MEMBERSHIP WITHDRAWAL FORM

Date:

To: The Board of Directors

I Delima Sheryl De Gracia, (Regular/Associate) am withdrawing my (Share Capital & Savings) from the
Cooperative.
Last Name Name Middle (₱___________________) (₱___________________)
APPLICANT'S INFORMATION

Personal Contact Number: 09996769718

Company/Govt. ID Number: P4574726C
Email Address: sheryldelima84@gmail.com
Home Address: Baugo II, Capt. Claudio, Toledo City
Position:
Company/Business:N/A
Reason/s For Withdrawal: Deposit to: Metrobank
No longer Employed
Name of Bank: Metrobank
Capital for Business Acct. Name: Sheryl Delima
Financial Reason Acct. No: 7193848832929
Other reason

SHERYL D. DELIMA

MEMBERSHIP INFORMATION DATA - FOR MAGCOOP USE ONLY

Share Capital as of application: Savings as of application:

Share Capital to be withdrawn: Savings to be withdrawn:

Remaining Share Capital after Remaining savings after

deduction: deduction:

OUTSTANDING LOAN BALANCE

Loan Balance:

Share:

Savings:
Application for Withdrawal Received and Processed Loan
by: Balance,
Computation
Verified By:
s & Journal
Other Information Verified By:
Entries
Checked By:

Loan & Investment Evaluator Loan and Investment Supervisor Collection Accounting Department
Department
RECOMMENDING APPROVAL: APPROVED BY:

OR

Operations Manager Administrative Manager General Board Member

Manager
REMARKS:

Full withdrawal/ termination of membership will result to the immediate cessation of any and all benefits given to a full fledged member, and no refund or any claim relating to membership shall be
entertained thereafter.

REQUIREMENTS FOR WITHDRAWAL OF SHARE CAPITAL / SAVINGS

Photocopy of COMPANY and GOVERNMENT VALID ID (front and back portion)
Latest deposit slip of your personal account (validated by the
machine) Depositor's copy of TIME DEPOSIT
CERTIFICATE