ANNEX B

GOVERNMENT SERVICE INSURANCE SYSTEM

RESTRUCTURING PROGRAM FOR SERVICE LOANS (GSIS-RPSL)
Form No. ___________
THIS APPLICATION SHALL NOT BE PROCESSED UNLESS COMPLETELY FILLED OUT.
WRITE “N/A” IF THE INFORMATION BEING ASKED IS NOT APPLICABLE.

WARNING: Direct or indirect commission of fraud, collusion, falsification, misrepresentation of facts, or any other kind of anomaly in the accomplishment
of this form, or in obtaining any benefit under this application, shall be subject to administrative and/or criminal action.

Name of Applicant Birth Date (MM/DD/YYYY)

Last Name First Name Middle Name

Business Partner No. Mobile Phone No. Email address

Mailing/Residential Address Landline

No. Street Brgy/District Municipality/ Zip Code Area Code Number

City
Former Office/ Office Address

UNDERTAKING

1. I certify that the information provided in this form are true, correct, complete and updated. The signature
appearing above my printed name below is authentic.
2. I agree to abide by GSIS policy to submit my GSIS application for benefit claim within the prescriptive period to
forestall loss of future benefit, if any.
3. I authorize GSIS to deduct my Outstanding Balance (OBAL) from my future benefits, if any.
4. I unconditionally agree to the TERMS AND CONDITIONS of the GSIS’s RESTRUCTURING PROGRAM FOR
SERVICE LOANS (GSIS-RPSL) printed at the back of this application form.
5. I authorize:
a. GSIS to regularly submit and disclose my credit data [as defined under Republic Act (R.A.) 9510 and its
Implementing Rules and Regulations] to the Credit Information Corporation (CIC) as well as any updates
or corrections thereof; and to send us updates about my loan applications/account through SMS/text,
email, mail or other available means of communication; and
b. CIC to share my credit data with accessing entities, outsourced entities and data subjects, in
accordance with the Implementing Rules and Regulations of R.A. No. 9510.
6. I hereby further waive confidentiality rules and laws as applicable to establish correctness, validity, and
authenticity of documents that would help facilitate the processing and evaluation of my application.
7. In case that it is proven that I have given false information or misrepresentation in this document or in any other
documents submitted in connection with my application for GSIS-RPSL, it shall be considered a ground for
disapproval of the application, cancellation of the loan, and shall be a cause for the total outstanding obligation
including condoned penalties and surcharges to be due and demandable and shall be subject to other sanctions
provided in GSIS policies.
8. I agree to notify GSIS of any material change affecting the information contained herein. I agree that all
information obtained by GSIS shall remain its property whether or not the loan is granted.
9. I agree that the Loan Redemption Insurance (LRI) Premium shall be subjected to regular actuarial review and
may be subject to change during the duration of the loan so as to assess the program viability.
10. I further agree to be bound by the current and general policies of GSIS and those that GSIS may adopt in the
future, that may have relation to or in any way affect my loan.

I understand that the processing/servicing/filing fee, notarial and all other fees pertaining to my loan obligation shall
be for my account.

_____________________________________________ ___________________________
Name and Signature of Borrower/ Authorized Date Signed
Representative

Coverage
1. This program shall apply to the following borrowers, regardless of their Period
with Paid Premiums, age, and/or future benefits: (a) Inactive members; (b)
Old-age pensioners; (c) Those who previously availed of Program for
Restructuring and Repayment of Debts (PRRD); and (d) Re-employed
members who cannot qualify or benefit from the Multi-Purpose Loan Program.
Repayment of Debts (PRD); (t) Multi-Purpose Loan (MPL); (u) Computer Loan
(CPL); and (v) All other loans that may be introduced by GSIS in the future.
Exclusion
The following loan accounts are not covered by this PPG: (1) Real Estate Loan; (2)
Deed of Conditional Sale; (3) Restructured Real Estate Loan; (4) Pension Loan; (5)
Pension Emergency Loan; and (6) Pensioner’s Restructured Loan.

