Philippine Government Forms All in One Location
GSIS co-signer's statement for bond
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GENERAL INSURANCE GROUP
GOVERNMENT SERVICE INSURANCE
GIF Bond No.
I am agreeable to sign with the applicant M ~ __ "",:""
covering bond applied for by him from you in the amount of P
I am aware of the responsibility which I will
assume in signing with
I am also aware
that you will reply on the truth of the following statement in consideration thereof.
You are hereby authorized to obtain such information wish to secure about myself pertaining to date hereunder
furnished you and I agree that this documents shall remain your property whether or not the bond shall be granted.
(Pleasejill up all bianks. Kind!)' print or !ype.your an.rwer.)
Living with spouse?
No. of Dependents:
Source of Income:
If married, name of spouse:
If not, address of spouse:
TOTAL Annual Income: P
a.) Salary/ Wages, p.a.: P
b.) From Business, p.a. P
c.) Other Income, p.a.: P
Res. Cert. A & B
If employed, please state: Name of EMPLOYER
No; of years in present position:
Name and TITLE of immediate SUPERIOR:
PREVIOUS EMPLOYMENT: Name of Employer:
Nature of Work:
Nature of Business:
No. of years in Employment:
No. of years in previous
. IF IN BUSINESS:
If engaged,please state:
Nature or kind of business:
Is it registered Withthe Bureau of Domestic Trade?
Whether sale ownership / partnership / corporation:
Capital PersonallyInvested: P
Firm or Trade name: --'-'--With SEe?
No. of years in Business:
REAL ESTATE OWNED:
Area in Sq. MJ.
Amount Held &
GIF Bond No.
Amount Held I?J
I nsurance Company
Date POUCT issued
Firm or Cffi«
Co-signor will state whether applicant is related to him and is so what manner:
Co-signor will state how long he has known the applicant:
Co-signor will state whether he has been borrower or co-maker or a personal note at any bank or guarantor with other
companies. If so, please state particulars:
I affirm that each of the answer given to the foregoing questions is true and correct:
" Philippines, this day
Signature of Co-signer
REPUBLIC OF THE PHILIPPINES
SUBSCRIBED AND SWORN to before me this
No. A & B
NOTE: Plepse attach t-opyofyour latest lncome Tax Return
. affiant exhibited to me his/her Residence Certificate