Application Form # ________

Series of 2021

UNITED FILIPINO SENIOR CITIZEN GLOBAL ASSOCIATION, INC.

#113 Jasmin Street, Luzviminda Village, Barangay Maa, Davao City, Philippines 8000
Contact Information: +63 916 398 6744; E-mail Address: daisykabs4@gmail.com

MORTUARY FUND REGISTRATION

1. Name / Pangalan: _________________________________________________________________
(Surname/Apelyido), (First Name/Pangalan) (Middle Name/Gitnang Pangalan)
2. Birthdate / Petsa ng Kapanganakan: (MM/DD/YYYY) ______________________________________
3. Gender/Kasarian: ( ) Male ( ) Female Others/Iba pa, paki-sulat: _________________
4. Present Address/Kasalukuyang Tirahan: (House #, Street, Barangay, City/Town/Province)
________________________________________________________________________________
5. Home Address (Philippines)/Tirahan sa Pilipinas: (House #, Street, Barangay, City/Town/Province)
_________________________________________________________________________________
6. Contact Information/Impormasyon upang makontak:

 Mobile Numbers: _____________________________________

 Email Address: _____________________________________
 Facebook Account: _____________________________________
 Others: _____________________________________
7. Names of beneficiaries/claimants in order of priority: (3 names)
(Mga pangalan ng benebisyaryo or tatangap ng pondo ayon sa prayoridad.)

a. __________________________________; ___________________________________________
(full name/kabuoang pangalan); (relationship to fundholder/relasyon sa may-ari ng pondo)

b. __________________________________________ ;
___________________________________
(full name/kabuoang pangalan); (relationship to fundholder/relasyon sa may-ari ng pondo)

c. __________________________________________ ;
___________________________________
(full name/kabuoang pangalan); (relationship to fundholder/relasyon sa may-ari ng pondo)

_____________________________________
Signed over printed name of applicant
(Pirmahan sa ibabaw ng nakasulat na pangalan)
------------------------------------------------------------------------------------------------------------------------------------------
8. Action/s taken on this application
This application has been reviewed and endorsed by:

Name: ____________________________________________ Chapter Country: ________________________

( ) Approved (Advise applicant to pay the membership fee, to wit:

Official Receipt Number ______________ Amount Paid & Date ___________________
( ) If disapproved, cite reasons and advise applicant of its application status.
REMARKS (Approving Officer):

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Approving Officials:

Satellite Office: Bergstrasse 10 8174 Stadel, Switzerland

Contact Information: (044) 858 1022; E-mail Address: rafreider@sunrise.ch Page 1 of 3
 Application Form # ________
Series of 2021

UNITED FILIPINO SENIOR CITIZEN GLOBAL ASSOCIATION, INC.

#113 Jasmin Street, Luzviminda Village, Barangay Maa, Davao City, Philippines 8000
Contact Information: +63 916 398 6744; E-mail Address: daisykabs4@gmail.com

________________________________________________ Date:_________________________
Name of Approving Official & Signature

Satellite Office: Bergstrasse 10 8174 Stadel, Switzerland

Contact Information: (044) 858 1022; E-mail Address: rafreider@sunrise.ch Page 2 of 3
 Application Form # ________
Series of 2021

UNITED FILIPINO SENIOR CITIZEN GLOBAL ASSOCIATION, INC.

#113 Jasmin Street, Luzviminda Village, Barangay Maa, Davao City, Philippines 8000
Contact Information: +63 916 398 6744; E-mail Address: daisykabs4@gmail.com

GUIDELINES FOR UFSCIGA MEMBERS

MORTUARY FUND PROGRAM
2021
Paliwanag at objectives ng programa:

Ang Mortuary Fund Program (MFP) ng UFSCIGA ay tugon sa mga pangangailangan ng

mga miembro sa panahon ng di inaasahang pagpanaw ng isang miembro. Ito ay simpleng
paraan ng pagiipon para sa paghahanda sa anumang pangangailangan tulad ng pinasyal na
ayuda na makukuha sa pamamagitan nitong programa. Maaring di sapat, subalit layunin
nitong makatulong bilang FORCED SAVINGS mula sa ambag ng bawat miembrong
magbibigay halaga sa kapakanan ng miembro at pamilya sa panahon ng ganitong uri ng
pagkakataon.

Ang bawat pondo’ng malikom mula sa MONTHLY CONTRIBUTIONS para MFP ay ilalagay
sa bank account ng UFSCIGA at maari lamang gamitin para sa partikular na pangangailangan
na ito. Para sa karagdagang guideline, basahin ang sumusunod:

1. Membership to the Mortuary Fund shall be mandatory to all UFSCIGA members.

2. Each member shall enroll with initial deposit of 500.00 upon registration.
3. Each member should at least contribute a minimum of 100 peso equivalent each month
as forced savings.
4. In case of death, all members shall automatically contribute P100 pesos equivalent for
each death, which will be taken from the mortuary fund contribution of the members.
5. Any member’s remaining contribution at the time of his/her demise may be claimed an
authorized representative.
6. The Mortuary Fund contribution may only be claimed by the named/designated
beneficiary upon application or enrollment and shall bring with him/her an
authenticated Death Certificate to be able to claim mortuary fund benefits from
UFSCIGA.
7. Members should regularly contribute for the Mortuary Fund deposits so as not to
exhaust it and to facilitate prompt releases of the Death Benefit.
8. The Mortuary Fund benefit shall be subject to 1% Administrative cost upon release to
its beneficiary.
9. The Mortuary Fund shall be deposited in a dedicated bank account.
10. Any member, at the time of his/her death, if found to have zero balance (despite
repeated reminder to replenish MFP contribution), the beneficiary will not be able to
avail or claim the regular MF Benefit program. However, the Committee on Social
Welfare shall initiate an act of “voluntary contribution” among members of the
Association and shall give whatever amount is raised as a kind of assistance to the
bereaved family.
11. Finally, it is the responsibility of each member to check the balance of his/her Mortuary
fund deposit.

Satellite Office: Bergstrasse 10 8174 Stadel, Switzerland

Contact Information: (044) 858 1022; E-mail Address: rafreider@sunrise.ch Page 3 of 3