HQP-SLF-065

(V08, 10/2024)
MULTI-PURPOSE LOAN APPLICATION FORM (MPLAF)
INSTRUCTIONS:
1. Accomplish this form in one (1) copy only. Print this form back to back on one single sheet of paper. Pag-IBIG MID NO. APPLICATION NO.
2. Type or print all entries in BLOCK or CAPITAL LETTERS. 121254178728
3. All data fields are mandatory. Otherwise, put N/A if not applicable.
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)
PENDANG MARK IBRAIM SIMEON  07/14/1989 GINGOOG CITY
COMPLETE MOTHER’S MAIDEN NAME NATIONALITY SEX MARITAL STATUS CITIZENSHIP EMAIL ADDRESS
 Male
X  Single/Unmarried
X  Widow/er  Annulled
DOMINICA C. SIMEON FILIPINO  Female  Married  Legally Separated
FILIPINO [email protected]
PRESENT HOME ADDRESS Unit/ Room No., Floor Building Name Lot No., Block No., Phase No. House No. CELL PHONE NUMBER HOME TELEPHONE NUMBER
PIER 6 NORTH HARBOR BGY 1 TONDO, NCR, CITY OF MANILA, FIRST DISTRICT 09162106029 N/A
Street Name 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. BUSINESS TELEPHONE NATURE OF WORK
NUMBER
PIER 6 NORTH HARBOR BGY 1 TONDO, NCR, CITY OF MANILA, FIRST DISTRICT DRIVER
Street Name Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code LOAN TERM DESIRED LOAN AMOUNT
 Two (2) Years 
x Maximum Loan Amount

X Three (3) Years  Others, specify: ______________
EMPLOYER/BUSINESS NAME LOAN PURPOSE
PHILIPPINE LION CITY REAL ESTATE INC. Non-Housing Related
 Vacation/travel
 Livelihood/additional capital in small
EMPLOYER/BUSINESS ADDRESS Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. Street Name  Special events
business
 Car repair
645-651 CLARO M. RECTO AVENUE, BARANGAY 7, TONDO I/II, CITY OF MANILA 1012  Tuition/Educational Expenses
 Health & wellness
Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code  Payment of utility/credit card bills

x Purchase of appliance &
furniture/electronic gadgets
 Others, specify
Housing Related
EMPLOYEE ID NUMBER DATE OF EMPLOYMENT SOURCE OF FUND ______________
 Minor home improvement/home
NOVEMBER 11, 2023 REAL ESTATE LESSOR renovation/ 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)
JETTA TRANSIT E LOGISTICS INC BAMBAN TARLAC 08/2018 11/2023

