Form No.

A-MATB-06-10

APPLICATION FOR MATURITY BENEFITS

_________________ (Date) THE PRESIDENT & GENERAL MANAGER Government Service Insurance System Financial Center, Roxas Blvd., Pasay City 1308 Sir: I have the honor to apply for maturity benefits provided for under my Certificate of Membership (CM) No. _______________ , which I am submitting together with this application. It is understood that the balances of all loan accounts-in-default, arrearages in other loans, balances of loans granted by virtue of my CM and other indebtedness with the GSIS that have fallen due shall be deducted from the proceeds of this claim. Upon filing of this application, it is understood that I have previously secured a tentative computation of the amount of benefits I will receive, including the amounts deducted therefrom in payment of my unpaid obligations with GSIS and I fully conform to the same. __________________________________ (Signature over Printed Name of Insured) GSIS ID # ________________ Tel. # ____________________ Mailing Address: _______________________________________________________________________ _ No. Street Barangay/District Municipality/City Zip Code

Dear Sir Clem: Good afternoon po. Inform ko lang po kayo na on process pa rin po ang application ninyo for retirement benefits sa GSIS. Sir, nagattach po ako ng Application for Maturity Benefits para naman po sa plano ninyo for your signature. Ang una po kasi na pinadala ninyo ay walang signature kaya ipinabalik. Para naman po sa clearance ninyo, nagattach po ako ng sample statement na kailangan ninyo pong gayahin upang maformalize po ang turn over ng mga gamit ninyo noong umalis po kayo sa DTI-NCR. Ibinase ko po ito sa pinagusapan natin sa telepono. Pwede ninyo po syang baguhin kung meron po kayong idaragdag. Kung okay na po, pwede nyo po siya pirmahan pero paki tangal na lang po yung sample format bago ninyo po iprint. Salamat po. Marilen Diaz TIDA, MSSD