HQP-SLF-065

MULTI-PURPOSE LOAN (MPL) (V05, 02/2021)

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 MIDDLE NAME MAIDEN MIDDLE NAME NO MIDDLE NAME DATE OF BIRTH PLACE OF BIRTH
(e.g., Jr., II) (for married women) (check if applicable only)

MOTHER’S MAIDEN NAME NATIONALITY SEX MARITAL STATUS CITIZENSHIP EMAIL ADDRESS
 Male  Single  Widow/er  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 TELEPHONE 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 TELEPHONE NUMBER NATURE OF WORK

Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code EMPLOYEE ID NUMBER DESIRED LOAN AMOUNT

EMPLOYER/BUSINESS NAME DATE OF EMPLOYMENT LOAN PURPOSE

Non-Housing Related
 Livelihood/additional capital in small business  Vacation/travel
EMPLOYER/BUSINESS ADDRESS Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. Street Name  Tuition/Educational Expenses  Special events
 Payment of utility/credit card bills  Car repair
 Purchase of appliance & furniture/electronic  Health & wellness
gadgets
Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code
Housing Related
 Minor home improvement/home renovation/  Others, specify
upgrades ________________
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

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 Implementing This office agrees to collect the corresponding monthly
Rules and Regulations of Pag-IBIG Fund, I hereby waive my rights under R.A. No. 1405 (Secrecy of Bank Deposits Act) and amortization on this loan and the MS of herein applicant
authorize 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 employer with whom I may get counterpart, and remit said amounts to Pag-IBIG Fund on or
employed in the future, to deduct the membership savings (MS) and monthly amortization due from my salary and remit the same to before the 15th day of each month, for the duration that the
Pag-IBIG Fund. If the resulting monthly net take home pay after deducting the computed monthly amortization on MPL falls below the loan remains outstanding. However, should we deduct the
monthly net take home pay as required under the GAA/company policy, I authorize Pag-IBIG Fund to compute for a lower loanable monthly amortization due from the applicant’s salary but failed
amount. to remit it on due date, this office agrees to pay the
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 corresponding penalty charged to applicant equivalent to 1/20
amount for every day of delay. of 1% of any unpaid amount for every day of delay and
If for any reason excess loan proceeds are erroneously credited to my payroll account/disbursement card, I hereby authorize Pag-IBIG
penalty for non-remittance equivalent to 1/10 of 1% per day of
Fund to debit/deduct the excess amount from my account without need of further notice of demand. Should my account balance be delay of the amount payable from the date the loan
insufficient, the Fund has the right to demand for the excess amount to be refunded. amortization or payments fall due until paid.
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 _________LAWRENCE T. TEJADA_________
Information (FOI) Manual. The credit information may also be transferred to service providers (e.g., Credit Information Corporation, HEAD OF OFFICE OR AUTHORIZED SIGNATORY
Bankers Association of the Philippines - Credit Bureau), likewise in accordance with laws and regulations. (Signature Over Printed Name)
Furthermore, I have read, understood and agree to be bound by the terms and conditions governing the
_____ Human Resources Manager __
eDisbursement Facility/Program and Pag-IBIG Fund’s partner-banks’ internal guidelines.
DESIGNATION
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.
800167271945 _______________ ______________
___________________________________ Pag-IBIG AGENCY CODE BRANCH CODE
Signature of Applicant Over Printed Name EMPLOYER ID NO.
PROMISSORY NOTE
5. I shall be considered in default in any of the following cases:
For value received, I promise to pay on due date without need of demand to the order of
a. Any willful misrepresentation in any of the documents executed in relation hereto;
Pag-IBIG Fund with principal office at Petron MegaPlaza, 358, Sen. Gil Puyat Avenue., City
b. Failure to pay any three (3) consecutive monthly amortizations;
of Makati the sum of Pesos:
c. Failure to pay any three (3) consecutive membership savings;
(P_______________) Philippine Currency, with an interest at the rate of 10.5% per annum d. Violation of any of the membership/STL/housing loan policies, rules, regulations, and
(equivalent rate of 17.50% based on diminishing principal balance), with interest during the guidelines of the Pag-IBIG Fund.
grace period and shall be amortized equally over the term of the loan. 6. In the event of default, the outstanding loan obligation shall become due and shall be
deducted from the Total Accumulated Value (TAV) after exerting all collection
I hereby waive notice of demand for payment and agree that any legal action, which may efforts. However, immediate offsetting of my outstanding loan obligation may be
arise in relation to this note, may be instituted in the proper court of Makati City. 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
Finally, this note shall likewise be subject to the following terms and conditions: unemployment; illness of the member-borrower or any of his immediate family
1. I shall pay the amount of Pesos: _______________________________ members as certified by a licensed physician that, by reason thereof, resulted in his
(P_______________) through salary deduction, whenever feasible, over a maximum failure to pay the required amortization when due; or death of any of his immediate
period of 24 months, with a grace period of 2 months. In case of suspension from family members that, by reason thereof, resulted in his failure to pay the required
work, leave of absence without pay, insufficiency of take home pay at any time during amortization when due.
the term of the loan, payments should be made directly to the Fund or its accredited 7. In the event of membership termination prior to loan maturity, any outstanding loan
collecting agents. obligation, shall be deducted from my TAV and/or any amount due me or my
2. Payments are due on or before the 15 th day of the month starting on beneficiaries in the possession of the Fund. In case of my death, the outstanding
_________________________ and 23 succeeding months thereafter. obligation shall be computed up to the date of death. Any payment received after date
3. Payments shall be applied according to the following order of priorities: Penalties, of death shall be refunded to my beneficiaries.
Interest and Principal. 8. In case of falsification, misrepresentation or any similar acts committed by me,
4. A penalty of 1/20 of 1% of any unpaid amount shall be charged to me for every day of Pag-IBIG Fund shall automatically suspend my loan privileges indefinitely. I shall
delay. 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:
________________________________ ________________________________ __________________________________
Witness Witness Signature of Applicant Over Printed Name
(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 are 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
RECEIVED BY: APPROVED/DISAPPROVED BY:

