FPF400

REQUEST FOR TRANSFER OF MEMBER'S RECORDS

AND LOAN DETAILS (RTMRLD)

_____________________
Date
Dear Sir/Madam:
I would like to request transfer of my membership records and loan details to the _________________ with
the following information:
Name of member:
Last Name First Name Name Extensions (Jr., Sr., II, etc.) Middle Name (Maiden)

Civil Status:
Single
Legally Separated

Married
Annulled

Widow/er
Home Address:

Telephone No.:

Present Company/Employer:

Company/Employer Address:

Telephone No.: Company ID No.:

Purpose of Transfer:
Claims
Consolidation

STL o Intra-branch (within the branch )

Others, pls. Specify__________ o Inter-branch (among branches)

Check if with:

Housing Loan
STL
Takeout date : __________________ DV/Check Date : __________________
Loan Status : __________________ Loan Status : __________________
Outstanding Balance : __________________ Outstanding Balance : __________________

Name of Previous Company/Employer Company/Employer Address/Contact No. Inclusive Date(s)

1.

2.

3.

4.

Requesting Pag-IBIG Fund Branch: ______________________________

Requested by:
Processed by:

___________________________________ Noted by:

Member's Signature Over Printed Name

Revised 08/2008