Reservation Form Page 6
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6HQP-HLF-063
HQP-HLF-063
MEMBERSHIP STATUS
MEMBERSHIP STATUS
VERIFICATION SLIP
VERIFICATION SLIP
__________
MSVS No. ___________
__________
MSVS No. ___________
Date Filed:
Date Filed:
Name of Developer (For Developer’s account)
Tel. No.
Name of Developer (For Developer’s 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
Fema le
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
Division Code
Station Code
Employee No.
Division Code
Station Code
Employee No.
For DECS
For DECS
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.)
Member’s
Member’s
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
Total No. of
Total No. of
LATEST CONTRIBUTION RECORD
LATEST CONTRIBUTION RECORD
Contributions
Contributions
Year/Month
PFR No./Date
Amount
Year/Month
PFR No./Date
Amount
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
Contributions
Contributions
Year/Month
PFR No./Date
Amount
Year/Month
PFR No./Date
Amount
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
_____________ ________________
_____________________
_____________ ________________
_____________________
Verified by:
Date
Verified by:
Date
Loan Entitlement
Loan Entitlement
MSVS APPROVAL
MSVS APPROVAL
Certified by:
Date
Certified by:
Date
Approved
Disapproved
Approved
Disapproved
Remarks
Remarks
(August 2012)
(August 2012)
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