MULTI-PURPOSE LOAN (MPL) HQP-SLF-065

(For IISP Branch Only)

APPLICATION FORM Pag-IBIG MID No./RTN APPLICATION No.
(To be filled out by applicant. Print this form back to back on one single sheet of paper)
Type or Print Entries
LAST NAME FIRST NAME NAME EXTENSION (e.g., Jr., II) MIDDLE NAME MAIDEN MIDDLE NAME DATE OF BIRTH PLACE OF BIRTH
(For married women)

MOTHER’S MAIDEN NAME NATIONALITY SEX MARITAL STATUS CITIZENSHIP EMAIL ADDRESS
 Male  Single  Widower  Annulled
 Female  Married  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 TEL. NUMBER

Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code APPLICANT’S TAXPAYER SSS/GSIS No.
IDENTIFICATION NUMBER (TIN)

PERMANENT HOME ADDRESS Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. Street Name BUSINESS TEL. NUMBER NATURE OF WORK

Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code DATE OF EMPLOYMENT EMPLOYEE ID NUMBER

EMPLOYER/BUSINESS NAME DESIRED LOAN AMOUNT

 Max of 60% (24-59 mos.)  Max of 70% (60-119 mos.)
 Max of 80% (at least 120 mos.)  Other, please specify __________
EMPLOYER/BUSINESS ADDRESS Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. Street Name LOAN PURPOSE
Non-Housing Related Housing Related
 Home Enhancement  House Repair
Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code  Tuition/Educational Expense  Minor home improvement
 Health and Wellness
 Livelihood  Others, specify _______________
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)

SIGNATURE OF APPLICANT PAYROLL ACCOUNT/DISBURSEMENT CARD/PACKAGE UNIT ID

In the event of the approval of my application for Multi-Purpose Loan, I hereby authorize
Pag-IBIG Fund to credit my loan proceeds through my Payroll Account/Disbursement Card
NAME OF BANK/BRANCH
that I have indicated on the right portion.

APPLICATION AGREEMENT
In consideration of the loan that may be granted by virtue of this application subject to the pertinent provisions of the This office agrees to collect the corresponding monthly
Implementing Rules and Regulations of Pag-IBIG Fund, I hereby waive my rights under R.A. No. 1405 and authorize amortization on this loan and the MS of herein applicant
Pag-IBIG Fund to verify/validate my payroll account/disbursement card. Furthermore, I hereby authorize my present through salary deduction, together with the employer
employer, ______________________________________________________________________________ or any counterpart, and remit said amounts to Pag-IBIG Fund on or
employer with whom I may get employed in the future, to deduct the monthly membership savings (MS) and monthly before the 15th day of each month, for the duration that the loan
amortization due from my salary and remit the same to Pag-IBIG Fund. If the resulting monthly net take home pay after remains outstanding. However, should we deduct the monthly
deducting the computed monthly amortization on MPL falls below the monthly net take home pay as required under the amortization due from the applicant’s salary but failed to remit it
GAA/company policy, I authorize Pag-IBIG Fund to compute for a lower loanable amount. on due date, this office agrees to pay the corresponding
penalty charged to applicant equivalent to 1/20 of 1% of any
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 and penalty for non-
unpaid amount for every day of delay. remittance equivalent to 1/10 of 1% per day of delay of the
If for any reason excess loan proceeds are erroneously credited to my payroll account/disbursement card, I hereby amount payable from the date the loan amortization or
authorize Pag-IBIG Fund to debit/deduct the excess amount from my account without need of further notice of demand. payments fall due until paid.
Should my account balance be insufficient, the Fund has the right to demand for the excess amount to be refunded.
I further authorize Pag-IBIG Fund to disclose my personal information to legal and regulating authorities as appropriate in _________________________________________
compliance with Anti-Money Laundering Act. HEAD OF OFFICE OR AUTHORIZED SIGNATORY
(Signature over Printed Name)
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.

________________________________________________
DESIGNATION
______________ _______________ ______________
___________________________________ Pag-IBIG AGENCY CODE BRANCH CODE
Signature of Applicant over Printed Name EMPLOYER ID NO.