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 that
NAME OF BANK/BRANCH
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 Rules This office agrees to collect the corresponding monthly
and Regulations of Pag-IBIG Fund, I hereby waive my rights under R.A. No. 1405 (Secrecy of Bank Deposits Act) 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 employer, through salary deduction, together with the employer
____________________________________________________________________ or any employer with whom I may get employed counterpart, and remit said amounts to Pag-IBIG Fund on or
in the future, to deduct the membership savings (MS) and monthly amortization due from my salary and remit the same to Pag-IBIG before the 15th day of each month, for the duration that the loan
Fund. If the resulting monthly net take home pay after deducting the computed monthly amortization on MPL falls below the monthly net remains outstanding. However, should we deduct the monthly
take home pay as required under the GAA/company policy, I authorize Pag-IBIG Fund to compute for a lower loanable amount. amortization due from the applicant’s salary but failed to remit
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 it on due date, this office agrees to pay the corresponding
for every day of delay. penalty charged to applicant equivalent to 1/20 of 1% of any
unpaid amount for every day of delay and penalty for non-
If for any reason excess loan proceeds are erroneously credited to my payroll account/disbursement card, I hereby authorize Pag-IBIG
Fund to debit/deduct the excess amount from my account without need of further notice of demand. Should my account balance be remittance equivalent to 1/10 of 1% per day of delay of the
insufficient, the Fund has the right to demand for the excess amount to be refunded. amount payable from the date the loan 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 ALKIN SIA
Information (FOI) Manual. The credit information may also be transferred to service providers (e.g., Credit Information Corporation, _________________________________________
Bankers Association of the Philippines - Credit Bureau), likewise in accordance with laws and regulations. AUTHORIZED SIGNATORY
(Signature Over Printed Name)
Furthermore, I have read, understood and agree to be bound by the terms and conditions governing the
eDisbursement Facility/Program and Pag-IBIG Fund’s partner-banks’ internal guidelines.
_________________________________________
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 DESIGNATION
hereby certify under pain of perjury that my signature appearing herein is genuine and authentic.
______________ _______________ ______________
MARK IBRAIM S. PENDANG
___________________________________ 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 5. I shall be considered in default in any of the following cases:
Pag-IBIG Fund with principal office at Petron MegaPlaza, 358, Sen. Gil Puyat Avenue., City a. Any willful misrepresentation in any of the documents executed in relation hereto;
of Makati the sum of Pesos: b. Failure to pay any three (3) consecutive monthly amortizations;
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 efforts.
I hereby waive notice of demand for payment and agree that any legal action, which may However, immediate offsetting of my outstanding loan obligation may be effected
arise in relation to this note, may be instituted in the proper court of Makati City. immediately upon approval of my request, provided such request is based on the
Finally, this note shall likewise be subject to the following terms and conditions: following justifiable reasons and upon validation by the Fund: Total disability or insanity;
1. I shall pay the amount of Pesos: _______________________________ Separation from service by reason of health; Death of member’s immediate family
(P_______________) through salary deduction, whenever feasible, over a period of member; Distressed member due to unemployment limited to layoff and/or closure of
two (2) years or three (3) years, with a grace period of 2 months. In case I am unable company; Critical illness of the member or any of his/her immediate family member, as
to pay through salary deductions for any of the following circumstances, such as but certified by a licensed physician under one of the following categories, subject to the
not limited to, suspension from work; leave of absence without pay; insufficiency of take approval of the DCEO-Member Services Cluster: cancer, organ failure, heart-related
home pay at any time during the term of the loan; or other circumstances analogous to illness, stroke and neuromuscular-related illness; Repatriation of OFW member from
the foregoing, payments should be made directly to the Pag-IBIG Fund office where host country and other meritorious grounds as may be approved for by the Board, by
the loan was released. reason thereof, resulted in his failure to pay the required amortization when due.
2. Payments are due on or before the 15th day of the month starting on 7. In the event of membership termination prior to loan maturity, any outstanding loan
_________________________. obligation, shall be deducted from my TAV and/or any amount due me or my
3. Payments shall be applied according to the following order of priorities: Penalties, beneficiaries in the possession of the Fund. In case of my death, the outstanding
Interest and Principal. obligation shall be computed up to the date of death. Any payment received after date
4. A penalty of 1/20 of 1% of any unpaid amount shall be charged to me for every day of of death shall be refunded to my beneficiaries.
delay. 8. In case of falsification, misrepresentation or any similar acts committed by me,
Signed in the presence of: Pag-IBIG Fund shall automatically suspend my loan privileges indefinitely. I shall abide
with all the applicable rules and regulations governing this lending program that
RUEL O. AYALA
________________________________ JOEY REY R. BUTRON
________________________________ Pag-IBIG Fund may promulgate from time to time.
Witness Witness
(Signature Over Printed Name) (Signature Over Printed Name) MARK IBRAIM S. PENDANG
__________________________________
Signature of Applicant 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
(V08, 10/2024)
GUIDELINES AND INSTRUCTIONS

