the

    Affidavit of Disinterested Persons of no attempt on


    member’s life
    others, specify ___________________________________
    ________________________________________________
    ________________________________________________

    separate with member during his/her lifetime, as supported by the

    Affidavit of Disinterested Persons of no separation


    others, specify ___________________________________
    _______________________________________________
    _______________________________________________

    Others, specify and attach documentary evidence to support the


    same _________________________________________________
    ______________________________________________________
    ______________________________________________________
    Page 5 of 5

    2. REMEDY OR RELIEF SOUGHT

    WHEREFORE, petitioner respectfully prays that judgment be issued declaring


    petitioner (state name of petitioner) to be deceased member (state deceased member’s
    name)’s dependent legitimate surviving spouse and primary beneficiary, entitled to the
    survivor’s pension benefit provided under the Social Security Law, as amended, and
    directing respondent SSS to:

    resume the survivor’s pension benefit from the time it was


    revoked/suspended on (state date of revocation/suspension)

    immediately pay the petitioner the survivor’s pension benefit accruing


    from the death of SSS member (state name of deceased member)

    Petitioner prays for such other reliefs as may be just and equitable in the premises.

    (place signed), Philippines, (date signed).

    (Name of petitioner and his/her signature or name/s and signature/s of his/her counsel
    or the assisting law student and his/her supervising attorney)

    VERIFICATION AND CERTIFICATION


    AGAINST FORUM SHOPPING

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