HQP-HLF-063 MEMBERSHIP STATUS VERIFICATION SLIP

Date Filed: __________

Name of Developer (For Developers account)

HQP-HLF-063 MEMBERSHIP STATUS VERIFICATION SLIP

MSVS No. ___________
Tel. No.

MSVS No. ___________ Date Filed: __________

Tel. No. Name of Developer (For Developers account)

Last Name

First Name

Name Ext.

Middle Name

Last Name

First Name

Name Ext.

Middle Name

Maiden Name (For married women)

Sex Male Female

Pag-IBIG MID No.

Maiden Name (For married women)

Sex Male Female

Pag-IBIG MID No.

Marital Status Single/ Married Widow/er Unmarried Company/Employer/Business Name Legally Separated Annulled

Date of Birth

Marital Status Single/ Married Widow/er Unmarried Company/Employer/Business Name Legally Separated Annulled

Date of Birth

Company/Employer/Business Address

Tel. No.

Company/Employer/Business Address

Tel. No.

For AFP Employee For DECS Employee

Branch of Service

Serial/Account No. Station Code

For AFP Employee For DECS Employee

Branch of Service

Serial/Account No. Station Code

Division Code

Employee No.

Division Code

Employee No.

EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP

NAME OF EMPLOYER/ADDRESS
FROM (Mo./Yr.)

EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP

NAME OF EMPLOYER/ADDRESS
FROM (Mo./Yr.)

TO (Mo./Yr.)

TO (Mo./Yr.)

Members Signature

Members Signature

FOR SERVICING DEPARTMENT / HOUSING LOANS DIVISION / Pag-IBIG INTERNATIONAL OPERATIONS GROUP
HOUSING VERIFICATION
Without With HOUSING LOAN Verified by: TOD _____________ Loan Value _______________ Date: HL Status _____________________

FOR SERVICING DEPARTMENT / HOUSING LOANS DIVISION / Pag-IBIG INTERNATIONAL OPERATIONS GROUP
HOUSING VERIFICATION
Without With HOUSING LOAN Verified by: TOD _____________ Loan Value _______________ Date: HL Status _____________________

PROVIDENT VERIFICATION
Year/Month LATEST CONTRIBUTION RECORD PFR No./Date Amount
Without CLAIMS MPL With Loan Value / Amount _____________ ________________ _____________ ________________ Verified by: DV Date Total No. of Contributions Claim Type / Last Applicable Month _____________________ _____________________ Date

PROVIDENT VERIFICATION
Year/Month LATEST CONTRIBUTION RECORD PFR No./Date Amount
Without With CLAIMS MPL Loan Value / Amount _____________ ________________ _____________ ________________ Verified by: DV Date Total No. of Contributions Claim Type / Last Applicable Month _____________________ _____________________ Date

Loan Entitlement

Loan Entitlement

MSVS APPROVAL
Certified by: Date

MSVS APPROVAL

Approved

Disapproved

Certified by:

Date

Approved

Disapproved

Remarks

Remarks

FOR RE-VALIDATION OF MSVS

HOUSING VERIFICATION
Without With HOUSING LOAN Verified by: TOD _____________ Loan Value _______________ Date: HL Status _____________________ HOUSING LOAN Verified by:

FOR RE-VALIDATION OF MSVS

HOUSING VERIFICATION
Without With TOD _____________ Loan Value _______________ Date: HL Status _____________________

PROVIDENT VERIFICATION
Year/Month LATEST CONTRIBUTION RECORD PFR No./Date Amount
Without CLAIMS MPL With Loan Value / Amount _____________ ________________ _____________ ________________ Verified by: DV Date Total No. of Contributions Claim Type / Last Applicable Month _____________________ _____________________ Date

PROVIDENT VERIFICATION
Year/Month LATEST CONTRIBUTION RECORD PFR No./Date Amount
Without With CLAIMS MPL Loan Value / Amount _____________ ________________ _____________ ________________ Verified by: DV Date Total No. of Contributions Claim Type / Last Applicable Month _____________________ _____________________ Date

Loan Entitlement

Loan Entitlement

MSVS APPROVAL
Certified by: Date

MSVS APPROVAL

Approved

Disapproved

Certified by:

Date

Approved

Disapproved

Remarks

Remarks

(August 2012)

(August 2012)