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)
