You are on page 1of 1

HQP-SLF-108

(V02, 10/2017)
TRANSMITTAL SLIP
(Accomplish in two (2) copies)

Employer Name : _____________________________ Pag-IBIG Employer ID No. : ____________________


Employer Address : _____________________________ Date Filed : ____________________

FOR Pag-IBIG FUND USE ONLY


NAME OF EMPLOYEE
(Last Name, First Name, Middle Initial) Application Number Remarks

No. of Applications per page: ________


Total No. of Applications: ________

Endorsed by: Received by: Date/Time Received:

_______________________________ __________________________ __________________________


(Employer’s Fund Coordinator/
Authorized Representative)

You might also like