Loyalty Card Application Form Pag Ibig – Fill Out and Use This PDF

INSTRUCTIONS

1.	Accomplish this form in one (1) copy.	5.	Accomplish only the “PRESENT HOME ADDRESS” if it is different from the
2.	Present at least one (1) valid ID acceptable to the Pag-IBIG Fund.		“PERMANENT HOME ADDRESS”
3.	Type or print all entries in BLOCK or CAPITAL LETTERS.	6.	On “CONTACT DETAILS” portion, indicate at least one (1) contact number.
4.	The “NAME EXTENSION” shall refer to JR., II, III and the like	7.	All fields which are marked with asterisk (*) are mandatory

*MEMBERSHIP CATEGORY

MANDATORY					VOLUNTARY
 EMPLOYED PRIVATE			 SELF-EMPLOYED (SE)		 EMPLOYED FOREIGN GOVERNMENT				 MEMBER OF COOPERATIVE/
 EMPLOYED GOVERNMENT  PROFESSIONAL/BUSINESS OWNER					 BARANGAY OFFICIAL/EMPLOYEE				TRADE UNION
 OVERSEAS FILIPINO			 JOB ORDER PERSONNEL		 NON-WORKING SPOUSE		 OVERSEAS FILIPINO IMMIGRANT
WORKER (OFW)			 OTHER EARNING GROUPS (OEGs)		 MEMBER OF RELIGIOUS GROUP		 OTHERS, Please specify
					 PENSIONER/INVESTOR/LESSOR		_________________________
				MEMBER’S PERSONAL DETAILS
*LAST NAME	*FIRST NAME			*NAME EXT. (e.g., Jr., II)	*MIDDLE NAME	*MAIDEN NAME (For married women)

*NAME OF SPOUSE (if married) (Last Name, First Name, Name Ext., Middle Name)

COMMON REFERENCE NUMBER (CRN/UMID)

- - -

ADDRESS AND CONTACT DETAILS

		PRESENT EMPLOYMENT DETAILS (if with more than (1) employer, use separate sheet and follow format below)
	*EMPLOYER/BUSINESS NAME					Monthly Income Range
						Less than P5,000
						P5,000 to less than P15,000
	*EMPLOYER/BUSINESS ADDRESS					P15,000 to less than P25,000
	Unit/Room No., Floor		Building Name	Lot No., Block No., Phase No. House No.		P25,000 to less than P35,000
						P35,000 to less than P50,00
						P50,000 or more
	Street Name		Subdivision	Barangay		*OCCUPATION
	Municipality/City		Province	*State/Country (if abroad)	ZIP Code	*NATURE OF WORK/ BUSINESS/ SOURCE OF
						FUNDS
	*EMPLOYMENT STATUS					
	Permanent/Regular	Casual		Contractual	Project-Based
						Part-Time/Temporary

*PREVIOUS EMPLOYMENT FROM DATE OF PAG-IBIG FUND MEMBERSHIP (Use another sheet if necessary)

