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  • OP FORMnew 6 1

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    Jerry Estremera
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    This document is an overpayment form from the Public Safety Mutual Benefit Fund, Inc. for members to request a refund for any overpayment or deduction from their approved salary or policy loan for a specified month or months. It requests the member's contact information, home address, email, printed name and rank, amount of overpayment, and signature. It also lists requirements to include a photocopy of PNP ID and specifies modes of release including insta credit, mailing, or deposit with a request for deposit section.

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    OP-FORMnew-6-1

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    This document is an overpayment form from the Public Safety Mutual Benefit Fund, Inc. for members to request a refund for any overpayment or deduction from their approved salary or policy loan for a specified month or months. It requests the member's contact information, home address, email, printed name and rank, amount of overpayment, and signature. It also lists requirements to include a photocopy of PNP ID and specifies modes of release including insta credit, mailing, or deposit with a request for deposit section.

    Copyright:

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

    OP FORMnew 6 1

    Uploaded by

    Jerry Estremera
    This document is an overpayment form from the Public Safety Mutual Benefit Fund, Inc. for members to request a refund for any overpayment or deduction from their approved salary or policy loan for a specified month or months. It requests the member's contact information, home address, email, printed name and rank, amount of overpayment, and signature. It also lists requirements to include a photocopy of PNP ID and specifies modes of release including insta credit, mailing, or deposit with a request for deposit section.

    Copyright:

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

    PUBLIC SAFETY MUTUAL BENEFIT FUND, INC.

    No. 318-320 Boni Serrano Ave., cor 1st and 2nd West Streets, San Juan City
    Tel. No. 721-8091; 726-1675 Telefax No. 727-9725

    DATE: __________________________
    CONTACT NUMBER: ______________________________________________

    HOME ADDRESS: _________________________________________________

    E-MAIL ADDRESS: _________________________________________________

    OVERPAYMENT FORM
    TO : THE MANAGER
    PSMBFI-AMD

    FROM : ___________________________________________________
    Please print name and rank

    Dear Sir/Madame:

    This is to request for refund regarding overpayment/deduction/s incurred in the payment of my


    approved salary/policy loan for the month/s___________________________________ amounting to
    Php______________________________.

    Thank you for your assistance regarding this matter.

    Respectfully yours,

    _______________________________
    Member’s Signature

    REQUIREMENTS:
     Photocopy of PNP ID back to back with 3 specimen signature

    MODE OF RELEASE: INSTA CREDIT MAILING REO ____ DEPOSIT

    REQUEST FOR DEPOSIT

    ___________
    I would like to request to deposit my overpayment to my Account with account
    number ____________________________________. Attached herewith the photocopy of said account
    for your perusal.
    _____________________________
    Member’s Signature

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