PAG-IBIG File W

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Employer's Name:

Address:

Zip Code:

Employer Type : G - Government

Pag-IBIG ID Employee ID Lastname First Name Middle Name

PAG-IBIG File Writer

Contact Number:

BR Code:

SSS/GSIS/Pag-IBIG ID:

Type of Payment: MC – Members contribution

Birth Date
Employee Contribution Employer Contribution TIN (YYYYMMDD) (