NAME: ____________________________________ OFFICE: _________________________________________ POSITION: ________________________

CHECKLIST OF REQUIREMENTS FOR STAFF MEMBERS

PART I
FOR PROCESSING OF APPOINTMENT PAPERS (Please submit/accomplish the following) :
1. Endorsement Letter/ List of Staff 2 copies
2. CS Form No. 33-A, Revised 2018 (Appointment Paper). *Entries should be typewritten, printed back to back 3 copies
3. DBM-CSC Form No. 1, Revised 2017 (Position Description Form) duly signed by House Member 2 copies
4. CS Form No. 212, Revised 2017 (Personal Data Sheet) with two (2) colored 4.5 cm X 3.5 cm (passport size) 2 copies
*Photos must be taken in appropriate office attire and in front of a white background.
NOTE: Information entered into the forms/documents should be consistent with the information in your birth certificate (i.e. name,
birthdate)/ Service Record (if applicable)
4.a Philippine Statistics Authority (PSA) copy of employee's birth certificate (1 original copy for 201 File and 2 photocopies for PDWG) 3 copies
4.b PSA copy of Marriage Contract for married employees (1 original for 201 File and 2 photocopies for PDWG) 3 copies
5. Duly accomplished Identification Information Sheet with two (2) colored 2 X 3 pictures 1 copy
*Photos must be taken in appropriate office attire and in front of a white background.
6. CS Form No. 4, Revised 2018 (Certificate of Assumption to Duty) duly signed by the House Member 3 copies
7. CS Form No. 32, Revised 2018 (Oath of Office) duly signed by the Appointee 3 copies
IMPORTANT: Pursuant to Sec. 19 Rule VI of the Civil Service Commission 2017 Omnibus Rules on Appointments and Other Human Resource Actions, an appointment shall be
submitted to the Commission within thirty (30) calendar days from the date of issuance.The responsible official/person who caused the delay in the submission of the
appointment may be held administratively liable for neglect of duty.
Ex. If effectivity date is 01 July 2022, the appointment paper must be submitted to the Civil Service Field Office on or before 30 July 2022.
(Please give the Human Resource Management Service (HRMS) at least ONE (1) WEEK to process the appointment papers prior to submission to the Civil Service Field Office).
PART II
FOR PROCESSING OF INITIAL SALARY:
A. FOR NEW EMPLOYEE (ORIGINAL APPOINTMENT):
Duly sworn Statement of Assets, Liabilities and Networth (HRep SALN Form 2019) duly signed by the House Member and stamped
8. 3 copies*
received by the Records Management Service (As of Date of Assumption)
*One copy for each: Human Resource Management Service, Records
Management Service and personal file
9. Certificate of Attendance with complete names of staff members and duly signed by the House Member 2 copies
10. Photocopy of appropriate validated BIR form/s (Downloadable at www.bir.gov.ph) 3 copies
Must be initially submitted in three (3) copies to the Tax Unit, Accounting Service for validation. Validated forms should be
submitted to HRMS:
a. For new employees without TIN: (Tax Unit, Accounting Service will generate the TIN from BIR online Portal)
Note: Due to the implementation of TRAIN LAW, provision for Personal and Additional Exemption are no longer applied.
- Duly accomplished Form 1902, attach a photocopy of ANY of the ff:
- Valid government-issued ID such as: GSIS, PhilHealth, Pag-ibig, postal, voter's ID, Passport, Driver's License etc.
- Philippine Statistics Authority copy of Employee's Birth Certificate
b. For new employees with TIN: (Without business or purely compensation income earner)
- If registered with Revenue District Office (RDO) at place of residence, secure validation slip from the same RDO
- If not registered, request transfer to RDO at place of residence using form 1905, duly stamped received by the previous RDO
c. For new employees with TIN: (With business or mixed income earner)
- Copy of Certificate of Registration (BIR Form 1901)
d. For Transferees from other office
- All employees with previous employer during the current year must submit a photocopy of BIR Form 2316 from previous employer in
addition to the above-mentioned forms applicable to them, (To be submitted to the Tax Unit, Accounting Service for consolidation of
income for the current taxable year.)
