a. SOCSO Form 21
b. SOCSO Form 10
c. SOCSO Form PKS (F) 1 Pin 1/91
d. Original Police Report
e. Original Medical Certificate
f. Photocopy of identity Card
g. Photocopy of Duty Roster/Punch Card
h. Photocopy of Salary Statement
i. Photocopy of SOCSO Monthly Contribution Report
j. Map of Place Accident Occurred
a. SOCSO Form 10
b. SOCSO Form PKS (P) 6 Pin 1/91
c. SOCSO Form PKS (F) 1 Pin 1/91
d. Original Medical Report
e. Photocopy of Police Report
f. A written application to SOCSO Local Office for
reference to the Medical Board
4. Fatal Case
a. SOCSO Form 21
b. SOCSO Form PKS (F) 1 Pin 1/91
c. SOCSO Form PKS (F) 43 Pin 1/91
d. Photocopy of Identity Card
e. Photocopy of Duty Roster/Punch Card
f. Map of Place Accident Occurred
g. Original Police report
h. Approval Letter for funeral
i. Original Death Certificate
j. Photocopies of Beneficiaries IC/Birth Certificate
k. Photocopy of Medical Report (if relevant)
l. Original Funeral receipt
m. Photocopy of Salary Statement
n. Photocopy of SOCSO Monthly Contribution Report
When the deceased employee does not leave any spouse or child, the following
additional documents are required.
a. SOCSO Form 24
b. SOCSO Form 26
c. SOCSO Form PKS (F) 43 Pin 1/91
d. Photocopy of Appointment Letter
e. Photocopy of Salary Statement
f. Death Certificate
g. Marriage Certificate (if relevant)
h. Photocopy of Widow Identity Card (if relevant)
i. Photocopy of All Children Identity Card/Birth Certificate (if relevant)
j.