06-08-2010/rpa Request for Pension Resumption

GSIS member request form for pension resumption

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GSIS MEMBER’S REQUEST FORM
Date:
Name:

Time:

(please write full name with middle initial)
GSIS Policy No./Retirement No.
Agency/Office Address:
Mailing Address:
Tel. No. (Office Landline):
Fax Number:
E-mail Address:
For DEP ED: Employee No.

GSIS ID No.

Residence Landline:
Cellphone No.:
STN No.

DIV. No.

Nature of Business/Request/Transaction (Please check appropriate box):
Loans Transaction
Date Filed
Membership Transaction
Issuance of Business Partner No.
Consolidated Loan
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:

Date Filed

Others:

For DEP ED Employees
Request for stoppage of loan deduction
Request for deduction of loan amortization

E-SERVICES
Pension Loan
Old Age Pension
Survivorship Pension
Commencement of Pension
Accrual of Pension
Request for Home Visit
Others:
Other Transactions

Date Filed

Date Filed

POSTING
Others:
Others:

Date Filed

CLAIMS
CSV
Maturity
Retirement/Survivorship
Burial
Death Claim
CEAP
HIP
Pre-need
EC
OLID
Disability

Date Filed

Specify type of loan and payment months and year

Details of Request:

MSO’s Analysis and Recommendation:

Signature over full name of transacting member

Signature over full name of attending MSO