2. This program shall cover the following service loan accounts that are already
considered in default: (a) Salary Loan (SL); (b) Enhanced Salary Loan (ESL); FOR GSIS USE ONLY
(c) Restructured Salary Loan (RSL); (d) Emergency Loan Assistance (ELA); Received by / Date: TMS Reference No. Date Created:
(e) Summer One-Month Salary Loan (SOS); (f) Member’s Cash Advance
(MCA); (g) eCard Plus Cash Advance (ECP); (h) Consolidated Loan (CNL); (i)
Enhanced Conso-Loan (CNL); (j) Emergency Loan (EML); (k) Home
Emergency Loan Program (HLP); (l) Study Now, Pay Later (SNP); (m) Fly THIS APPLICATION IS NOT FOR SALE AND MAY BE REPRODUCED.
PAL, Pay Later (FPL); (n) Educational Assistance Loan (EAL); (o) Stock
Purchase Loan (SPL); (p) Policy Loan (PRG); (q) Optional Policy Loan (POL);
(r) GSIS Financial Assistance Loan (GFL); (s) Program for Restructuring and
1. Condonation of Penalties/Surcharges. For inactive members and old-age
pensioners, all unpaid penalties and surcharges that have accrued on the
OBAL of their eligible service loan accounts from the date of their separation to
date of availment of the GSIS-RPSL shall be condoned.
For borrowers with existing PRRD accounts, the penalties and surcharges that
have accrued from the date of default of the PRRD loan to the date of
availment of the GSIS-RPSL shall be condoned.
(c) Notarized Special Power of Attorney (SPA), if applicable.
10. Transactions through Representative/s. Borrowers may designate their
agent/s or representative/s to sign the Application Form, Restructuring
Agreement and/or other related documents for GSIS-RPSL. For this purpose, a
notarized SPA which specifically authorizes the agent/s to sign the documents
related to GSIS-RPSL must be submitted. Nevertheless, documents relating to
an application for claim of GSIS benefits cannot be the subject of an SPA.

For re-employed members, the condonation of penalties and surcharges shall For all other purposes, an authorization letter would suffice.
be computed from the latest date of separation prior to last re-employment up
to the date of availment of GSIS-RPSL. 11. Payment Mechanism. Subject to applicable rules, the following modes of
payment shall be available to GSIS-RPSL availees:
2. Settlement of Account. The OBAL, net of condoned penalties and a. OTC payment in Cash and/or Manager’s Check in any GSIS Office;
surcharges, may be settled by the borrower in full or by installment, with a b. OTC payment through authorized External Payment Service Providers;
required minimum down payment (DP) of ten percent (10%) of the OBAL after c. Payment to any of the GSIS approved Online Payment Facilities;
condonation. d. Payment to be shifted to payroll deduction in case of re-employment;
and
The restructured balance shall be subject to an interest rate computed per e. Payment to be shifted to old-age pension deduction, in case of retirees
annum compounded annually (p.a.c.a.), as follows: who will receive their pension after the guaranteed period under R.A.
No. 8291, or at the age of 60 under R.A. No. 8291 or P.D. No. 1146, in
Interest Rate on the accordance with existing policies on pension administration.
Option DP Remaining Balance
for Restructuring 12. Penalty for Arrearages. An account incurs penalty for arrearages if:
a. There is payment for monthly installment but such payment is delayed;
1 At least 10% 6% b. The actual amount paid is less than the amount due for the month; or
2 At least 25% 5% c. There is no payment made for the month.
3 At least 50% 4%
4 At least 75% 3% It shall incur a penalty of one percent (1%) per month, compounded monthly
until the arrears are paid. A fraction of a month is considered one (1) month.
3. Computation of OBAL and Eligibility of Borrowers
13. Application of Payments
a. Full Payment Option. The borrowers may opt to fully pay their a. Every payment shall be applied to the amount due, following this order
outstanding obligation/s to be computed as follows: of priority:
i. RI premium;
Account Amount ii. Penalty, if any;
OBAL as of Date of Availment xxx,xxx.xx iii. Interest; and
Less: Condonable Amount iv. Principal.
Penalties xx,xxx.xx b. If in arrears, the “move-up” policy shall be adopted wherein the
Surcharges xx,xxx.xx payments are first applied to the earliest unpaid month until the month’s
Remaining OBAL after Condonation xx,xxx.xx full amount due has been fully paid.
(TO BE PAID IN FULL)
14. Default. A restructured loan account is considered in default when the total
b. Restructuring Program: unpaid obligation is equivalent to more than six (6) monthly amortizations.

All borrowers with outstanding service loan obligation are eligible to avail
of the restructuring program.
For old-age pensioners, however, the following additional conditions
should be satisfied:
In the event of default, the OBAL of the restructured loan becomes due and
demandable without need of demand or further notice. In case of failure to pay
the OBAL declared in default, the OBAL shall be charged with a penalty of
twelve percent (12%) interest p.a.c.m. and surcharge of six percent (6%)
p.a.c.m. from the date of default until the date of full payment.

i. the old-age pensioner’s basic monthly pension (BMP) is greater
than the tentative computed monthly amortization; and
ii. the resulting BMP after pension loan, pensioner’s emergency
loan and GSIS-RPSL amortization must at least be 25% of the
BMP.
15.
This restructuring program shall allow borrowers to avail of lower interest
rates depending on the chosen DP.
A GSIS-RPSL account that is in default shall be the subject of appropriate legal
action. If the borrowers have unpaid GSIS benefits that are due at the time that
the borrowers have defaulted with their GSIS-RPSL, the GSIS benefits shall be
applied as payment to the OBAL of the defaulted loan and the remaining
balance, if any, shall be subject of appropriate legal action.
Pre-Termination. The restructured loan may be pre-terminated by paying the
OBAL before the end of the loan term. No fees shall be charged to the
borrower in case of pre-termination.

