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Request for Deduction Request for Deduction

Please deduct the following amounts from Please deduct the following amounts from
my loan proceeds: my loan proceeds:
Sariling Sikap Loan Balance P Sariling Sikap Loan Balance P

Equity Loan Balance Equity Loan Balance


Certificate Loan Balance Certificate Loan Balance
Calamity Loan Balance Calamity Loan Balance
Insurance Premium Insurance Premium
Other Charges Other Charges

Total Deductions P Total Deductions P

Less: Interest Rebates Less: Interest Rebates

Net Deductions Net Deductions

_____________________________ _____________________________
(Signature Over Printed Name) (Signature Over Printed Name)
Division No.: _______ Division No.: _______
Station No.: _______ Station No.: _______
Employee No.: _________________ Employee No.: _________________
Date: _________________ Date: _________________

Request for Deduction Request for Deduction

Please deduct the following amounts from Please deduct the following amounts from
my loan proceeds: my loan proceeds:

Sariling Sikap Loan Balance P Sariling Sikap Loan Balance P

Equity Loan Balance Equity Loan Balance


Certificate Loan Balance Certificate Loan Balance
Calamity Loan Balance Calamity Loan Balance
Insurance Premium Insurance Premium
Other Charges Other Charges
Total Deductions P Total Deductions P

Less: Interest Rebates Less: Interest Rebates

Net Deductions Net Deductions

_____________________________ _____________________________
(Signature Over Printed Name) (Signature Over Printed Name)
Division No.: _______ Division No.: _______
Station No.: _______ Station No.: _______
Employee No.: _________________ Employee No.: _________________
Date: _________________ Date: _________________

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