HQP-TMF-191

(V03, 07/2018)

PAYMENT INSTRUCTION FORM (PIF)

SAN FERNANDO
______________________________
Pag-IBIG Servicing Branch

Employer ID Number : 209361190004

Payment Instruction Date : September 07, 2021
7212 50E7 AE50
Payment Instruction Number

EMPLOYER/BUSINESS NAME : DON DON TEI FAST FOOD

ADDRESS AND CONTACT DETAILS

Unit/Room No., Floor Building Name Lot No., Block No. AREA CODE TELEPHONE NUMBER
GF STALL 7 SM CITY CLARK Business (Direct Line)
Phase No. House No. Street Name
M A ROXAS ST Business (Trunk Line) Local
Subdivision Barangay Municipality
Cell Phone
MALABANIAS ANGELES CITY
09985404872
Province Region Zip Code
Business Email Address
PAMPANGA REGION 3 (CENTRAL LUZON) 2009 ddtsmckpif2013@gmail.com

PERIOD COVERED
TYPE OF PAYMENT AMOUNT DUE CLIENT PRINT VALIDATION
From To
MEMBER SAVINGS 08 - 2021 08 - 2021 1,000.00

TOTAL AMOUNT 1,000.00

Prepared by: Date:

______________________________ 09/07/2021
____________
MELVINSON
Name and MARIMLA VISDA
Designation
COMPANY REPRESENTATIVE

REMINDERS:
09/07/2021
1. This form is valid from ______________ 10/06/2021
to ______________. If payment to be made is beyond the reflected validity period, this form will not be accepted
by any accredited collecting partner/s.
2. Please remit MS/pay loan obligation on or before the due date to avoid incurring penalties.

Employer ID Number 209361190004

PIN: 721250E7AE50 Total Amount Due Php 1,000.00

TO BE FILLED OUT BY THE PAYOR
DON DON TEI FAST FOOD
Cash Payment
GF STALL 7, SM CITY CLARK, M A ROXAS ST, MALABANIAS,
Check Payment
ANGELES CITY, PAMPANGA, 2009
Check No.
Bank/Branch