GSIS’s PROGRAM FOR RESTRUCTURING AND REPAYMENT OF DEBTS (GSIS-PRRD) 411212018-RLA Form PRRD-REV 0 (Application form) GSIS sys appuication SHALL NOT BE PROCESSED UNLESS COMPLETELY FILLED OUT. WRITE “N/A” IF THE INFORMATION BEING ASKED IS NOT APPLICABLE. WARNING: Director indrect commission of fraud, colusion falsticaton, misrepresentation of facts, or any other kind of anomaly in the| ‘accomplishment ofthis fom, or in obtaining any beneft under his application, shall be subject to administrative andlor cminal action. [BP No. of Borrower CRN (FUMID caraholder [OLD 1D No. if eCard Plus cardholden Name of BarronerIGSIs Monte: Date of ith LastName FirstName Middle Name [wim Do Ty TyTvT¥ Nar of Legal HeriSuccession in interest Date of Birth LastName FirstName Middle Name [ww Lo }o [vy Tv T¥ Residential Address Zip Code (Office Address Zip Code [Celiphone No. E-mail Address (available) Landline No, (favailabley [Name of Last Employer (Government) of Borrower/GSIS Member [Employer Address [zip Code MODE OF AVAILMENT UNDER GSIS PRRD: FULL PAYMENT INSTALLMENT / RESTRUCTURING. INDERTAKING 1. | certify that the information provided in this form are true and correct. 2. | unconditionally agree to the TERMS AND CONDITIONS of the GSIS’s PROGRAM FOR RESTRUCTURING AND REPAYMENT OF DEBTS (GSIS-PRRD) printed at the back of this application form, 3. Incase that it is proven that | have given false information or misrepresentation in this document or in any other documents submitted in connection with my application for GSIS-PRRD, | undertake to pay the outstanding balance including condoned penalty. Name and Signature of Borrower / Legal Heir/ Date Signed Successor-in-Interest FOR GSIS USE ONLY Received by / Date: ‘TMS Reference No. Dale Created ‘THIS APPLICATION IS NOT FOR SALE AND MAY BE REPRODUCED.TERMS AND CONDITIONS Condonstion of Penalties. Under this program, all_unpaid panaltslsurchargs tat have accrued on the oustanding balanoes of he Sige oan accounts shal be condoned Settlement of Account. The outstanding obligation, no of condoned Panaltestourchargs, may be sete by the borrower in ul (100%) orn Pall wth a minum patal payment of ten parent (10%). The remaining Balance shal be vosrusred subject tothe tome an oontone in ths program. Computation of Outstanding Balance under the Condonation Program. Tho emount of eustandng balance under tho condonaten program sal be computed a foiows: HORI ona neo seers The aan suar hese Shas prea acne sme somes ee ant Restructuring Option: | ursnaing obigaten os of Sas of Avamnene —| — v0 ‘Less: Unpaid accrues Penates" ate Oat of SOO ‘Separionup to Date o avanant. “ ‘Remaining OBAL afer Condonation BO, ‘Ad. havanee Reserpion rewance(Rl)Premium| YC ‘Remaining OBAL ae for Setiement WEIR ‘Less Pafal Payee Advane=R 20200000 lrest Rate. The remaining Outstanding Balance (OBAL) for resting. shall be abject to an ilereat rate of 0% per sneum ‘ompoundod analy Term of Payment. Tho rstuctuod obligation shall be payable over a maximum period of vee (3) year Regular Monthly Payment. ‘The Reguar Monthy Payment (RMP) shall bo computed as ows: Me aren ny A Pramiam Table of Annuity Factors ‘Lean Term “Annuity Factor years 11 2 yea 1 p97 ZIT Syeos bar 30 Loan Redemption Insurance. A loan redemption insuranes (LR cover ‘Sha be attached the festutised loan computed based onthe Mery FI Rate provided beiow and the oustanding talance fo be amortized oan Term Monthly Rate {per P,000 of Loan Armount) Tear ope 752 2 yeas to pay 268 Yeas © pay a ‘The premium fr LR shal frm part ofthe computed monty amorizaon of the resid loan. In eaee of desth of the borrower vain the payment pera, the oustanding balance of the restuctured lan shall be {overed by th LA provided tna loa ono mn aul. Due Date ofthe Monthly Amortization of the Restrctured Amount. ‘Tho tte date (FDO) ofthe recived loan shal Bo on tho mon fotoning the granting ofthe ecructred lan, and every end ofthe oth thereae unl he oan fly pai. ‘Grace Period In the Payment of Amortization. There shall be 2 10: ‘donde’ day grace period rom the date when to ropaymont fas de. No ponaly of surcharge willbe Imposed on repayment made during ths Petiod To isa, repayment due on November 30,2098 shat have [rac pore tp to December 10, 2018. Payment made afer December 4, 20%8 shall incur penalty. When the paymont due date fais on \weatend er hada. the payrnent may be made onthe net working day ‘thou pealy or surcharge Payment Mechanism. The allowing mode of payment shal be svalable forthe RIP, ate opin of the boro 8. Over The Counter / Dect Paymont (OP) in Cash, andor B.