Fillable SLF066 Calamity Loan Application Form V05 Fillable Final

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SLF066 Calamity Loan Application Form V05 Fillable Final

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CALAMITY LOAN
APPLICATION FORM
(To be filled out by applicant. Print this form back to back on one single sheet of paper)
Type or Print Entries
HQP-SLF-066
(V05, 02/2020)
Pag-IBIG MID NO./RTN
APPLICATION NO.
LAST NAME FIRST NAME NAME EXTENSION MIDDLE NAME MAIDEN MIDDLE NAME NO MIDDLE NAME
(e.g., Jr., II) (for married women) (check if applicable only)
DATE OF BIRTH
PLACE OF BIRTH
MOTHER’S MAIDEN NAME
SEX
Male
Female
MARITAL STATUS
CITIZENSHIP
EMAIL ADDRESS
Single
Married
Widow/er Annulled
Legally Separated
PRESENT HOME ADDRESS Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. Street Name
CELL PHONE NUMBER (Required)
HOME TELEPHONE NUMBER
Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code
APPLICANT’S TAXPAYER
IDENTIFICATION NUMBER (TIN)
SSS/GSIS NO.
PERMANENT HOME ADDRESS Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. Street Name
BUSINESS TELEPHONE NUMBER
NATURE OF WORK
Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code
DATE OF EMPLOYMENT
EMPLOYEE ID NUMBER
EMPLOYER/BUSINESS NAME
NAME OF TYPHOON/CALAMITY
DESIRED LOAN AMOUNT
EMPLOYER/BUSINESS ADDRESS Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. Street Name
LOAN PURPOSE
Non-Housing Related
Home Enhancement
Tuition/Educational Expense
Health and Wellness
Livelihood
Housing Related
House Repair
Minor home improvement
Others, please specify
___________________________
Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code
PREVIOUS EMPLOYMENT DETAILS FROM DATE OF Pag-IBIG MEMBERSHIP (Use another sheet if necessary)
EMPLOYER/BUSINESS NAME
EMPLOYER/BUSINESS ADDRESS
FROM (mm/yy)
TO (mm/yy)
APPLICATION AGREEMENT
In consideration of the loan that may be granted by virtue of this application subject to the pertinent provisions of the Implementing
Rules and Regulations of Pag-IBIG Fund, I hereby waive my rights under R.A. No. 1405 (Secrecy of Bank Deposits Act) and
authorize Pag-IBIG Fund to verify/validate my payroll account/disbursement card. Furthermore, I hereby authorize my present
employer, ____________________________________________________________________ or any employer with whom I may get
employed in the future, to deduct the membership savings (MS) and monthly amortization due from my salary and remit the same to
Pag-IBIG Fund. If the resulting monthly net take home pay after deducting the computed monthly amortization on Calamity Loan falls
below the monthly net take home pay as required under the GAA/company policy, I authorize Pag-IBIG Fund to compute for a lower
loanable amount.
I understand that should I fail to pay the monthly amortization due, I shall be charged with a penalty of 1/20 of 1% of any unpaid amount
for every day of delay.
If for any reason excess loan proceeds are erroneously credited to my payroll account/disbursement card, I hereby authorize Pag-IBIG
Fund to debit/deduct the excess amount from my account without need of further notice of demand. Should my account balance be
insufficient, the Fund has the right to demand for the excess amount to be refunded.
I authorize Pag-IBIG Fund to disclose, submit, share or exchange any of my account information to legal and government regulating
agencies, other banks, partner-merchants or third party in accordance with R.A. No. 9510 (Credit Information System Act), R.A.
No. 10173 (Data Privacy Act of 2012), and other related or pertinent laws and regulations, as described in Pag-IBIG Fund’s
Freedom of Information (FOI) Manual. The credit information may also be transferred to service providers (e.g., Credit Information
Corporation, Bankers Association of the Philippines - Credit Bureau), likewise in accordance with laws and regulations.
Furthermore, I have read, understood and agree to be bound by the terms and conditions governing the
eDisbursement Facility/Program and Pag-IBIG Fund’s partner-banks’ internal guidelines.
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.
