July 12, 2019

PAG-IBIG Fund – Tagbilaran City Branch

Galleria Luisa, Gallares Street
Tagbilaran City, Bohol

Dear Sir/Madam:

Greetings!

I am writing to you concerning my Application for Condonation relative to my unpaid

contributions and the penalties related thereto.

I am the owner and proprietor of Crystal J Waters, which was closed down by me sometime in
January 2019 due to financial constraints. Sometime in May 2019, I received a letter from you good office,
concerning my non-paid contributions during the operating life of Crystal J Waters. Despite my diligent
efforts to locate FORM R-5, to determine the employees registered and the contributions paid for a
specific time period, I am unable to find it within the bulk of my files. That being said, I would like to settle
and pay any unpaid contributions that have been determined by your good office, in the hope that you
would waive all the penalties and surcharges related to the same.

Hoping for your kind consideration.

Thank you and more power!

Very truly yours,

Juvy S. Lim