Government Service Insurance System(GSIS)

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Date: Nov. 8, 2021, 3:11 p.m.

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Date: 2021-11-08 15:34:42.000000

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COVID 19 CLAIM APPLICATIOON FORM

Published by Government Service Insurance System(GSIS) on Nov. 8, 2021.
Requested from GSIS by E. Rodriguez at 03:11 PM on Nov. 8, 2021.
Purpose: COVID 19 ASSISTANCE
Date of Coverage: 05/05/2021 - 05/25/2021
Tracking no: #GSIS-267688116260

I.DANAO Nov. 8, 2021, 3:11 p.m.

i WOULD LIKE TO REQUEST FOR THE COVID 10 APPLICATION CLIAM BENEFIT FORM

A.OCAMPO Nov. 8, 2021, 3:34 p.m.

Relative to your query, kindly find attached list of basic requirements for EC Covid related case for government employees. You may file for Employees Compensation claim by complying the documentary requirements. Claim may be submitted thru drop box at nearest GSIS Office. Thank you. CLAIM FORM: https://www.gsis.gov.ph/downloads/forms/2021/20210914-ECC-IBCP-HCPI-III.pdf?csrt=6382085736058238282

Attachments:

FOI EC Compensation COVID Checklist GSIS.pdf - Anna Ocampo - [email protected]

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