Employers Data Form Edf
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1
2HQP-PFF-002
FOR Pag-IBIG Fund USE ONLY
EMPLOYER’S DATA
Pag-IBIG EMPLOYER ID NUMBER
FORM (EDF)
REGISTRATION TRACKING NUMBER
INSTRUCTIONS
1. Accomplish this form in one (1) copy.
2. Type or print all entries in BLOCK or CAPITAL LETTERS.
3. On the "CONTACT DETAILS" portion, indicate at least one (1) contact number.
4. All fields which are marked with asterisk (*) are mandatory.
5. On the “INDUSTRY” portion, indicate industry based on the List of Industry at the back of the form.
6. Submit duly accomplished form and present required supporting documents based on the Checklist of Requirements found at the back of the form.
*EMPLOYER/BUSINESS NAME
ADDRESS AND CONTACT DETAILS
*EMPLOYER/BUSINESS ADDRESS
AREA CODE
TELEPHONE NUMBER
Unit/Room No., Floor
Building Name
Business (Direct Line)
Lot No., Block No.,
Phase No.
House No
Street Name
Business (Fax)
Subdivision
Barangay
Business (Trunk Line)
Local
Municipality/City
Cell Phone
Province
ZIP Code
Business Email Address
EMPLOYER/BUSINESS DETAILS
START OF BUSINESS OPERATION
*INDUSTRY
*WITH RETIREMENT PLAN
PHILIPPINE BUSINESS
DATE OF
REGISTRY No.
ISSUANCE
Yes
No
m
m
d
d
y
y
y
y
*BRANCH/OFFICE
*TYPE OF EMPLOYER
DTI/SEC/CDA REGISTRATION
DATE OF
ISSUANCE
Head Office
Private
CERTIFICATE No.
Branch (Please Specify) ___________
Government
For Private Employers
*TAXPAYER IDENTIFICATION NUMBER (TIN)
*LEGAL PERSONALITY
Cooperative/Trade Association
Sole Proprietorship
For Private Employers
Foreign-owned Corporation
Partnership
SSS Employer Number
Corporation
For Government Employers
Date of Registration
*CLASSIFICATION
Constitutional Office
National Government
Government-Owned and Controlled Corporation (GOCC)/
Local Government Unit (LGU)
m
m
d
d
y
y
y
y
Government Financial Institution (GFI)
For Government Employers
GSIS BUSINESS PARTNER No.
PREVIOUS EMPLOYER/BUSINESS NAME (If applicable)
AGENCY/BRANCH/DIVISION CODE
I HEREBY CERTIFY THAT THE INFORMATION GIVEN AND ALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT.
________________________________________
____________________________
____________________
*Head of Office/Authorized Representative
*Designation/Position
Date
(Signature over Printed Name)
FOR Pag-IBIG FUND USE ONLY
RECEIVED BY
DATE
(Rev. 02.2, 01/2015)
THIS FORM MAY BE REPRODUCED. NOT FOR SALE.
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Parent category: Business