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: θ Single θ Legally Separated

θ Married θ Annulled
θ Widow/er
Home Address:

Telephone No.:

Present Company/Employer:

Company/Employer Address:

Telephone No.: Company ID No.:

Purpose of Transfer: θ Claims θ Consolidation

θ STL μ Intra-branch (within the branch)
θ Others, pls. Specify _____________ μ Inter-branch (among branches)

Check if with:
θ Housing Loan θ 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