PROMISSORY NOTE
For value received, I promise to pay on due date without need of demand to the order of Pag-
5. I shall be considered in default in any of the following cases:
IBIG Fund with principal office at Petron MegaPlaza, 358, Sen. Gil Puyat Avenue., City of Makati
a. Any willful misrepresentation in any of the documents executed in relation hereto;
the sum of Pesos:
b. Failure to pay any three (3) consecutive monthly amortizations;
(P_______________) Philippine Currency, with an interest at the rate of 10.5% per annum c. Failure to pay any three (3) consecutive membership savings;
(effective rate of 17.50%), with interest during the grace period capitalized and paid equally over d. Violation of any policies, rules, regulations and guidelines of the Pag-IBIG Fund.
the term of the loan. 6. In the event of default, the outstanding loan obligation shall become due and demandable. As
a consequence thereof, the outstanding loan obligation, consisting of the principal, interest and
I hereby waive notice of demand for payment and agree that any legal action, which may arise penalties shall be subjected to offsetting against my Total Accumulated Value (TAV). However,
in relation to this note, may be instituted in the proper court of Makati City. immediate offsetting of my outstanding loan obligation may be effected immediately upon
approval of my request, provided such request is based on the following justifiable reasons
Finally, this note shall likewise be subject to the following terms and conditions: and upon validation by the Fund: Borrower’s unemployment; illness of the member-borrower or
1. I shall pay the amount of Pesos: _______________________________ any of his immediate family member as certified by a licensed physician, by reason thereof,
(P_______________) through salary deduction, whenever feasible, over a maximum resulted in his failure to pay the required amortization when due; or death of any of his
period of 24 months, with a grace period of 2 months. In case of suspension from work, immediate family members, by reason thereof, resulted in his failure to pay the required
leave of absence without pay, insufficiency of take home pay at any time during the term of amortization when due.
the loan, payments should be made directly to the Fund or its accredited collecting agents. 7. In the event of membership termination prior to loan maturity, any outstanding loan obligation,
2. Payments are due on or before the 15th day of the month starting on shall be deducted from my TAV and/or any amount due me or my beneficiaries in the
_________________________ and 23 succeeding months thereafter. possession of the Fund. In case of my death, the outstanding obligation shall be computed up
3. Payments shall be applied according to the following order of priorities: Penalties, Interest to the date of death. Any payment received after death shall be refunded to my beneficiaries.
and Principal. 8. In case of falsification, misrepresentation or any similar acts committed by me, Pag-IBIG Fund
4. A penalty of 1/20 of 1% of any unpaid amount for every day of delay. 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.
Signed in the presence of:
__________________________________
___________________________________ __________________________________ Signature of Applicant over Printed Name
Witness Witness
(Signature over Printed Name) (Signature over Printed Name)

AUTHORITY TO DEDUCT (Optional)

In case of retirement/separation from employment, I hereby authorize my employer to deduct any outstanding MPL balance from my retirement SIGNATURE OF APPLICANT
or separation benefits to fully settle my loan obligation. In the event that my retirement/separation benefits is not sufficient to settle the
outstanding balance of my MPL 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.
THIS PORTION IS FOR Pag-IBIG FUND USE ONLY
CLAIM/HOUSING LOAN/STL VERIFICATION
PARTICULARS WITH WITHOUT DV/CHECK / APPLICATION / P.N./AGREEMENT NO. DATE FILED VERIFIED DATE
CLAIMS
HOUSING LOAN
MULTI-PURPOSE LOAN (MPL)
CALAMITY LOAN
LOAN APPROVAL
LOAN AMOUNT GRANTED INTEREST PREVIOUS LOAN BALANCE LOAN PROCEEDS MONTHLY AMORTIZATION

REVIEWED BY DATE APPROVED BY DATE DISAPPROVED BY DATE

THIS FORM CAN BE REPRODUCED. NOT FOR SALE (V01, 05/2016)

 GUIDELINES AND INSTRUCTIONS
A. Loan Purpose
To provide financial assistance to Pag-IBIG I member for:
1. Minor home improvement/home renovation/upgrades;
2. Livelihood/additional capital in small business;
CERTIFICATE OF NET PAY 3. Tuition/educational expense;
4. Health and wellness;
5. Purchase of appliance and furniture/electronic gadgets;
6. Bills/credit card payment;
7. Vacation/travel;
8. Special events;
9. Car repair;
10. Balance transfer/debt consolidation; and
11. Other needs
NAME OF BORROWER B. Who May File
Any Pag-IBIG Fund member who satisfies the following requirements may apply for a Multi-Purpose
Loan (MPL):
For the month of: _________________ 1. The member has made at least 24 monthly contributions.
2. Has five (5) MCs for the last six (6) months as of month prior to date of loan application.
3. If with existing 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 is/are not in default as of date of
application.
Basic Salary _________________
C. How to File
The applicant shall:
Add: Allowances 1. Secure the Multi-Purpose Loan Application Form (MPLAF) from any Pag-IBIG Fund NCR/ Regional
branch.
2. Accomplish 1 copy of the application form.
_____________________ __________ 3. Attach photocopy of payroll account/disbursement card/deposit slip (for newly-opened account).
4. Submit complete application, together with the required documents to any Pag-IBIG Fund NCR/
Regional Branch. Processing of loans shall commence only upon submission of complete
_____________________ __________ documents.

