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GSIS Members Request Form 2as

The GSIS Member's Request Form is used to request transactions and services from the Government Service Insurance System (GSIS). It collects the member's personal details and the nature of the request, which can include loans, claims, membership updates, or e-services. The form is then analyzed by a Member Service Officer who provides a recommendation to process the request.

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1K views

GSIS Members Request Form 2as

The GSIS Member's Request Form is used to request transactions and services from the Government Service Insurance System (GSIS). It collects the member's personal details and the nature of the request, which can include loans, claims, membership updates, or e-services. The form is then analyzed by a Member Service Officer who provides a recommendation to process the request.

Uploaded by

aerosmith_julio6627
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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CRMD Form No.

06-08-2010/rpa
GSIS MEMBERS REQUEST FORM

Date: Time:
Name:
(please write full name with middle initial)
GSIS Policy No./Retirement No. GSIS ID No.
Agency/Office Address:
Mailing Address:
Tel. No. (Office Landline): Residence Landline:
Fax Number: Cellphone No.:
E-mail Address: For DEP ED: Employee No. STN No. DIV. No.

Nature of Business/Request/Transaction (Please check appropriate box):


Loans Transaction Date Filed Membership Transaction Date Filed
Consolidated Loan Issuance of Business Partner No.
Policy Loan Re-insurance

Housing Loan Conversion of Life Policy (ELP)

Refund/Recomputation Request for duplicate copy of contract


Request for GSIS Clearance Change of name/status/birth
Others: Others:

For DEP ED Employees Date Filed CLAIMS Date Filed


Request for stoppage of loan deduction CSV
Request for deduction of loan amortization Maturity
Retirement/Survivorship
Burial
E-SERVICES Date Filed Death Claim
Pension Loan CEAP
Old Age Pension HIP
Survivorship Pension Pre-need
Commencement of Pension EC
Accrual of Pension OLID
Request for Home Visit Disability
Others:
POSTING Date Filed
Others:
Other Transactions
Others:
Specify type of loan and payment months and year
Details of Request:

MSOs Analysis and Recommendation:

Signature over full name of transacting member Signature over full name of attending MSO

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