HQP-HLF-068

HOUSING LOAN APPLICATION (V09, 03/2024)

Pag-IBIG MID Number/RTN OF APPLICANT Housing Account Number (HAN), if with existing HAN

(PRINT ALL ENTRIES IN BLOCK OR CAPITAL LETTERS)

LOAN PARTICULARS
PURPOSE OF LOAN WITH EXISTING HOUSING APPLICATION
 YES  NO
 Purchase of fully developed residential lot or adjoining residential lots If yes, indicate Housing Application No. _______________________
 Purchase of a residential house and lot, townhouse or condominium
DESIRED LOAN AMOUNT (Exclusive of DESIRED LOAN TERM (Years)
unit, inclusive of a parking slot the co-borrower’s desired loan amount, if any)
 Construction or completion of a residential unit on a residential lot
 Home improvement DESIRED RE-PRICING PERIOD (Year/s)
 Refinancing of an existing housing loan  1  3  5  10  15  20  25  30
 Purchase of a parking slot MODE OF PAYMENT
 Purchase of residential lot plus cost of transfer of title  Salary deduction  Collecting Agent
 Purchase of residential unit plus cost of transfer of title  Over-the-Counter  Bank
______(Transfer Cost)______  Post-Dated Checks  Developer
 Cash/Check  Remittance Center
COLLATERAL
PROPERTY LOCATION (Street, Municipality, Province) TYPE OF PROPERTY
 Rowhouse  Single Detached  Townhouse
 Single Attached  Condominium  Duplex
NAME OF DEVELOPER/REGISTERED TITLE HOLDER DESCRIPTION OF
EXISTING PROPOSED
IMPROVEMENTS
TCT/OCT/CCT NO. TAX DECLARATION NO. LOT/UNIT NO. BLOCK/BLDG NO. No. of
STOREYS
IS PROPERTY PRESENTLY LAND AREA FLOOR AREA AGE OF HOUSE (For Purchase of a
TOTAL FLOOR
MORTGAGED? Residential Unit)
SQM SQM AREA
 YES  NO SQM SQM
IS THE PROPERTY AN OFFSITE COLLATERAL?  YES  NO REASONS FOR USE OF OFFSITE COLLATERAL
If yes, use separate sheet for the offsite collateral details
BORROWER’S DATA
LAST NAME FIRST NAME NAME EXTENSION MIDDLE NAME CITIZENSHIP DATE OF BIRTH (mm/dd/yy) SEX
M F
PERMANENT HOME ADDRESS MARITAL STATUS
Unit/Room No., Floor Building Name Lot No., Blk No., Phase No., House No. Street Name  Single/Unmarried  Annulled
 Married  Widow/er ATTACH HERE
 Legally Separated 1”X1”
Subdivision Barangay Municipality/City Province and State Country (if abroad) ZIP Code NO. OF DEPENDENT/S ID PHOTO

PRESENT HOME ADDRESS BORROWER’S CONTACT DETAILS (Indicate country

Unit/Room No., Floor Building Name Lot No., Blk No., Phase No., House No. Street Name code if abroad)
COUNTRY + AREA CODE TELEPHONE NO.
Home
Subdivision Barangay Municipality/City Province and State Country (if abroad) ZIP Code

Cell Phone
HOME OWNERSHIP YEARS OF STAY EE SSS/GSIS ID No.
 Owned  Company  Living w/ relatives/parents IN PRESENT
 Mortgaged  Rented at P__________/mo. HOME ADDRESS EMPLOYER’S CONTACT DETAILS (Indicate country
code if abroad)
EMPLOYER/BUSINESS NAME (If self-employed) TIN COUNTRY + AREA CODE TELEPHONE NO.
Business (Direct Line)
EMPLOYER/BUSINESS ADDRESS OCCUPATION
Unit/Room No., Floor Building Name Lot No., Block No., Phase No., House No. Street Name  Employed Business (Trunk Line)
 Self-Employed
Subdivision Barangay Municipality/City Province and State Country (if abroad) ZIP Code
Employer/Business Email Address

MAILING ADDRESS/CONTACT DETAIL ALTERNATE MAILING ADDRESS

Email Address ______________________________  Present Home Address  Permanent Home Address  Employer/Business Address

INDUSTRY PREFERRED TIME TO BE CONTACTED (For

 Accounting Basic Materials Health and Social Work;  Technology Employer)
 Activities of Private Construction Health and Medical Services  Transport, Storage
Households as Business Process Outsourcing Life Sciences and Communications
Employer’s & (BPO) Management  Travel and Leisure
Undifferentiated Education & Training Manufacturing  Wholesale & Retail
Production Electricity, Gas and Water  Media Trade; Repair of POSITION & DEPARTMENT YEARS IN
Activities of Supply Mining and Quarrying Motor Vehicles, EMPLOYMENT/
Private Extra-Territorial Organization & Other Community, Social & Motorcycles, BUSINESS
Households Bodies Personal Service Activities Personal &
 Agriculture, Financial Services/  Public Administration & Household Goods
Hunting, Forestry Intermediation Defense; Compulsory Social
& Fishing HR/Recruitment Security
SPOUSE’S PERSONAL DATA
LAST NAME FIRST NAME NAME EXTENSION MIDDLE NAME Pag-IBIG MID NO./RTN

CITIZENSHIP DATE OF BIRTH (mm/dd/yy) TIN

EMPLOYER/BUSINESS NAME (If self-employed) YEARS IN EMPLOYMENT/ BUSINESS

EMPLOYER/BUSINESS ADDRESS OCCUPATION POSITION & DEPARTMENT

Unit/Room No., Floor Building Name Lot No., Block No., Phase No., House No. Street Name  Employed
 Self-Employed
Subdivision Barangay Municipality/City Province and State Country (if abroad) ZIP Code BUSINESS TEL. NO.