HQP-TMF-191

(V03, 07/2018)

PAYMENT INSTRUCTION FORM (PIF)

TARLAC
______________________________
Pag-IBIG Servicing Branch

Employer ID Number : 208505130000

Payment Instruction Date : November 21, 2020
7203 26EE B5BE
Payment Instruction Number

EMPLOYER/BUSINESS NAME : PALLADIUM MEMORIAL GARDEN INC

ADDRESS AND CONTACT DETAILS

Unit/Room No., Floor Building Name Lot No., Block No. AREA CODE TELEPHONE NUMBER
Business (Direct Line)
Phase No. House No. Street Name
Business (Trunk Line) Local
Subdivision Barangay Municipality
Cell Phone
MALACAMPA CAMILING
09187569284
Province Region Zip Code
Business Email Address
TARLAC REGION 3 (CENTRAL LUZON) 2306 palladium05memorial@yahoo.com

PERIOD COVERED
TYPE OF PAYMENT AMOUNT DUE CLIENT PRINT VALIDATION
From To
MEMBER SAVINGS 10 - 2020 10 - 2020 600.00

TOTAL AMOUNT 600.00

Prepared by: Date:

______________________________ 11/21/2020
____________
MARIA
NameELENA
andESTEBAN BADILLO
Designation
OFFICE MANAGER

REMINDERS:
11/21/2020
1. This form is valid from ______________ 12/20/2020
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 208505130000

PIN: 720326EEB5BE Total Amount Due Php 600.00

TO BE FILLED OUT BY THE PAYOR
PALLADIUM MEMORIAL GARDEN INC
Cash Payment
MALACAMPA, CAMILING, TARLAC, 2306
Check Payment
Check No.
Bank/Branch