-Baymento be sited to a penaion deduston, fase ofa ‘Seeuosana ou earns Wicd acne aeeeree pee od under RA 6281, ora tho age of 60 under RA 8231 or PO'1146. mn accordance wih exaing palioes on penscn «© Dedotn fem sunivership pension. in case he outstanding ‘obigaton vil bo. sated. by the loge spouse receiing Sure pension ram the GSI. For ful or partal payment of the outstanding obligation, the acceptable node of pajment shal be Cachor Manager's Check. 111. Penalty for Artearages. An accounts considered in areas a here Spayient for meni instalment But such payment is deayed: (2) he ‘Seta! amen pas othe rent es han he amu forthe sams font: oF (thee 6 ne payment made forthe month It shal lncur ponay atte vale-of 1% por mann, compounded month, unl the [Sroar are paid rscton of months conatered one (1) marth 12. Application of Payments. Every payment shal be inly spied tothe “sneunt ue, folowing his order of penny, (a) A promi, (2) Penalty ‘Sy {0) ineret and (8) Principal. i arr, te "move. potcy sha Be adopted whove ta payments aa fat applod othe earls! unpaid toni inl he mont Ml amaunt due has ben ly pl 10, Defaut. A restuctred loan account is considered in defaut when the ‘ola unpald eblgaton 2. aquvalrt to more. than six (6) monthly ‘Snortzaions. Inthe event of default, the oustanding balance of the ‘ested loan becomes die snd domandsble host need of coma {rfuer notice. In cabs o fala to pay the custanding Dance declared Sh dota, the oulstaning balance shall be charged wih penalty of 126 inert per anrum compounded month (p.a.cm) and aaatona penalty foe pcm, fom the date ot deta unt he dato cf tal payer. tt ‘ase no ler fire Bonet is scoring on the pat ofthe borer, the ‘ppropraie legal acon shal be apped. the torower is ened to ‘ure bene rem GSIS (eg. separation beret stage 0), the bent ‘hal est be applied as payment fo the oustanding balance of the ‘efauted ban, and te remaining balance shal be subject of elastin 14, PrecTermination. The restuctred lan may be pro teminatod by paying the oustanding balance before tho and of tho loan tm. No fos thal be ‘charged tothe boroner in ase of pre teminaton. 15, Refund of Overpayment after End of Loan Tetm. tthe er of he an {arm, any overpayment shal be Vested in accordance wih the poiies tho olind of ean overpayment. 16. No Renewal, The GSIS-PRRD is 2 cne-ime ofr ofthe GSIS and fe not 17, Attomey's Fees, Should the GSIS be compelled to refer the loan o any potion thereat oan Allomey at Law for tection x to sore any ight Fereunderagsinet tho borower or aval of any remedy under th aw this Agreement the borowsr shal pay an aroun equivalent to 25% of ‘smeuns clslanding and unpaid ae and fr aloneys fees and gation 18. Venue. Any legal ston, suitor proceeding arising cut or elaing otis [gfocmenk, sal bo brought or inetd he appropriate courte in the (Cy of Pasay or such oer venue ate exclusive open of GSI, Inthe ‘vent the borower inate any legal acon arising ftom ot under this [Rgreement, for whalaver casos, the borrower agrees to inte such ‘Seton oly inthe Cy where the pnp offen of GSS sates. 10, Notices. Al notees required under tis Agrement fort enforcement ‘shallbe sen tothe Resisontal Adstess inated inthe Personal Data porton of his ioan application. The netces sen tothe sald address shal eval and shal serve ao sufeent noes tothe boower forall aga inion and purposes, | confim that | have resd_and fly undestood the GSIS's PROGRAM FOR [RESTRUCTURING AND REPAYMENT OF DEBTS (GSIS-PRRD) Tors and CConions and ardeiake to comply em, | carlin my undrsaing of the Pivacy Pokey ofthe GSIS pusuant 0 the raqutements of Republe Ac (A) No. 10173, arse known as the Daa Privacy ‘ck and consent othe mame of callin use, aces, scsi ad process) (ny personal ane senstve personal dla bythe SIS Final, pursuant to RA, No. 9510, thenwse known asthe ‘Cec frat System ‘Act ae ts inplemerting Res and Regains (RR). hereby acknowledge and fnsert to: 1) the regu submission and asclswe of my base cet daa and ‘dae thereon tothe Cred xomation Capraton (IC) and 2 the sharing of my (ise ret data th lnders authored y the CIC, and cred reporing agencies and sourced ents cy acceded bythe CI, suet to fe proviso of RA. No, 2810. 1 ae eer rv ows ard regulations ‘WENBERIBORROWER (Signature over Printed Name) DATE SIGNED TWN.