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HQP-HLF-063 HQP-HLF-063

MEMBERSHIP STATUS MEMBERSHIP STATUS


VERIFICATION SLIP VERIFICATION SLIP

Date Filed: __________ MSVS No. ___________ Date Filed: __________ MSVS No. ___________
Name of Developer (For Developers account) Tel. No. Name of Developer (For Developers account) Tel. No.

Last Name First Name Name Ext. Middle Name Last Name First Name Name Ext. Middle Name

Maiden Name (For married women) Sex Pag-IBIG MID No. Maiden Name (For married women) Sex Pag-IBIG MID No.
Male Male
Female Female
Marital Status Date of Birth Marital Status Date of Birth
Single/ Married Widow/er Legally Annulled Single/ Married Widow/er Legally Annulled
Unmarried Separated Unmarried Separated
Company/Employer/Business Name Company/Employer/Business Name

Company/Employer/Business Address Tel. No. Company/Employer/Business Address Tel. No.

For AFP Branch of Service Serial/Account No. For AFP Branch of Service Serial/Account No.
Employee Employee
For DECS Division Code Station Code Employee No. For DECS Division Code Station Code Employee No.
Employee Employee
EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP
NAME OF EMPLOYER/ADDRESS FROM (Mo./Yr.) TO (Mo./Yr.) NAME OF EMPLOYER/ADDRESS FROM (Mo./Yr.) TO (Mo./Yr.)

Members Members
Signature Signature

FOR SERVICING DEPARTMENT / HOUSING LOANS DIVISION / FOR SERVICING DEPARTMENT / HOUSING LOANS DIVISION /
Pag-IBIG INTERNATIONAL OPERATIONS GROUP Pag-IBIG INTERNATIONAL OPERATIONS GROUP
HOUSING VERIFICATION HOUSING VERIFICATION
Without With TOD Loan Value HL Status Without With TOD Loan Value HL Status

HOUSING HOUSING
_____________ _______________ _____________________ _____________ _______________ _____________________
LOAN LOAN
Verified by: Date: Verified by: Date:

PROVIDENT VERIFICATION PROVIDENT VERIFICATION


LATEST CONTRIBUTION RECORD Total No. of LATEST CONTRIBUTION RECORD Total No. of
Year/Month PFR No./Date Amount Contributions Year/Month PFR No./Date Amount Contributions

Without With DV Date Loan Value / Claim Type / Without With DV Date Loan Value / Claim Type /
Amount Last Applicable Month Amount Last Applicable Month
CLAIMS _____________ ________________ _____________________ CLAIMS _____________ ________________ _____________________
MPL _____________ ________________ _____________________ MPL _____________ ________________ _____________________

Loan Entitlement Verified by: Date Loan Entitlement Verified by: Date

MSVS APPROVAL MSVS APPROVAL


Certified by: Date Certified by: Date
Approved Disapproved Approved Disapproved
Remarks Remarks

FOR RE-VALIDATION OF MSVS FOR RE-VALIDATION OF MSVS


HOUSING VERIFICATION HOUSING VERIFICATION
Without With TOD Loan Value HL Status Without With TOD Loan Value HL Status

HOUSING HOUSING
_____________ _______________ _____________________ _____________ _______________ _____________________
LOAN LOAN
Verified by: Date: Verified by: Date:

PROVIDENT VERIFICATION PROVIDENT VERIFICATION


LATEST CONTRIBUTION RECORD Total No. of LATEST CONTRIBUTION RECORD Total No. of
Year/Month PFR No./Date Amount Contributions Year/Month PFR No./Date Amount Contributions

Without With DV Date Loan Value / Claim Type / Without With DV Date Loan Value / Claim Type /
Amount Last Applicable Month Amount Last Applicable Month
CLAIMS _____________ ________________ _____________________ CLAIMS _____________ ________________ _____________________
MPL _____________ ________________ _____________________ MPL _____________ ________________ _____________________

Loan Entitlement Verified by: Date Loan Entitlement Verified by: Date

MSVS APPROVAL MSVS APPROVAL


Certified by: Date Certified by: Date
Approved Disapproved Approved Disapproved
Remarks Remarks

(August 2012) (August 2012)