The Dependent Declaration Form is a crucial document used in Indonesian employment contexts to establish and maintain accurate records of employees' dependents for various benefit programs and compliance purposes. This form is typically required at the time of employment, during annual benefits enrollment periods, or when an employee experiences qualifying life events that affect their dependent status. The document ensures compliance with Indonesian regulations, including Law No. 13 of 2003 on Manpower and related social security legislation, while facilitating proper administration of benefits and tax obligations. It contains detailed information about eligible dependents, supporting documentation requirements, and necessary certifications to validate the declared information.
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1. Employee Information: Basic details of the employee including full name, employee ID, department, date of hire, and current position
2. Declaration Purpose: Statement specifying the purpose of the declaration (e.g., healthcare benefits, tax purposes, insurance coverage)
3. Dependent Details: Comprehensive information about each dependent including full name, relationship to employee, date of birth, national ID number, and current address
4. Eligibility Confirmation: Declarations confirming that listed dependents meet the criteria for dependency status under Indonesian law
5. Supporting Documentation: List of required documents that must be attached to verify the dependent status (e.g., marriage certificate, birth certificates)
6. Employee Certification: Employee's declaration of truth and accuracy of the provided information, including acknowledgment of legal consequences for false declarations
7. Employer Acknowledgment: Section for employer's receipt and processing of the declaration
1. Previous Declaration Reference: Reference to any previous dependent declarations, used when updating existing records
2. Special Circumstances: Section for declaring any special circumstances affecting dependency status (e.g., disability, full-time student status over 21)
3. Benefit Selection: Used when the form needs to specify which benefits are being requested for each dependent
4. Foreign Dependent Information: Additional information required for dependents who are not Indonesian citizens
5. Emergency Contact Details: Optional section for emergency contact information for each dependent
1. Schedule A - Document Checklist: Detailed list of required supporting documents for different types of dependents
2. Schedule B - Dependent Eligibility Criteria: Comprehensive list of criteria that define eligible dependents under various benefit programs
3. Appendix 1 - Change Log: Form for recording any changes to dependent information over time
4. Appendix 2 - Additional Dependent Information: Supplementary form for cases where there are more dependents than can fit on the main form
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