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  • Withdrawal Form

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    Jerico D. Campos
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    This document outlines the general requirements and process for submitting a withdrawal claim to the Philippine Public School Teacher Association retirement benefits program. It lists the necessary documents which include a certificate of membership, withdrawal letter, valid ID copies, and recent payslips. It also requests information on how and where to send the withdrawal check proceeds and includes spaces for the applicant's signature and contact details.

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    PPSTA Withdrawl form

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    This document outlines the general requirements and process for submitting a withdrawal claim to the Philippine Public School Teacher Association retirement benefits program. It lists the necessary documents which include a certificate of membership, withdrawal letter, valid ID copies, and recent payslips. It also requests information on how and where to send the withdrawal check proceeds and includes spaces for the applicant's signature and contact details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    66 views1 page

    Withdrawal Form

    Uploaded by

    Jerico D. Campos
    This document outlines the general requirements and process for submitting a withdrawal claim to the Philippine Public School Teacher Association retirement benefits program. It lists the necessary documents which include a certificate of membership, withdrawal letter, valid ID copies, and recent payslips. It also requests information on how and where to send the withdrawal check proceeds and includes spaces for the applicant's signature and contact details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PHILIPPINE PUBLIC SCHOOL TEACHER ASSOCIATION

    245 Banawe St., Quezon City


    Retirement Claims Department
    Website: www.ppsta.net; Email: support@ppsta.com
    Tel Nos.: (02) 988-14-19 / (02) 988-14-20 local: 303 to 307
    Mobile Nos: 0906-2538260/0917-5714986

    Sir / Madam:

    I have the honor to submit herewith a claim application for benefit under the New Mutual Retirement
    Benefit System (NMRBS), Mutual Retirement Benefit System (MRBS), and Mutual Retirement Benefit System
    Plus (MRBS Plus). The following information is hereby furnished for the Withdrawal Benefit of the
    ___________________________________

    A. General Requirements - Withdrawal claim:

    Certificate of Membership:

    NMRBS Policy MRBS Policy MRBS Plus Policy

    In case of loss, Affidavit of Loss (re: PPSTA Certificate)

    Withdrawal Letter with Signature

    Clear photocopy of two Valid ID’s with signature and contact number (back and front)

    Latest Payslip
    For Active Members
    Latest Pay slip showing last deduction and succeeding pay slip with no
    deduction (for NMRBS and MRBS Plus only)

    Remarks:

    Mail my check to: Sub-office Home Address OR coming on schedule date _________

    Upon receipt of the proceeds of the said benefit, I shall release and forever discharge the
    Association, its assigns and successors-in-interest from any similar claims whatsoever arising from my
    membership with the Association.

    2 Specimen Signatures
    ___________________ ________________________________
    Signed Over Printed Name
    ___________________ (Member)

    ______________________________
    Address:

    _______________________________
    Contact Number:

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