12 Place of Birth - indicate the City/Municipality/ Province/Country where the registrant was born. Specify only the country if born outside the Philippines.
13Sex - check the appropriate box.
14Height - indicate height in centimeters (cm). Conversion: 1 foot = 30.48 cm
1 inch = 2.54 cm
Example: 5’3” = 160.02 cm
15Weight - indicate weight in kilograms (kg). Conversion: 1 pound (lb) = 0.4536 kilogram Example: 120 lbs = 54.43 kg
16Common Reference Number (CRN) - indicate if available.
17Marital Status - check the appropriate box.
18Citizenship - indicate your nationality.
19Prominent Distinguishing Facial Features - indicate your distinguishing features that can be found on the face such as “mole under the right eye” or “mole or birth mark on the left cheek/forehead”.
20Frequency of Membership Savings (MS) Payment - check appropriate box if payment of MS is not thru payroll deduction.
21Taxpayer Identification Number (TIN) - indicate your 9-digit TIN issued by the Bureau of Internal Revenue (BIR).
22SSS/GSIS Number - for private employees, indicate your 10-digit Social Security Number, and for government employees, indicate your 11-digit Business Partner Number.
23Employee Number - refers to your company ID number.
For AFP/PNP Employee, indicate Serial/Badge No.
For DepEd Employee, aside from Employee Number, indicate Division Code-Station Code
24Permanent Home Address - indicate the address of your permanent residence.
25Present Home Address - indicate the address where you currently reside, and the state/country only if present address is outside the Philippines.
26Preferred Mailing Address - check the appropriate box to indicate your chosen address to receive mail.
27Contact Numbers - indicate the country and area code only if outside Metro Manila or based abroad.
28Occupation - indicate your job, profession, or type of work to earn a living.
For Other Working Group (OWG)/Informal Sector, select from the following:
-Public Utility Transport Driver
-Market Vendor
-Farmer
-Fisher Folk
-Others (Other workers in the informal sector)
29Employment Status - check the appropriate box.
30Employer/Business Name - indicate complete Employer/Business Name appearing in the registration certificate or employment contract (applicable for Formally Employed, OFW and Self-employed Professional/Business Owner).
31Employer/Business Address - indicate complete Employer/Business Address appearing in the registration certificate or employment contract (applicable for Formally Employed, OFW and Self- employed Professional/Business Owner).
32Type of Work - check the appropriate box (applicable for OFW only).
33Monthly Income - indicate your income or earning per month.
34Office Assignment - check the appropriate box to indicate whether assigned to Head Office or a particular Branch.
35Date Employed - indicate inclusive date of employment under current employer.
36Previous Employment From Date of Pag-IBIG Membership - indicate details of your previous employment.
37Heirs - indicate your legal heir/s in accordance with the Laws of Succession, as provided in the New Civil Code of the Philippines, as amended.
38Certification - affix your signature and indicate the date when the MDF was accomplished.
39Acknowledgement - to be accomplished by Pag-IBIG Fund.