(SIGNATURE OVER PRINTED NAME) _____________ (SIGNATURE OVER PRINTED NAME) _____________
(POSITION/DESIGNATION) DATE (POSITION/DESIGNATION) DATE

THIS FORM CAN BE REPRODUCED. NOT FOR SALE

 HQP-SLF-065
GUIDELINES AND INSTRUCTIONS (V05, 02/2021)
A. Who May File
Any Pag-IBIG Fund member who satisfies the following requirements:
1. Has made at least 24 monthly membership savings (MS);
 A member who has withdrawn his MS due to membership maturity or who has optionally withdrawn his
MS, cannot obtain an MPL unless and until after he has subsequently paid 24 MS following the month of
CERTIFICATE OF NET PAY the said withdrawal.
 A member, who does not meet the required 24 MS, may nevertheless, be allowed to avail of an MPL 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 within the last six (6) months prior to the 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;
and
5. Has sufficient proof of income.
B. How to File
NAME OF BORROWER The applicant shall:
1. Secure the Multi-Purpose Loan Application Form (MPLAF) 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.
For the month of: _________________ 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.
Basic Salary _________________ 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:
Add: Allowances 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 calamity loan, the loanable amount shall be the difference between the 80% of the
borrower’s TAV and the outstanding balance of his calamity loan.
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 (NTHP) 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 of 10.5% p.a. (equivalent rate of 17.50% based on diminishing
principal balance) 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 two (2)
_____________________ __________ 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)
calendar days from the DV/Check date, the loan shall be cancelled.
d) Other acceptable modes of disbursement.
Gross Monthly Income __________ 5. Loan Payments
5.1 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.
Less: Deductions 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 third (3rd) 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
Issued this _______ day of _________, 20__. b. Leave of absence without pay
_____________________
I certify under pain of perjury that__________
the above- c. Insufficiency of take home pay at any time during the term of the loan; or
d. Other circumstances analogous to the foregoing.
mentioned information is true and correct. 5.7 Payment shall be applied according to the following order of priorities:
____________________ __________ a. Penalties; if any
b. Interest; and
c. Principal
_____________________ __________
D. ___________________________________________
Loan Renewal
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.
HEAD OF OFFICE/AUTHORIZED SIGNATORY
6. Penalties
E. Loan Renewal (Signature over printed name)
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 only upon presentation of proof
that non-payment was due to the fault of the employer. In such case, penalties due from the borrower shall
Total Deductions __________ be charged to the employer. Non-remittance of the total loan 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.
Net Monthly Income __________ 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.
Issued this ________ day of ____, 20___. D. Other Provisions
1. The MPL and/or Calamity Loan programs 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
I certify under pain of perjury that the versa. Application for loans on these two programs shall be governed by their corresponding guidelines.
The outstanding loan balance of the calamity loan shall not be deducted from the proceeds of the MPL.
above-mentioned information is true and 2. In no case shall the aggregate STL exceed eighty percent (80%) of the borrower’s TAV.
correct. 3. A borrower may renew his MPL after payment of equivalent to six (6) monthly amortizations; not earlier than
the sixth (6th) monthly amortization due date; and provided that he meets the eligibility requirement. The
proceeds of the new loan shall be applied to the borrower’s outstanding MPL obligation and the net
_______ LAWRENCE T. TEJADA_________ proceeds shall then be released to him. In case of full payment prior to loan maturity, a borrower shall be
HEAD OF OFFICE/AUTHORIZED SIGNATORY allowed to apply for a new loan anytime thereafter.
(Signature Over Printed Name) 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 MPL 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 MPL, he may apply for a new MPL 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.