This office agrees to collect the corresponding monthly
amortization on this loan and the MS of herein applicant through
salary deduction, together with the employer counterpart, and
remit said amounts to Pag-IBIG Fund on or before the 15
th
day
of each month, for the duration that the loan remains
outstanding. However, should we deduct the monthly
amortization due from the applicant’s salary but failed to remit it
on due date, this office agrees to pay the corresponding penalty
charged to applicant equivalent to 1/20 of 1% of any unpaid
amount for every day of delay and penalty for non-remittance
equivalent to 1/10 of 1% per day of delay of the amount payable
from the date the loan amortization or payments fall due until
paid.
_________________________________________
HEAD OF OFFICE OR AUTHORIZED SIGNATORY
(Signature over Printed Name)
____________________________________
Signature of Applicant Over Printed Name
___________________________________________
DESIGNATION
______________
Pag-IBIG
EMPLOYER ID
NO.
_______________
AGENCY CODE
______________
BRANCH CODE
PROMISSORY NOTE
For value received, I promise to pay on due date without need of demand to the order of
Pag-IBIG Fund with principal office at Petron MegaPlaza, 358, Sen. Gil Puyat Avenue., City of
Makati the sum of Pesos:
(P_______________) Philippine Currency, with an interest rate of 5.95% per annum, with
interest during the grace period and shall be amortized equally over the term of the loan.
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.
Finally, this note shall likewise be subject to the following terms and conditions:
1. I shall pay the amount of Pesos: _______________________________
(P_______________) through salary deduction, whenever feasible, over a maximum
period of 24 months, with a grace period of three (3) months. In case of suspension from
work, leave of absence without pay, insufficiency of take home pay during the term of the
loan, payments should be made directly to the Pag-IBIG Fund office where the loan was
released.
2. Payments are due on or before the 15
th
day of the month starting on
_________________________ and 23 succeeding months thereafter.
3. Payments shall be applied according to the following order of priorities: Penalties, Interest
and Principal.
4. A penalty of 1/20 of 1% of any unpaid amount for every day of delay shall be charged to
me.
5. I shall be considered in default in any of the following cases:
a. Any willful misrepresentation made in any of the documents executed in relation hereto;
b. Failure to pay any three (3) consecutive monthly amortizations;
c. Failure to pay any three (3) consecutive monthly membership savings;
d. Violation of any of the membership/STL/housing loan policies, rules, regulations and guidelines of
the Pag-IBIG Fund.
6. In the event of default, the outstanding loan obligation shall become due and demandable shall be
deducted from the Total Accumulated Value (TAV), after exerting all collection efforts. As a
consequence, thereof the outstanding loan obligation, consisting of the principal, interest and
penalties shall be subjected to offsetting against my TAV. However, immediate offsetting of my
outstanding Calamity Loan obligation may be effected immediately upon approval of my request,
provided such request is based on the following justifiable reasons and upon validation by the Fund:
Borrower’s unemployment; illness of the member-borrower or any of his immediate family members
as certified by a licensed physician, by reason thereof, resulted in his failure to pay the required
amortization when due; or death of any of his immediate family members, by reason thereof,
resulted in his failure to pay the required amortization when due.
7. In the event of membership termination prior to loan maturity, any outstanding loan balance,
including the unpaid interest, penalties and charges, shall be deducted from my TAV and/or any
amount due to my beneficiaries in the possession of the Fund. In case of my death, the outstanding
obligation shall be computed up to the date of death. Any payment received after date of death
.shall be refunded to my beneficiaries.
8. In case of falsification, misrepresentation or any similar acts committed by me, Pag-IBIG Fund shall
automatically suspend my loan privileges indefinitely. I shall abide with all the applicable rules and
regulations governing this lending program that Pag-IBIG Fund may promulgate from time to time.
__________________________________
Signature of Applicant over Printed Name
Signed in the presence of:
___________________________________
Witness
(Signature over Printed Name)
__________________________________
Witness
(Signature over Printed Name)
AUTHORITY TO DEDUCT (Optional)
In case of retirement/separation from employment, I hereby authorize my employer to deduct any outstanding Calamity Loan balance from my
retirement or separation benefits to fully settle my loan obligation. In the event that my retirement/separation benefits are not sufficient to settle
the outstanding balance of my Calamity Loan or my employer fails for whatever reason, to deduct the same from said retirement/separation
benefits, I hereby authorize Pag-IBIG Fund to apply whatever benefits are due me from the Fund to settle the said obligation.