A. Who May File

Any Pag-IBIG Fund member who satisfies the following requirements:
CERTIFICATE OF NET PAY 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, shall
be allowed to apply for an MPL provided said member has subsequently accumulated 24 MS or at least its
equivalent from the cut-off date of membership maturity or optional 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.
NAME OF BORROWER B. How to File
The applicant shall:
1. Secure the Multi-Purpose Loan Application Form (MPLAF) from any Pag-IBIG Fund Branch or download from
For the month of: _________________ Pag-IBIG website at www.pagibigfund.gov.ph.
2. Accomplish one (1) copy of the application form.
3. Submit the accomplished application form, together with the required documents to any Pag-IBIG Fund Branch.
Processing of loans shall commence only upon submission of the complete documents.
C. Loan Features
Basic Salary _________________ 1. Loan Amount
A qualified Pag-IBIG member shall be allowed to borrow an amount based on the lowest of the following:
1.1 Desired Loan Amount
Add: Allowances 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 17.5% 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 period of two (2) years or three (3) years, at the option of the member upon loan
_____________________ __________ application, with a grace period of two (2) months.
However, in the event that the borrower does not indicate the chosen loan term, the default term shall be three (3)
years.
_____________________ __________ 4. Loan Release
The loan proceeds shall be released through any of the following modes:
a) Crediting to the borrower’s disbursement card or Loyalty Card Plus;
_____________________ __________ 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 despite notice to the borrower (either by email, registered mail or personal delivery
to his postal address, or Short Message Service (SMS) informing him that the same is available for release, the
check shall be cancelled and the loan will be reversed.
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.
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.
Less: Deductions 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, such as but not limited to:
_____________________ __________ a. Suspension from work
b. Leave of absence without pay
c. Insufficiency of take home pay at any time during the term of the loan; or
_____________________ __________ d. Other circumstances analogous to the foregoing.
5.7 Payment shall be applied according to the following order of priorities:
a. Penalties; if any
b. Interest; and
_____________________ __________ c. Principal
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.
Issued this _______ day of _________,
____________________ 20__.
__________ 6. Penalties
I certify under pain of perjury that the above- 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
mentioned information is true and correct.
_____________________ __________ was due to the fault of the employer. In such case, penalties due from the borrower shall 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, without need for demand:
D. ___________________________________________
Loan Renewal a. Any willful misrepresentation made by the borrower in any of the documents executed in relation hereto.
HEAD
Total OF OFFICE/AUTHORIZED SIGNATORY
Deductions __________ b. Failure of the borrower to pay any three (3) consecutive monthly amortizations.
E. Loan Renewal (Signature over printed name) c. Failure of the borrower to pay any three (3) consecutive Pag-IBIG monthly savings; 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.
Net Monthly Income __________
D. Other Loan 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 versa. Application for loans
on these two programs shall be governed by their corresponding guidelines.
2. In no case shall the aggregate STL exceed eighty percent (80%) of the borrower’s TAV.
3. For both 2-year and 3-year terms, a borrower may renew his/her 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 approved loan shall be applied to the borrower’s outstanding MPL obligation and the net proceeds
Issued this ________ day of ____, 20___. shall then be released to him. In case of full payment prior to loan maturity, a borrower shall be allowed to apply for a
new loan anytime thereafter.
4. In the event of membership termination prior to loan maturity, the outstanding loan obligation shall be deducted from
I certify under pain of perjury that the the borrower’s TAV and/or any amount due him or his beneficiaries in the possession of the Fund. In case of the
borrower’s death, the outstanding loan obligation shall be computed up to the date of death. Any payments received
abovementioned information is true and after death shall be refunded to the borrower’s beneficiaries.
correct. 5. Borrower may request for the immediate offsetting of his/her outstanding MPL balance against his/her TAV. It shall be
effected upon approval of the borrower’s request, provided, the request is based on the following justifiable reasons:
Total disability or insanity; Separation from service by reason of health; Death of member’s immediate family member;
________________________________________ Distressed member due to unemployment limited to layoff and/or closure of company; Critical illness of the member or
any of his/her immediate family member, as certified by a licensed physician under one of the following categories,
AUTHORIZED SIGNATORY subject to the approval of the DCEO-Member Services Cluster: cancer, organ failure, heart-related illness, stroke and
(Signature Over Printed Name) neuromuscular-related illness; Repatriation of OFW member from host country and other meritorious grounds as may
be approved for by the Board, 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.
7. In case there is a need to update in the borrower’s address and contact details (i.e. present home address, permanent
home address, email address, cell phone number, home telephone number and business telephone number) at point
of loan application, the borrower shall not be required to submit Member’s Change of Information Form (MCIF, HQP-
PFF-049). The updating of information shall be based on the submitted MPLAF.
However, in case the information that needs to change/update is other than the address and contact details, the
concerned borrower is required to submit the accomplished MCIF together with the supporting documents, if
necessary. Please refer to the Checklist of Requirements specified at the back portion of the MCIF.