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    HLF913 AuthorizedRepresentativenInformationSheet V01

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    bookingrequest11
    This document is an authorized representative information sheet for Pag-IBIG Fund, a Philippine government housing loan program. It collects personal information about the authorized representative such as name, address, contact details, relationship to the applicant, and asks questions about past legal issues or representation of other housing loans. The authorized representative must certify that the information is true and correct, authorize sharing of personal information, and agree to Pag-IBIG Fund's policies, including being responsible for fees. They also cannot have a conflict of interest with any vendors involved in the loan.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    HLF913 AuthorizedRepresentativenInformationSheet V01

    Uploaded by

    bookingrequest11
    2K views1 page
    This document is an authorized representative information sheet for Pag-IBIG Fund, a Philippine government housing loan program. It collects personal information about the authorized representative such as name, address, contact details, relationship to the applicant, and asks questions about past legal issues or representation of other housing loans. The authorized representative must certify that the information is true and correct, authorize sharing of personal information, and agree to Pag-IBIG Fund's policies, including being responsible for fees. They also cannot have a conflict of interest with any vendors involved in the loan.

    Original Description:

    housing loan documents

    Original Title

    HLF913_AuthorizedRepresentativenInformationSheet_V01

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    © © All Rights Reserved

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    This document is an authorized representative information sheet for Pag-IBIG Fund, a Philippine government housing loan program. It collects personal information about the authorized representative such as name, address, contact details, relationship to the applicant, and asks questions about past legal issues or representation of other housing loans. The authorized representative must certify that the information is true and correct, authorize sharing of personal information, and agree to Pag-IBIG Fund's policies, including being responsible for fees. They also cannot have a conflict of interest with any vendors involved in the loan.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views1 page

    HLF913 AuthorizedRepresentativenInformationSheet V01

    Uploaded by

    bookingrequest11
    This document is an authorized representative information sheet for Pag-IBIG Fund, a Philippine government housing loan program. It collects personal information about the authorized representative such as name, address, contact details, relationship to the applicant, and asks questions about past legal issues or representation of other housing loans. The authorized representative must certify that the information is true and correct, authorize sharing of personal information, and agree to Pag-IBIG Fund's policies, including being responsible for fees. They also cannot have a conflict of interest with any vendors involved in the loan.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    HQP-HLF-913

    (V01, 01/2023)

    AUTHORIZED REPRESENTATIVE INFORMATION SHEET


    (PRINT ALL ENTRIES IN BLOCK OR CAPITAL LETTERS)

    AUTHORIZED REPRESENTATIVE’S DATA


    LAST NAME FIRST NAME NAME EXTENSION MIDDLE NAME

    ATTACH HERE
    RELATIONSHIP TO THE MEMBER-APPLICANT/BORROWER/BUYER/SELLER DATE OF BIRTH (mm/dd/yy) CITIZENSHIP 1”X1”
    ❑ Consanguinity/Affinity ______________________________________________ ID PHOTO OF
    (Please indicate relationship to Member-applicant/Borrower/Co-Borrower/Buyer/Seller) APPLICANT
    ❑ Attorney-In-Fact to _________________________________________________
    (Please indicate name of Member-applicant/Borrower/Co-Borrower/Buyer/Seller)
    EE SSS/GSIS ID No. TIN SEX MARITAL STATUS
    ❑M ❑F ❑ Single/Unmarried ❑ Married ❑ Widow/er
    ❑ Legally Separated ❑ Annulled
    PERMANENT HOME ADDRESS AUTHORIZED REPRESENTATIVE’S
    Unit/Room No., Floor Building Name Lot No., Blk No., Phase No., House No. Street Name CONTACT DETAILS (Indicate country code if
    abroad)
    COUNTRY + AREA CODE TELEPHONE NO.
    Subdivision Barangay Municipality/City Province and State Country (if abroad) ZIP Code
    Home

    PRESENT HOME ADDRESS


    Unit/Room No., Floor Building Name Lot No., Block No., Phase No., House No. Street Name Cell Phone

    Subdivision Barangay Municipality/City Province and State Country (if abroad) ZIP Code Email Address

    MISCELLANEOUS
    (Answer the following questions with YES or NO. If your answer is YES, please elaborate on the details as required)
    Have you ever been assigned as Pag-IBIG Fund’s authorized housing loan representative in the past? ❑ Yes ❑ No
    If yes, please indicate the previous number of housing loan accounts you have represented.
    Are you being compensated by the Housing Loan Applicant as Attorney-in-fact? ❑ Yes ❑ No
    If Yes, please indicate the creditor’s name, nature and amount involved.
    Are there past or pending cases against you? ❑ Yes ❑ No
    If Yes, please indicate the nature, plaintiff, amount involved and the status.
    CHARACTER REFERENCES
    NAME ADDRESS TEL. NO.

    CERTIFICATION
    I hereby certify that the foregoing information/statement is to my knowledge, true, correct, complete, and updated. The signature appearing above my printed name
    below is genuine.
    I authorize Pag-IBIG Fund to share my personal information with other government agencies and third parties, as may be necessary in the management of his/her/their
    account/s, subject to the limits under Republic Act No. 10173 (Data Privacy Act of 2012), and its Implementing Rules and Regulations. Further, I promise to notify Pag-IBIG
    Fund of any amendments or changes in my personal information indicated herein.
    I hereby certify that I do not represent a counter party in any transaction related to Housing Loan application, and that I am not an attorney-in-fact or employee of a
    vendor/real estate broker representing the vendor or has business interest for a vendor/contractor/broker, etc., that may be engaged in the procurement of the loan with Pag-
    IBIG Fund; and if I do, I must fully disclose such interests in the form.
    I hereby state whether I am compensated/not compensated by the Housing Loan Applicant as Attorney-in fact.

    I hereby agree that any misrepresentation of a material fact is a ground for disapproval of the application, cancellation of the loan, and shall be a cause for the total
    outstanding obligation to be due and demandable and shall be subject to other sanctions provided in existing Pag-IBIG Fund guidelines. I agree to notify Pag-IBIG Fund of
    any material change affecting the information contained herein. I agree that all information obtained by Pag-IBIG Fund shall remain its property whether or not the loan is
    granted.
    I further agree to be bound by the current and general policies of Pag-IBIG Fund and those that the Pag-IBIG Fund may adopt in the future, that may have relation to or
    in any way affect his/her/their loan.
    I understand that the processing/service/filing fee, notarial and all other fees pertaining to the registration of mortgage on property shall be for his/her/their account.

    _____________________________________________________________
    SIGNATURE OVER PRINTED NAME OF AUTHORIZED REPRESENTATIVE

    ___________________________________
    DATE

    THIS FORM CAN BE REPRODUCED. NOT FOR SALE.

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