HQP-HLF-063

HQP-HLF-063
MEMBERSHIP STATUS
VERIFICATION SLIP
Date Filed: __________

MEMBERSHIP STATUS
VERIFICATION SLIP

MSVS No. ___________ Date Filed: __________

MSVS No. ___________

Name of Developer (For Developers account)

Tel. No.

Name of Developer (For Developers account)

Tel. No.

Last Name

Middle Name

Last Name

Middle Name

First Name

Name Ext.

Sex

Maiden Name (For married women)

Pag-IBIG MID No.

First Name

Name Ext.

Sex

Maiden Name (For married women)

Male
Female
Marital Status

Date of Birth

Single/
Married
Widow/er
Unmarried
Company/Employer/Business Name

Legally
Separated

Pag-IBIG MID No.

Male
Female
Annulled

Company/Employer/Business Address

Marital Status

Date of Birth

Single/
Married
Widow/er
Unmarried
Company/Employer/Business Name

Tel. No.

Legally
Separated

Annulled

Company/Employer/Business Address

Tel. No.

For AFP
Employee

Branch of Service

Serial/Account No.

For AFP
Employee

Branch of Service

Serial/Account No.

For DECS
Employee

Division Code

Station Code

For DECS
Employee

Division Code

Station Code

Employee No.

EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP

NAME OF EMPLOYER/ADDRESS

FROM (Mo./Yr.)

TO (Mo./Yr.)

Members
Signature

EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP

NAME OF EMPLOYER/ADDRESS

TO (Mo./Yr.)

FOR SERVICING DEPARTMENT / HOUSING LOANS DIVISION /

Pag-IBIG INTERNATIONAL OPERATIONS GROUP

HOUSING VERIFICATION
Without With
HOUSING
LOAN

HOUSING VERIFICATION

TOD

Loan Value

HL Status

_____________

_______________

_____________________

Verified by:

Date:

Without With

TOD

HOUSING
LOAN

_____________

Verified by:

LATEST CONTRIBUTION RECORD

PFR No./Date
Amount
Without

With

CLAIMS
MPL

DV Date

Loan Value /
Amount
_____________ ________________
_____________ ________________

Loan Entitlement

Verified by:

Certified by:

Date

HL Status

_______________

_____________________

PROVIDENT VERIFICATION
Total No. of
Contributions
Claim Type /
Last Applicable Month
_____________________
_____________________
Date

Year/Month

LATEST CONTRIBUTION RECORD

PFR No./Date
Amount
Without With

CLAIMS
MPL

DV Date

Loan Value /
Amount
_____________ ________________
_____________ ________________

Loan Entitlement

Verified by:

Certified by:

Date

MSVS APPROVAL

Approved

Loan Value

Date:

PROVIDENT VERIFICATION

Total No. of
Contributions
Claim Type /
Last Applicable Month
_____________________
_____________________
Date

MSVS APPROVAL

Disapproved

Remarks

Approved

Disapproved

Remarks

FOR RE-VALIDATION OF MSVS

FOR RE-VALIDATION OF MSVS

HOUSING VERIFICATION
Without With

TOD

HOUSING
LOAN

_____________

Verified by:

Loan Value
_______________

HOUSING VERIFICATION
HL Status
_____________________

Date:

Without With
HOUSING
LOAN

LATEST CONTRIBUTION RECORD

PFR No./Date
Amount
Without

CLAIMS
MPL

With

DV Date

Loan Value /
Amount
_____________ ________________
_____________ ________________

Loan Entitlement

Verified by:

Certified by:

Date

TOD

Loan Value

HL Status

_____________

_______________

_____________________

Verified by:

Date:

PROVIDENT VERIFICATION
Year/Month

FROM (Mo./Yr.)

Members
Signature

FOR SERVICING DEPARTMENT / HOUSING LOANS DIVISION /

Pag-IBIG INTERNATIONAL OPERATIONS GROUP

Year/Month

Employee No.

PROVIDENT VERIFICATION
Total No. of
Contributions
Claim Type /
Last Applicable Month
_____________________
_____________________
Date

Year/Month

LATEST CONTRIBUTION RECORD

PFR No./Date
Amount
Without With

CLAIMS
MPL

DV Date

Loan Value /
Amount
_____________ ________________
_____________ ________________

Loan Entitlement

Verified by:

Certified by:

Date

MSVS APPROVAL

Approved

Total No. of
Contributions
Claim Type /
Last Applicable Month
_____________________
_____________________
Date

MSVS APPROVAL

Disapproved

Remarks

Approved

Disapproved

Remarks

(August 2012)

(August 2012)