APPLICATION FOR PENALTY CONDONATION/ FOR HDMF USE ONLY SPECIAL SHORT-TERM LOAN (STL)

(TO BE FILLED OUT BY APPLICANT)

PLEASE READ GUIDELINES AND INTRUCTIONS AT THE BACK. TYPE OR PRINT ALL INFORMATION IN CAPITAL LETTERS.

FLS011

PURPOSE SPECIAL STL PENCON & SPECIAL STL TAV OFFSETTING WITH PENCON

LAST NAME

FIRST NAME

NAME EXTENSION
(e.g., JR, II)

MIDDLE NAME

NO MIDDLE NAME REGISTRATION TRACKING No. APPLICATION No.

(if applicable only)

MOTHER'S MAIDEN NAME

GENDER
MALE FEMALE

CIVIL STATUS
SINGLE MARRIED WIDOW/ER ANNULLED LEGALLY SEPARATED

DATE OF BIRTH
mm dd yyyy

PLACE OF BIRTH

SSS/GSIS ID No.

TIN

PERMANENT HOME ADDRESS (Pls. indicate complete address)

HOME TEL. No.

CELLPHONE No.

LAST EMPLOYER/BUSINESS NAME

EMPLOYER/BUSINESS ADDRESS

DATE OF DISPLACEMENT

SIGNATURE OF APPLICANT IN THE EVENT OF THE APPROVAL OF MY APPLICATION FOR SPECIAL SHORTTERM LOAN, I HEREBY AUTHORIZE HDMF TO CREDIT MY LOAN PROCEEDS THROUGH MY LANDBANK ACCOUNT THAT I HAVE INDICATED ON THE RIGHT PORTION.
.

MEMBER'S LANDBANK ACCOUNT NO.

BRANCH (Where member maintains LandBank account)

LANDBANK ADDRESS

APPLICATION AGREEMENT
I certify that the information given and any or all statements made herein are true and correct to the best of my knowledge and belief. I hereby certify under pain of perjury that my signature appearing herein is genuine and authentic. Should there be no loan proceeds after TAV offsetting, if any, this application shall serve as application for penalty condonation. In case of falsification, misrepresentation or any similar acts committed by me, HDMF shall automatically suspend my loan privileges indefinitely. I shall abide with all the applicable rules and regulations governing this lending program that HDMF may promulgate from time to time. In case of membership termination prior to full payment of the loan, I understand that no claim for provident benefit shall be paid to me or my beneficiaries until after the full satisfaction of any amount arising from this agreement which remains unpaid as of the date of such termination

_____________________________________ Signature of Applicant over Printed Name

PROMISSORY NOTE
For value received, I promise to pay on due date without need of demand to the order of Home Development Mutual Fund (HDMF) with principal office at the Atrium of Makati, Makati Ave., City of Makati the sum of Pesos: (P_______________) Philippine Currency, with interest at the rate of 10.75% p. a., compounded monthly. Interest shall be charged during the grace period. I hereby waive notice of demand for payment and agree that any legal action, which may arise in relation to this note, may be instituted in the proper court of Makati City, or in any locality where HDMF conducts its business, through its Branches. Finally, this note shall likewise be subject to the following terms and conditions: 1. The borrower shall pay the amount of Pesos: _______________________________ (P_______________) directly to any HDMF office or to any of its authorized collecting agents. Should the borrower become employed at any time within the term of the loan, he may opt to pay thru his new employer. 2. Payments are due on or before the fifteenth (15th) of the month starting on the thirteenth (13th) month from date of approval of loan application. 3. The borrower who fails to pay the full monthly amortization when due shall pay 1/2% of the amount due for every month of delay. A fraction of a month shall be considered as one month. 4. The monthly payment shall be applied according to the following order of priorities: Penalties, Interest and Principal. 5. The borrower shall be considered in default in any of the following cases: a. Any willful misrepresentation made by the borrower in any of the documents executed in relation hereto. b. Failure to pay any three (3) consecutive monthly amortizations and other obligations on the loan during the term of the loan. c. Violation by the borrower of any of the policies, rules, regulations and guidelines of the Fund. 6. In the event of default, the outstanding loan balance, all accumulated interests and penalties shall become due and demandable. The said amount shall be applied against the borrowers TAV on the fifth (5th) month of non-payment.

_____________________________________ Signature of Applicant over Printed Name

Signed in the presence of:

____________________________
Witness (Signature over Printed Name)

___________________________
Witness (Signature over Printed Name)

THIS PORTION IS FOR HDMF USE ONLY

LOAN EVALUATION
DOCUMENTS SUBMITTED
NOTICE OF SEPARATION/TERMINATION CERTIFICATE OF RETRENCHMENT/LAY-OFF PROOF OF BILLING ADDRESS VALID ID CARD REFLECTING COMPLETE ADDRESS PASSPORT (FOR OFW ONLY) DFA ISSUED TRAVEL DOCUMENTS (FOR OFW ONLY) OTHERS ____________________

REMARKS

VALIDATED BY

DATE

CLAIM/STL VERIFICATION
PARTICULARS CLAIMS MPL/CALAMITY LOAN NONE WITH DV/CHECK NO. / APPLICATION NO. DATE FILED / DV NO. VERIFIED BY DATE