SIGNATURE OF APPLICANT
THIS PORTION IS FOR Pag-IBIG FUND USE ONLY
RECEIVED BY DATE
REVIEWED BY DATE
APPROVED/DISAPPROVED BY DATE
THIS FORM CAN BE REPRODUCED. NOT FOR SALE
In the event of the approval of my application for Calamity Loan, I hereby authorize Pag-IBIG
Fund to credit my loan proceeds through my Payroll Account/Disbursement Card that I have
indicated on the right portion.
SIGNATURE OF APPLICANT
PAYROLL ACCOUNT/DISBURSEMENT CARD/PACKAGE UNIT ID
NAME OF BANK/BRANCH
GUIDELINES AND INSTRUCTIONS
A. Who May File
Any Pag-IBIG Fund member who satisfies the following requirements:
1. Has made at least twenty-four (24) monthly savings (MS);
A member who has withdrawn his MS due to membership maturity, or who has optionally withdrawn his MS,
cannot avail a calamity loan unless and until after he has subsequently paid 24 MS following the month of
said withdrawal.
A member who does not meet the required 24 MS may nevertheless, be allowed to avail of a calamity loan
if his total savings is at least equivalent to 24 MS, at the rate applicable to him.
2. Has made at least one (1) MS for the last six (6) months as of month prior to date of loan application;
3. If with existing Pag-IBIG Housing Loan, the account must not be in default as of the date of application;
4. If with existing MPL and/or Calamity Loan, the account/s must not be in default as of date of application;
5. Is a resident of the area which is declared calamity-stricken; and
6. Has sufficient proof of income.
B. How to File
The applicant shall:
1. Secure the Calamity Loan Application Form (CLAF) from any Pag-IBIG Fund Branch or download from
Pag-IBIG website at www.pagibigfund.gov.ph.
2. Accomplish 1 copy of the application form.
3. For releasing of loan proceeds through Payroll Account/Disbursement Card, attach photocopy of payroll
account/disbursement card/deposit slip (for newly-opened account).
4. Submit accomplished application, together with the required documents to any Pag-IBIG Fund Branch.
Processing of loans shall commence only upon submission of complete documents.
C. Loan Features
1. Loan Amount
A qualified Pag-IBIG member shall be allowed to borrow an amount based on the lowest of the following:
1.1 Desired Loan Amount
1.2 Loan Entitlement
The loan entitlement shall be equivalent to eighty percent (80%) of TAV. However, if the borrower has an
existing MPL, the loanable amount shall be the difference between the 80% of the borrower’s TAV and the
outstanding balance of his MPL.
1.3 Capacity to Pay
The loanable amount shall be limited to an amount which will not render the borrower’s Net Take Home
Pay (NTPH) to fall below the minimum requirement as prescribed by the General Appropriation Act (GAA)
or company policy, whichever is applicable.
2. Interest Rate
The loan shall be charged with an interest rate of 5.95% per annum, with interest during the grace period and
shall be amortized equally over the term of the loan.
3. Loan Term
The loan shall be repaid over a maximum period of twenty-four (24) months, with a grace period of three (3)
months.
4. Loan Release
The loan proceeds shall be released through any of the following modes:
a) Crediting to the borrower’s disbursement card;
b) Crediting to the borrower’s bank account through LANDBANK’s Payroll Credit Systems Validation
(PACSVAL);
c) Check payable to the borrower. However, when the check remains unclaimed for a period of thirty (30)
days from the DV/Check date, the said loan shall be cancelled and the loan shall be reversed.
d) Other acceptable modes of disbursement.
5. Loan Payments
5.1 The loan shall be repaid in equal monthly payments in such amounts as may fully cover the principal and
interest over the loan period. Said amortization shall be made, whenever feasible, through salary
deduction.
5.2 For self-employed individuals, Overseas Filipino Workers (OFWs) or other types of individual payors,
monthly payments shall be paid over-the-counter or any other modes of payment approved by the Fund.
5.3 Payments shall be remitted to the Fund on or before the fifteenth (15
th
) day of each month starting on the
fourth (4
th
) month following the date on the DV/check or manual disbursement voucher.
5.4 If the due date falls on a non-working day, the monthly amortization shall be paid on the first working day
after the due date.
5.5 The borrower may fully pay the outstanding balance of the loan prior to loan maturity.
5.6 The borrower shall pay directly to the Fund in case the borrower is unable to pay through salary deduction
for any of the following circumstances:
a. Suspension from work;
b. Leave of absence without pay;
c. Insufficiency of take home pay at any time during the term of the loan; or
d. Other circumstances analogous to the foregoing.
