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SSS Form E-417 A AFFIDAVIT OF SEPARATION FROM EMPLOYMENT/SELF-EMPLOYMENT I Filipino married/single/separated/divorced of legal age and residing at after having been sworn to in accordance with the law hereby depose and state 1. 3. That I cannot secure a certification of separation from my last employer in the Philippines because. That my declared business for self-employment attached certification from Barangay in dated. 5. That I have stopped practicing my profession as effective 6. That I am executing this Affidavit to attest to the truth of the foregoing facts and to support my application for retirement benefit. That I am a bonafide member of the Philippine Social Security System with SSS number 2. That I was separated from my last employer with address at again re-employed in the Philippines and ceased employment whatsoever in the United Kingdom effective. 3. That I cannot secure a certification of separation from my last employer in the Philippines because. That my declared business for self-employment attached certification from Barangay in dated. 5. That I have stopped practicing my profession as effective 6. That I am executing this Affidavit to attest to the truth of the foregoing facts and to support my application for retirement benefit. FURTHER AFFIANT SAYETH NAUGHT. Affiant ATTESTED/PROCESSED BY SSS Representative London IDs Presented SSS No* Freedom Pass Passport No* Issued at on and valid until. That I am a bonafide member of the Philippine Social Security System with SSS number 2. That I was separated from my last employer with address at again re-employed in the Philippines and ceased employment whatsoever in the United Kingdom effective. 3. That I cannot secure a certification of separation from my last employer in the Philippines because. 3. That I cannot secure a certification of separation from my last employer in the Philippines because. That my declared business for self-employment attached certification from Barangay in dated. 5. That I have stopped practicing my profession as effective 6. That my declared business for self-employment attached certification from Barangay in dated. 5. That I have stopped practicing my profession as effective 6. That I am executing this Affidavit to attest to the truth of the foregoing facts and to support my application for retirement benefit. That I am executing this Affidavit to attest to the truth of the foregoing facts and to support my application for retirement benefit. FURTHER AFFIANT SAYETH NAUGHT. Affiant ATTESTED/PROCESSED BY SSS Representative London IDs Presented SSS No* Freedom Pass Passport No* Issued at on and valid until. That I am a bonafide member of the Philippine Social Security System with SSS number 2. That I was separated from my last employer with address at again re-employed in the Philippines and ceased employment whatsoever in the United Kingdom effective. 3. That I cannot secure a certification of separation from my last employer in the Philippines because. That my declared business for self-employment attached certification from Barangay in dated. 5. That I have stopped practicing my profession as effective 6.