Beijing Social Insurance Personal Rights and Profits Record (Insurers’ Payment Information)Special Seal for Personal Rights and Profits Record of xxx Social Insurance Fund Management Center (Seal, 1100000076348)Insurer’s name:Verification code:Social security No.:Checking S/N:Unit name:Checking date:Unit’s change record for endowment insurance:Unit NamePayment FromPayment ToActual Payment MonthsDetails of five insurances:Payment from toActual payment for endowment insuranceActual payment for medical insuranceActual payment for unemployment insuranceActual payment for work-related injury insuranceActual payment for maternity insuranceMonthsAnnual payment basePersonal paymentMonthsAnnual payment basePersonal paymentMonthsAnnual payment basePersonal paymentMonthsAnnual payment baseMonthsAnnual payment basePage 1 of 2Beijing Social Insurance Personal Rights and Profits Record (Insurers’ Payment Information)Special Seal for Personal Rights and Profits Record of xxx Social Insurance Fund Management Center (Seal, 1100000076348)Insurer’s name:Verification code:Social security No.:Checking S/N:Unit name:Checking date:Payment from toActual payment for endowment insuranceActual payment for medical insuranceActual payment for unemployment insuranceActual payment for work-related injury insuranceActual payment for maternity insuranceMonthsAnnual payment basePersonal paymentMonthsAnnual payment basePersonal paymentMonthsAnnual payment basePersonal paymentMonthsAnnual payment baseMonthsAnnual payment baseSupplementary materials:The insurer’s total payment years of the endowment insurance in our city is fifteen years and three months (in which: the actual payment years before is year and month) and the total payment years of the medical insurance is.The total amount of principal and interests in the insurer’s personal account of endowment insurance in our city is RMB Yuan until the end of.Remarks: 1. In case you need to verify the information, please log in http://www.bjrbj.gov.cn/csibiz/ within 30 days after , enter “I need to verify the personal rights and profits record” and input the checking code and S / N to verify. Black seal has the same effect as red seal. 2. Please properly keep your personal rights and profits record for information safety.3. The above “payment from to” bar with a “*” indicates that there is supplementary payment in the year.xxx Social Insurance Fund Management Center Date: Page 2 of 2
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