Request For Transfer Of Member'S Records And Loan Details (Rtmrld)

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FPF400
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:
Noted by:
___________________________________
Member's Signature Over Printed Name
Revised 08/2008

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