EIS Form 7 - Employment Insurance System Application

This is a mandatory form that must be completed to apply for all benefits under EIS

H. Insured Person Declaration

Name* (as per MyKad)

NRIC No.*

H1.

I acknowledge that the information and details given are correct to the best of my knowledge and understanding.*

H2.

I declare that I am able to work, available to work and actively seeking for work.
(please ignore H2 if still working with another employer, continue to confirm H3)

H3.

I declare that I am currently working with another employer.
(Please ignore H3 if not working with any employer, continue to confirm H5)

H4.

I acknowledge that I have returned to work with an employer after this job loss occurred.
(Please ignore H4 if not working with any employer, continue to confirm H5)

H5.

I also note that all of the above information, if found to be untrue or false, may result in SOCSO suspending the benefits I am eligible to receive. I shall also be liable to repay the benefits which I have received from SOCSO.*

H6.

SOCSO reserves the right to take legal action if the information presented is incorrect or false*

I. Required Documents

Document Name	Category	Upload Date	File Name	Action
Copy of Identity Card	Mandatory
Letter of Termination from Employer / Applicant	Mandatory
Copy of Salary Slips (6 months from LOE)	Mandatory
Copy of Bank Account	Mandatory