LOAN APPROVAL
DATE GRANTED APPROVED LOAN VALUE MONTHLY AMORTIZATION REPAYMENT PERIOD

REVIEWED BY

DATE

ACTION TAKEN
APPROVED DISAPPROVED

REMARKS

APPROVING AUTHORITY

DATE

THIS FORM CAN BE REPRODUCED. NOT FOR SALE

Revised 05/2009

GUIDELINES AND INSTRUCTIONS

A. WHO MAY FILE Any HDMF member who satisfies the following requirements: 1. Has been displaced from work beginning October 2008 due to the following reasons: 1.1 Closure of the company/employer 1.2 Retrenchment/lay-off 1.3 In the case of Pag-IBIG Overseas Program (POP), those who were repatriated to the Philippines due to pre-termination of employment contract resulting from retrenchment, closure of the company, or armed conflict. 2. Has made at least twenty-four (24) monthly contributions. B. HOW TO FILE The applicant shall: 1. Secure Application for Penalty Condonation/Special STL from any HDMF NCR/Regional branch. NOTE: At point of loan application, the member shall be required to update his membership records via the on-line Membership Registration System or by submitting a completely filled out Members Data Form (MDF). 2. Accomplish 1 copy of the application form. 3. Under PACSVAL releasing, attach photocopy of passbook or Automated Teller Machine (ATM) card reflecting the account name and bank account number. 4. Attach photocopy of the following documents, the original copies of which must be presented for authentication: a. Notice of Separation/Termination or Certification of Retrenchment/Lay-off b. Proof of billing address or valid ID card reflecting complete address* *Any proof of billing address (e.g., parents, spouse, etc.) may be used provided that the member-applicant is residing in the said address. c. For displaced OFWs - Passport or DFA issued travel documents - Employment Contract reflecting date of contract 5. Submit complete application to HDMF NCR/Regional branch maintaining your record. Processing of loans shall commence only upon submission of complete documents. C. LOAN FEATURES 1. PENALTY CONDONATION An eligible borrower whose outstanding MPL/Calamity Loan is delinquent and who files an application for Special STL shall be granted penalty condonation. Prior to TAV offsetting, all penalties incurred up to date of approval of application for Special STL shall be condoned. If during evaluation the borrower has no loan proceeds or if the borrower decides not to claim the same, the application for Special STL shall serve as his application for penalty condonation. It shall be reckoned up to date of approval of application. 2. TAV OFFSETTING Pursuant to Section 11 of HDMF Circular No. 56-H, a borrowers existing Multi-Purpose Loan (MPL) or Calamity Loan may be subjected to immediate TAV offsetting due to unemployment. Hence, the outstanding balance and all unpaid interests as of date of approval of application for Special STL and/or penalty condonation shall be applied against his TAV. 3. LOAN AMOUNT The loanable amount shall be equivalent to fifty percent (50%) of members Total Accumulated Value (TAV). In case the borrowers outstanding MPL/Calamity Loan underwent offsetting, his loan amount shall be equivalent to fifty percent (50%) of his remaining TAV. 4. LOAN TERM The loan shall have a term of three (3) years, inclusive of a one-year grace period on principal payments. 5. INTEREST RATE The loan shall bear an interest at the rate of 10.75% per annum, compounded monthly. Interest shall be charged during the grace period. 6. LOAN RELEASE The loan proceeds shall be released through any of the following modes: a. Credited to the borrowers bank account through the LANDBANKs Payroll Credit Systems Validation (PACSVAL) / and other similar modes of payment b. Through check, payable to the borrower 7. LOAN PAYMENT The special STL shall be paid in equal monthly amortizations in such amounts as may fully cover the principal and interest over the loan period. The first monthly amortization of the Special STL shall begin on the thirteenth (13th) month from date of approval of loan application. The monthly payments shall be paid every fifteenth (15th) of the month. Should the due date fall on a non-working day, the monthly payments shall be paid on the first working day after due date. Payments shall be made directly to any HDMF office or to its authorized collecting agents/banks. Should the borrower become employed at any time within the term of the loan, he may opt to pay thru his new employer. The borrower who fails to pay the full monthly amortization when due shall pay one-half percent (1/2%) of the amount due for every month of delay. A fraction of a month shall be considered as one month. The monthly payment shall be applied according to the following order of priorities: a.) Penalties b.) Interest c.) Principal Any amount paid in excess of the required monthly amortization shall be applied to future amortizations. The borrower has the option to pay his total obligation in full at any time within the term of the loan. Thereafter, he shall be allowed to avail of a new loan under the regular MPL program.

8. DEFAULT The borrower shall be considered in default in any of the following cases: a. Any willful misrepresentation made by the borrower in any of the documents executed in relation hereto. b. Failure to pay any three (3) consecutive monthly amortizations and other obligations on the loan during the term of the loan. c. Violation by the borrower of any of the policies, rules, regulations and guidelines of the Fund. A Notice of Default shall be issued to the borrower. 9. EFFECTS OF DEFAULT In the event of default, the outstanding loan balance, all accumulated interests and penalties shall become due and demandable. The said amount shall be applied against the borrowers TAV on the fifth (5th) month of non-payment. 10. LOAN RENEWAL A borrower may avail of an MPL under the regular program after paying at least six (6) monthly amortization payments.