Account Amount 16. Refund of Overpayment after End of Loan Term. At the end of the loan
OBAL as of Date of Availment xxx,xxx.xx term, any overpayment shall be treated in accordance with the policies on the
refund of loan overpayments.
Less: Condonable Amount
Penalties xx,xxx.xx 17. Non-Renewal. The GSIS-RPSL is a one-time offer of the GSIS and is not
Surcharges xx,xxx.xx renewable.
Remaining OBAL After Condonation xx,xxx.xx
Less: Chosen DP xx,xxx.xx 18. Attorney’s fees. Should the GSIS be compelled to refer the loan or any portion
Net OBAL for Restructuring xx,xxx.xx thereof to an Attorney-at-Law for collection or to enforce any right hereunder
against the borrower or avail of any remedy under the law or this Agreement,
4. Payment Schedule. The restructured balance may, at the option of the the borrower shall pay an amount equivalent to twenty-five percent (25%) of all
borrower, be paid within a period of one (1) year but not more than five (5) amounts outstanding and unpaid as and for attorney’s fees and litigation
years. In the case of old-age pensioners, the computed monthly amortization expenses.
shall be deducted from their monthly pension until fully paid, in accordance with
the policies on pension administration. 19. Venue. Any legal action, suit or proceeding arising out or relating to this
Agreement, shall be brought or instituted in the appropriate courts in the City of
5. Loan Redemption Insurance (LRI). An LRI cover shall be attached to the Pasay or such other venue at the exclusive option of GSIS. In the event the
restructured loan, computed based on the LRI rate provided and the Net OBAL borrower initiates any legal action arising from or under this Agreement, for
for Restructuring to be amortized. whatever causes, the borrower agrees to initiate such action only in the City
where the principal office of GSIS is located.
The premium for LRI shall form part of the computed monthly amortization of
the restructured loan and shall be subjected to regular actuarial review and 20. Notices. All notices required under this Agreement for its enforcement shall be
may be subject to change during the duration of the loan so as to assess the sent to the residential address indicated in the personal data portion of this loan
program viability. application. The notices sent to the said address shall be valid and shall serve
as sufficient notice to the borrower for all legal intents and purposes.
To ensure that the member is covered with LRI from the date of loan
restructuring, an advance LRI premium equivalent to one (1) month shall be
collected upon approval of the GSIS-RPSL application together with the DP.
___________________________________ ______________________
MEMBER-BORROWER / DATE SIGNED
In case of death of the borrower within the payment period, the theoretical AUTHORIZED REPRESENTATIVE
balance of the restructured loan shall be covered by the LRI provided the loan
is not in default. However, any arrearages equivalent to the difference between
(Signature over Printed Name)
the OBAL and the theoretical balance shall still be collected from the heirs of ____________________
the deceased member. TIN
6. Due Date of Monthly Amortization of the Restructured Amount

The first due date (FDD) of the restructured loan shall be on the month
following the granting of the restructured loan, and every moth thereafter until
the loan is fully paid.

For example, a restructured loan granted on May 24, 2023 shall have an FDD
of June 2023.

7. Grace Period in the Payment of Amortization. There shall be a grace period

of ten (10) calendar days from the date when the repayment falls due. No
penalty or surcharge shall be imposed on repayment made during this period.

8. Filing of GSIS-RPSL. The processing of unclaimed benefit and deduction

therefrom of outstanding obligations, if any, shall follow the existing policies on
determining the reckoning dates in the accrual of interests for service loans and
shall precede the processing of the GSIS-RPSL.

The GSIS-RPSL shall be filed Over-the-Counter (OTC) at any GSIS office.

9. Documentary Requirements. The following documents should be submitted

to the GSIS before an application for GSIS-RPSL is accepted:

(a) Accomplished Application Form for GSIS-RPSL duly signed by the borrower
or the borrower’s representative/s;

Clear photocopy or scanned copy of GSIS eCard, valid passport, PhilID or any
two (2) acceptable government-issued IDs or documents with date of birth and
signature; and