HQP-PFF-093

REQUEST FOR TRANSFER OF MEMBER’S RECORDS

AND LOAN DETAILS (RTMRLD)

_____________________
Date

Dear Sir/Madam:
I would like to request transfer of my membership records and loan details to the ______________
with the following information:

Name of member: _________________________________________________________

Last Name First Name Name Extensions (Jr., Sr., II, etc.) Middle Name (Maiden)

Civil Status:  Single  Legally Separated

 Married  Annulled
 Widow/er
Home Address: ________________________________________________________________
________________________________________________________________
Telephone No.: _____________________________
Present Company/Employer: ___________________________________________________
Company/Employer Address: ___________________________________________________
___________________________________________________
Telephone No.: _____________________________ Company ID No.: __________________

Purpose of Transfer:  Claims  Consolidation

 STL o Intra-branch (within the branch)
 Others, pls. specify o Inter-branch (among branches)
_________
Check if with:
 Housing Loan  STL
Takeout date : _______________ DV/Check Date : _______________
Loan status : _______________ Loan Status : _______________
Outstanding Balance : _______________ Outstanding Balance :_______________

Name of Previous Company/Employer Company/Employer Address/Contact No. Inclusive Date(s)

1.
2.
3.
4.

Requesting Pag-IBIG Fund Branch: _________________________________________

Requested by:
Processed by: ___________________
__________________________________
Member’s Signature Over Printed Name Noted by: ___________________

(V02, 02/2017)