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: JGC PHILIPPINES INC.
Company/Employer Address: 2109 Prime St. Madrigal Business Park,
Ayala Alabang, Muntinlupa City
Telephone No.: 876-6000 loc 84101 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