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PFF417 RequestResettingVirtualAccountPassword V01

This document is a request form for resetting a member's virtual Pag-IBIG account password. It requires the member to provide their name, date of birth, email address, phone number and reason for resetting. The member must then certify that the information is true and correct. The form has sections for the member signature and date, as well as for Pag-IBIG fund use with options to approve or disapprove the request.

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ajcn060492
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11K views1 page

PFF417 RequestResettingVirtualAccountPassword V01

This document is a request form for resetting a member's virtual Pag-IBIG account password. It requires the member to provide their name, date of birth, email address, phone number and reason for resetting. The member must then certify that the information is true and correct. The form has sections for the member signature and date, as well as for Pag-IBIG fund use with options to approve or disapprove the request.

Uploaded by

ajcn060492
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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HQP-PFF-417

(V01, 10/2023)

REQUEST FOR RESETTING OF MEMBER’S VIRTUAL


Pag-IBIG ACCOUNT PASSWORD
INSTRUCTIONS:
1. This form shall be accomplished in two (2) copies.
2. Print in BLOCK/CAPITAL LETTERS.
3. Submit the duly accomplished form together with photocopy of one (1) valid ID to any Pag-IBIG Fund Branch.
NAME (Last Name, First Name, Name Extension, if applicable and Middle Name) Pag-IBIG MID NO.

DATE OF BIRTH EMAIL ADDRESS CELL PHONE NO.

REASON FOR RESETTING

 Forgot password  Compromised account


 Failed to answer the security question thru Virtual Pag-IBIG  Others: Please specify, ____________________
CERTIFICATION
I hereby certify that the information given, and all statements made herein are true and correct. Likewise, I hereby authorize
Pag-IBIG Fund to collect record, organize, update/modify, consult, use, consolidate, block, erase or destruct my personal data as
part of my information. I hereby affirm my right to: (a) be informed; (b) object to processing; (c) access; (d) rectify, suspend or
withdraw my personal data; (e) damages; and (f) data portability pursuant to the provision of R.A. No. 10173 (Data Privacy Act of
2012).
_______________________________________ _________________
SIGNATURE OVER PRINTED NAME DATE
FOR Pag-IBIG FUND USE ONLY
RECEIVED BY:  APPROVED  DISAPPROVED

(SIGNATURE OVER PRINTED NAME) ______________ (SIGNATURE OVER PRINTED NAME) ______________
(POSITION/DESIGNATION) DATE (POSITION/DESIGNATION) DATE
REMARKS:

HQP-PFF-417
(V01, 10/2023)

REQUEST FOR RESETTING OF MEMBER’S VIRTUAL


Pag-IBIG ACCOUNT PASSWORD
INSTRUCTIONS:
1. This form shall be accomplished in two (2) copies.
2. Print in BLOCK/CAPITAL LETTERS.
3. Submit the duly accomplished form together with photocopy of one (1) valid ID to any Pag-IBIG Fund Branch.
NAME (Last Name, First Name, Name Extension, if applicable and Middle Name) Pag-IBIG MID No.

DATE OF BIRTH EMAIL ADDRESS CELL PHONE NO.

REASON FOR RESETTING

 Forgot password  Compromised account


 Failed to answer the security question thru Virtual Pag-IBIG  Others: Please specify, ____________________
CERTIFICATION
I hereby certify that the information given, and all statements made herein are true and correct. Likewise, I hereby authorize
Pag-IBIG Fund to collect record, organize, update/modify, consult, use, consolidate, block, erase or destruct my personal data as
part of my information. I hereby affirm my right to: (a) be informed; (b) object to processing; (c) access; (d) rectify, suspend or
withdraw my personal data; (e) damages; and (f) data portability pursuant to the provision of R.A. No. 10173 (Data Privacy Act of
2012).
_______________________________________ _________________
SIGNATURE OVER PRINTED NAME DATE
FOR Pag-IBIG FUND USE ONLY
RECEIVED BY:  APPROVED  DISAPPROVED

(SIGNATURE OVER PRINTED NAME) ______________ (SIGNATURE OVER PRINTED NAME) ______________
(POSITION/DESIGNATION) DATE (POSITION/DESIGNATION) DATE
REMARKS:

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