EMPLOYER/BUSINESS NAME

1

EMPLOYER/BUSINESS ADDRESS

FROM

TO

m m d d

y y y y

m m d d y y y y

EMPLOYER/BUSINESS NAME

2

EMPLOYER/BUSINESS ADDRESS

FROM

TO

THIS FORM MAY BE REPRODUCED. NOT FOR SALE

			HQP-PFF-108
			(V06, 08/2020)
		*OTHER INFORMATION
	STATUS OF HOME OWNERSHIP		FUTURE PLANS ON HOME OWNERSHIP
			
	Owned		Purchase a Residential Unit through Personal
	Renting
			Fund
	Living with Parents/Relatives
			Avail of a Loan for Purchase of Residential Unit
	Mortgaged
	Pag-IBIG Fund		or Construction of House
	Banks and Other Financial Institution		Renovate the current house through availment of
	If mortgaged with Bank or other Financial Institution, are you interested to transfer your		loan
			Continue to rent
	Loan to Pag-IBIG Fund?
	_____Yes _____No		Continue to live with parents/relatives
	DESIRED LOAN AMOUNT (IF INTERESTED WITH	HOW MUCH CAN YOU AFFORD IN TERMS OF	EDUCATIONAL ATTAINMENT
	PAG-IBIG FUND FINANCING)	MONTHLY PAYMENT FOR HOUSING LOAN?
	Less than P750,000	Less than P5,000 per month	Elementary
			High School
	P750,000 up to P1,700,000
		P5,000 to less than P10,000 per month
			College/Bachelor’s Degree
	Above P1,700,000 up to P3,000,000
		P10,000 to less than P15,000 per month	Master's/Doctoral Degree
	Above P3,000,000 up to P6,000,000
		P15,000 and above per month	Vocational
	NO. OF CHILDREN/DEPENDENTS	NO. OF VEHICLES OWNED	ESTABLISHMENT YOU WISH TO BE A Pag-IBIG
	STILL STUDYING		LOYALTY CARD PARTNER

AGREEMENT

I hereby certify that the information given and all statements made herein are true and correct. I agree that the information I have provided may be used or shared with third parties conducting surveys, marketing activities or promotional offers of Pag-IBIG Fund and its partners. Any promotional offer of Pag-IBIG Fund may be emailed to me at the provided email address. Any telephone calls I make to Pag-IBIG Fund may be monitored and recorded for the purpose of providing quality customer service. In case of falsification, misrepresentation or any similar acts committed by the applicant Pag-IBIG Fund shall automatically suspend the benefits that can be secured through this card indefinitely.

I hereby agree to abide with the terms and conditions of this card program, including the terms and conditions of the card and the privacy policy of the accredited Partner-Bank. In the event that I do not abide with the terms and conditions of this program, the Pag-IBIG Fund has the right to deny me of any benefit under this card program.

I hereby authorize the Pag-IBIG Fund, its agents and representatives, upon application for any benefit relating to or under this card program, to conduct investigation deemed appropriate to ascertain my credit standing and financial capability in evaluating availment of such benefit; including but not limited to, request consumer reporting or reference agencies for consumer reports of my credit history and to disclose, submit, share or exchange any of my account information and reports to consumer reporting or reference agencies, government regulatory agencies, other banks, merchant partners or third party. The Credit information may also be transferred to service providers such as TransUnion (TU), Bankers Association of the Philippines – Credit Bureau, Credit Information Corporation, etc. Likewise, I hereby authorize the Fund, to disclose, submit or share my account information to the accredited Partner-Bank for the purpose of account opening and other bank transactions and in compliance with the Know-Your-Client requirements of the Bangko Sentral ng Pilipinas (BSP) and R.A. No. 10173 (Data Privacy Act of 2012). I agree to advise the Partner-Bank in writing of any change in the above information.

I hereby agree to the disclosures to be made by Pag-IBIG Fund in connection with this Agreement, provided the same are not contrary to law and public policy.

SIGNATURE OF MEMBER

DATE

NOTE:

1.If you do not wish to receive emails containing promotional offers or find any incorrect information, you may send an email at contactus@pagibigfund.gov.ph or call Tel. (02) 8724-4244.

2.Your Pag-IBIG Loyalty Card Plus is not a government-issued I.D., but may be used in all Pag-IBIG Fund transactions.

3.If your mode of payment is through Deduction from Loan Proceeds, no cash payment shall be collected.

THIS PORTION IS FOR PAG-IBIG FUND LOYALTY CARD ENROLLMENT KIOSK ONLY

RECEIPT OF APPLICATION

MODE OF PAYMENT	APPLICATION THRU		TYPE OF ID PRESENTED
CASH  DEDUCTION FROM LOAN	INDIVIDUAL	EMPLOYER
PROCEEDS
RECEIVED BY	DATE		REMARKS




LIST OF VALID IDS ACCEPTABLE TO THE PAG-IBIG FUND/BANKS