D. Loan Features
1. Loan Amount
A qualified Pag-IBIG member shall be allowed to borrow an amount based on the lowest of the
following: desired loan amount, loan entitlement, capacity-to-pay.
_____________________ __________ 1.1 Loan Entitlement
The loan entitlement shall depend on the number of contributions the borrower has made, based
on the following schedule:
_____________________ __________ Number of Contributions Loan Amount
24 to 59 months Up to 60% of the Total Accumulated Value (TAV)
_____________________ __________ 60 to 119 months Up to 70% of the TAV
At least 120 months Up to 80% of the TAV

1.2 Capacity to Pay

An eligible borrower’s loan shall be limited to an amount for which statutory deductions, the
monthly repayment of principal and interest, and other obligations will not render the borrower’s
__________ net take home pay to fall below the minimum requirement as prescribed by the General
Gross Monthly Income Appropriation Act (GAA) or company policy, whichever is applicable.

If borrower has an existing Calamity Loan, the loanable amount shall be the difference between
80% of the borrowers TAV and the outstanding balance of his Calamity Loan; provided, it does
Less: Deductions not exceed the borrower’s loan entitlement.

2. Interest Rate and Loan Period

2.1 The loan shall be charged with a nominal interest of 10.5% p.a. (effective rate of 17.50%), with
_____________________ __________ interest during the grace period, capitalized and paid equally over the term of the loan.

2.2 The loan shall be repaid over a maximum period of twenty-four (24) months, with a grace period
of two (2) months.
_____________________ __________ 3. Loan Release
The loan proceeds shall be released through any of the following modes:
a) Crediting to the borrower’s cash card/disbursement card;
_____________________ __________ b) Crediting to the borrower’s bank account through LANDBANK’s Payroll Credit Systems Validation
(PACSVAL);
c) Through check payable to the borrower;
_____________________ __________ d) Other similar modes of payments.

4. Loan Payments
_____________________ __________ 4.1 The loan shall be paid 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.
4.2 Payments shall be remitted to the Fund on or before the fifteenth (15th) day of each month,
Total Deductions __________ starting on the third (3rd) month following the date on the DV/check.
4.3 The borrower may fully pay the outstanding balance prior to loan maturity.
4.4 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 such as but not limited to:
a. Suspension from work
Net Monthly Income __________ b. Leave of absence without pay
c. Insufficiency of take home pay at any time during the term of the loan
4.5 Payment shall be applied according to the following order of priorities:
a. Penalties
b. Interest
Issued this _______ day of _________, 20__. c. Principal
I certify under pain of perjury that the above- 4.6 Accelerated Payments – any amount in excess of the required monthly amortization shall be
applied to future amortizations when due.
mentioned information is true and correct.
5. Penalty
The borrower shall be charged a penalty of 1/20 of 1% of any unpaid amount for every day of delay.
However, for borrowers paying their loans through salary deduction, penalties shall be reversed only
upon presentation of proof that non-payment was due to the fault of the employer. The said penalties
___________________________________________ including the penalty for non-remittance equivalent to 1/10 of 1% per day of delay of the amount
HEAD OF OFFICE/AUTHORIZED SIGNATORY payable from the date the loan amortizations or payments fall due until paid, shall then be charged
against the employer.
(Signature over printed name)
6. 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 Pag-IBIG monthly amortizations.
c. Failure of the borrower to pay any three (3) consecutive Pag-IBIG monthly savings.
d. Violation by the borrower of any of the policies, rules, regulations and guidelines of Pag-IBIG
I hereby authorize ____________________________, Fund.
our Fund Coordinator or Liaison Officer to file my MPL
E. Other Provisions
Application and receive the Pag-IBIG Fund Check in 1. The MPL and Calamity Loan shall be treated as separate and distinct from each other. Hence, the
my behalf. member shall be allowed to avail of an MPL while he still has an outstanding Calamity Loan, and vice
versa. In no case, however, shall the aggregate short-term loan exceed eighty percent (80%) of the
borrower’s TAV.
2. For borrowers with existing Calamity Loan at the time of the availment of MPL, the outstanding loan
balance of the Calamity Loan shall not be deducted from the proceeds of the MPL.
________________________________
Signature of Applicant over Printed Name F. Loan Renewal
A borrower may renew his MPL upon payment of at least six (6) posted monthly amortizations and he
meets the eligibility requirement. The proceeds of the new loan shall be applied to the borrower’s
outstanding MPL obligation and the net proceeds shall then be released to the borrower.