11. Photocopy of Landbank ATM Card and approval by House Member (if applicable). 2 copies
B. FOR REAPPOINTMENT/REEMPLOYMENT (In addition to item Nos. 1-10)
12. Service Record ( 2 original or 2 certified photocopies) 2 copies
13. Duly Approved Accountability Clearance (2 original or 2 certified photocopies) 2 copies
14. Certificate of Last Salary Received (2 original or 2 certified photocopies) 2 copies
C. FOR TRANSFEREE (In addition to item Nos. 1-13), if applicable.
15. Certificate of Last Salary and Benefits Received. (2 original or 2 certified photocopies) 2 copies
16 Certificate of Earned Leave Credits (Original and one photocopy) 2 copies
PART III
Please proceed to GSIS, PhilHealth, Pag-IBIG desks for processing of your membership.
Kindly submit two (2) copies each of the duly accomplished appropriate forms, together with the required attachments.
17. Government Service Insurance System (GSIS) 1 copy
a. GSIS Membership Information Sheet (MIS)
*MIS may be downloaded from the GSIS website, https://www.gsis.gov.ph/downloadable-forms/?csrt=9698631976014144772
18. Philippine Health Insurance Corporation (PhilHealth) 2 copies
a. For registration
1. Duly accomplished Philhealth Member's Registration Form (PMRF) (PHILHEALTH IDENTIFICATION NUMBER (PIN) IS REQUIRED)
2. Photocopy of Birth Certificate
3. Photocopy of 2 valid Identification Cards
Philhealth Identification Number (PIN) _ _ _ _ _ _ _ _ _ _ _ _
b. For updating/amendment of information on Member's Data Record (MDR)
Additional dependent (Children below 21 years old) - Duly accomplished PMRF (Pls. indicate PIN) and photocopy of Birth Certificate of children
Additional dependent (Parents who are 60 years old and above, totally dependent to the member) - Duly accomplished PMRF (pls. indicate PIN)
and photocopy of Birth Certificate of Member
Change of Civil Status and additional dependent (spouse) - Duly accomplished PMRF (pls. indicate PIN) and photocopy of Marriage Certificate
*PMRF may be downloaded from the Philhealth website, https://www.philhealth.gov.ph/downloads/
19. Pag-IBIG Home Development Mutual Fund (Pag-IBIG) 2 copies
a. For newly-hired employees WITHOUT PAG-IBIG MEMBER IDENTIFICATION (MID) NUMBER
1. Register using the link- https://www.pagibigfundservices.com/PubReg/NewReg_Page.aspx
2. Duly accomplished Pag-IBIG Membership Data Form (MDF), HQP-PFF-039,V08 (REGISTRATION TRACKING NUMBER (RTN) IS REQUIRED)
Registration Tracking Number (RTN)_ _ _ _ _ _ _ _ _ _ _ _ _
3. Photocopy of two (2) valid IDs with date of birth and signature
b. For newly-hired or reappointed employees WITH PAG-IBIG MID NO.
1. Duly accomplished Pag-IBIG Member's Change of Information Form (MCIF) (PAG-IBIG MID NO. IS REQUIRED)
Pag-IBIG Member Identification Number (MID) _ _ _ _ _ _ _ _ _ _ _ _
2. Photocopy of two (2) valid IDs with date of birth and signature
c. For updating of records of newly hired or reappointed employees with previous employer
1. Duly accomplished Pag-IBIG Member's Change of Information Form (MCIF) (PAG-IBIG MID NO. IS REQUIRED)
Pag-IBIG Member Identification Number (MID) _ _ _ _ _ _ _ _ _ _ _ _
2. Duly accomplished Request for Consolidation/Merging of Member's Record Form, HQP-PFF-093, V04
3. Photocopy of two (2) valid IDs with date of birth and signature
Note: Request for Increase/Upgrade of Pag-IBIG Membership Savings (Item d) and enrollment in the Modified Pag-IBIG II (item e) are voluntary
d. Increase/upgrade of Pag-IBIG Membership Savings of newly-hired or reappointed employees WITH PAG-IBIG MID NO.
1. Duly accomplished Request to Upgrade Membership Savings (MS), HQP-PFF-250, V02
2. Photocopy of two (2) valid IDs with date of birth and signature
e. Modified Pag-IBIG II Enrollment of newly-hired or reappointed employees WITH PAG-IBIG MID NO.
1. Duly accomplished Modified Pag-IBIG II Enrollment Form (MP2EF), HQP-PFF-226,V05
2. Photocopy of two (2) valid IDs with date of birth and signature
*Pag-IBIG forms may be downloaded from the Pag-IBIG website, https://www.pagibigfund.gov.ph/forms_provident.html
LEGEND: ü(CHECK) - SUBMITTED m(ENCIRCLED NUMBER) - NOT YET SUBMITTED X - NOT APPLICABLE
Note: Appointment Requirements except BIR forms are downloadable from www.congress.gov.ph.