Hqp Pff 162 Form Pag Ibig – Fill Out and Use This PDF

HQP-PFF-162

APPLICATION FOR PENALTY DISCOUNT

ON PROVIDENT OBLIGATION

(For Delinquent/Unregistered Employer)

EMPLOYER/BUSINESS NAME

Pag-IBIG EMPLOYER ID No./

REGISTRATION TRACKING NUMBER

EMPLOYER/BUSINESS ADDRESS

DATE FILED

DATE OF REGISTRATION WITH CONCERNED AGENCIES (SEC/DTI/CDA)

START OF BUSINESS OPERATION

m m

d d

y y

y y

REASON FOR FAILURE TO REGISTER COVERED EMPLOYEES AND/OR REMIT THE REQUIRED

TELEPHONE NUMBER

MEMBERSHIP SAVINGS

WITH PREVIOUS AVAILMENT OF

PENALTY CONDONATION

YES

NO

APPLICATION AGREEMENT

I hereby certify that I have read and understood the contents hereof, including the guidelines and instructions indicated at the back portion of this form. I further certify that all information I have indicated herein are true and correct to the best of my knowledge and belief, and that my signature appearing herein is genuine and authentic.

In case of falsification, misrepresentation or any similar acts committed by me, Pag-IBIG Fund shall automatically disapprove/cancel my application. I shall abide with all the applicable rules and regulations governing the penalty discount and payment scheme that the Fund shall promulgate from time to time.

In case of non-compliance to the guidelines governing this program, I understand that we shall continue to incur penalties on unremitted Membership Savings and shall be held criminally liable and prosecuted in accordance with the penal provisions of R.A. 9679.

______________________________________________				________________________		________________
HEAD OF OFFICE/AUTHORIZED REPRESENTATIVE				Designation/Position			Date
	(Signature over Printed Name)
		THIS PORTION IS FOR Pag-IBIG FUND USE ONLY
RECEIVED BY			REMARKS		DATE
		COMPUTATION OF TOTAL PROVIDENT OBLIGATION
	DETAILS			AMOUNT	COMPUTED BY		DATE
PERIOD COVERED (From________ To__________)
TOTAL UNREMITTED MEMBERSHIP SAVINGS			
DEPRIVED DIVIDENDS			
TOTAL ASSESSED PENALTIES (TAP)					REVIEWED BY		DATE
LESS:
INITIAL PAYMENT			
(PFR No. ____________ PFR Date ___________)
TAP DISCOUNT					APPROVED BY		DATE
TOTAL
PAYMENT SCHEME		FULL PAYMENT		INSTALLMENT No. of Months____

THIS FORM MAY BE REPRODUCED. NOT FOR SALE.

(Rev. 00, 07/2014)

GUIDELINES AND INSTRUCTIONS

A.Who May File

Any delinquent/unregistered employer who satisfies the following requirements:

1.The employer must pay in full the total unremitted membership savings, deprived dividends, and a minimum of 40% of the Total Assessed Penalties (TAP) as of payment date.

2.It must not have collected the membership savings from its employees but failed to remit the same.

3.If the employer has previously availed of a penalty condonation, it must have fully complied with the terms of said condonation.

B.How To File

The applicant shall:

1.Secure and accomplish the Application for Penalty Discount (For Delinquent/Unregistered Employer) from the concerned Pag-IBIG Branch.

2.Submit complete application and required documents to concerned Pag-IBIG Branch.

C.DISCOUNT ON TOTAL ASSESSED PENALTIES (TAP)

It shall be based on the percentage of cash payment on the TAP and shall be in accordance with the schedule provided in the table below:

% of Paid Penalty to TAP	Discount Rate on TAP
60%	40%
50% - <60%	20%
40% - <50%	10%

D.PAYMENT SCHEME FOR THE BALANCE OF TAP

The balance of the penalty (i.e., less the initial payment and the discount) shall be paid in the following manner:

1.If the balance is less than P25,000.00, by full payment within seven (7) days from the date of approval of the discount.

2.If the balance is at least P25,000.00, by installment within a maximum period of twelve (12) months from the date of approval of the discount. The first installment shall be due on the 30th day from the date of approval and the succeeding due dates every 30th day thereafter.

3.The employer shall be required to issue post-dated checks to cover the 12-month installment.

4.Should the employer fail to pay any installment as it falls due, the portion of the penalty deducted from the TAP shall be re-imposed.

CHECKLIST OF REQUIREMENTS

IMPORTANT

1.Pag-IBIG FUND RESERVES THE RIGHT TO REQUEST ADDITIONAL DOCUMENTS, IF DEEMED NECESSARY. THE PROCESSING OF PENALTY DISCOUNT SHALL COMMENCE ONLY UPON SUBMISSION OF COMPLETE DOCUMENTS.

2.IN ALL INSTANCES WHEREIN PHOTOCOPIES ARE SUBMITTED, THE ORIGINAL DOCUMENT MUST BE PRESENTED FOR AUTHENTICATION.