5.7 Payments shall be applied according to the following order of priorities:
a. Penalties; if any
b. Interest; and
c. Principal
5.8 Any amount in excess of the required monthly amortization shall be applied to succeeding amortizations
which will be posted on the next due date.
6. Penalties
A penalty of 1/20 of 1% of any unpaid amount shall be charged to the borrower for every day of delay. For
borrowers paying through salary deduction, penalties shall only be reversed upon presentation of proof that
non-payment was due to the fault of the employer. In such case, penalties due from the borrower shall be
charged to the employer. Non-remittance of the total amortization shall likewise subject the employer with a
penalty of 1/10 of 1% per day of delay of the amounts payable from the date the loan amortization or payments
fall due until paid.
7. Default
The borrower shall be 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 of the borrower to pay any three (3) consecutive monthly amortizations;
c. Failure of the borrower to pay any three (3) consecutive MS; or
d. Violation by the borrower of any of the membership/STL/housing loan policies, rules, regulations and
guidelines of Pag-IBIG Fund.
8. Effects of Default
In the event of default, the outstanding loan obligation shall become due and demandable. The outstanding
loan obligation shall be deducted from the TAV after exerting all collection efforts.
D. Availment Period
The Pag-IBIG member-victim must avail himself of the Pag-IBIG calamity loan within a period of ninety (90) days
from the declaration of calamity.
E. Other Loan Provisions
1. The calamity loan and MPL shall be treated as separate and distinct from each other. Hence, the member
shall be allowed to avail of an MPL while he still has an outstanding calamity loan and vice versa. Application
for loans on these two programs shall be governed by their corresponding guidelines. The outstanding loan
balance of the MPL shall not be deducted from the proceeds of the calamity loan.
2. In no case shall the aggregate STL exceeds 80% of the borrower’s TAV.
3. Should another calamity occur in the same area, a borrower may renew his calamity loan anytime. The
outstanding balance of his existing loan, together with any accrued interests, penalties and charges, shall be
deducted from the proceeds of the new calamity loan.
4. In the event of membership termination prior to loan maturity, the outstanding balance shall be deducted from
the borrower’s TAV, and/or any amount due him or his beneficiaries in the possession of the Fund. In case of
borrower’s death, the outstanding balance shall be computed up to the date of death. Any payments received
after death shall be refunded to the borrower’s beneficiaries.
5. Offsetting of the borrower’s outstanding calamity loan balance against his TAV shall be effected immediately
upon approval of the borrower’s request; provided, such request is based on any of the following justifiable
reasons and has been verified by the Fund: Borrower’s unemployment; Illness of the borrower or any of his
immediate family members as certified by a licensed physician that, by reason thereof, resulted in his failure
to pay the required amortizations when due; or death of any of his immediate family members that, by reason
thereof, resulted in his failure to pay the required amortizations when due.
6. If TAV offsetting has been effected on the borrower’s defaulting calamity loan, he may apply for a new calamity
loan provided he has paid at least 6 monthly amortizations prior to default and its consequent offsetting against
the borrower’s TAV. However, if he has paid less than 6 monthly amortizations prior to default, he may apply
for a new loan only after two (2) years from the date of TAV offsetting.
Issued this _______ day of _________, 20__.
I certify under pain of perjury that the above-
mentioned information is true and correct.
___________________________________________
HEAD OF OFFICE/AUTHORIZED SIGNATORY
(Signature over printed name)
CERTIFICATE OF NET PAY
NAME OF BORROWER
For the month of:
_________________
Basic Salary
_________________
Add: Allowances
_____________________
__________
_____________________
__________
_____________________
__________
_____________________
__________
_____________________
__________
_____________________
__________
Gross Monthly Income
__________
Less: Deductions
_____________________
__________
_____________________
__________
_____________________
__________
_____________________
__________
_____________________
__________
_____________________
__________
Total Deductions
__________
Net Monthly Income
__________
Issued this ________ day of ____, 20___.
I certify under pain of perjury that the
above-mentioned information is true and
correct.
________________________________________
HEAD OF OFFICE/AUTHORIZED SIGNATORY
(Signature Over Printed Name)
HQP-SLF-066
(V05, 02/2020)
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SLF066 Calamity Loan Application Form V05 Fillable Final

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Completed 16 July 2020

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