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Housing Loan Application

Pag - Ibig application form for housing loan

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: HQP-HLF-068
(V06, 06/2017)

HOUSING LOAN APPLICATION

Housing Account Number (HAN), if with existing HAN

Pag-IBIG MID Number/RTN
(PRINT ALL ENTRIES IN BLOCK OR CAPITAL LETTERS)

LOAN PARTICULARS
PURPOSE OF LOAN
Purchase:
 Fully Developed Residential Lot or Adjoining
Residential Lots
 Fully Developed Residential Lot with Construction of
a Residential Unit
 Pag-IBIG Fund Acquired Properties
 Residential Unit (House & Lot)
 Townhouse or Condominium Unit
 Townhouse or Condominium Unit inclusive of a
parking slot
 Adjoining Property
 Residential Unit with Home Improvement

Construction/Improvement:
 House Construction
 Home Improvement
Refinancing:
 Existing Mortgage Loan
 Existing Mortgage with Home Improvement
 Existing Mortgage on a Residential Lot with Construction of
a Residential Unit
Additional Loan:
 House Construction
 Home Improvement
 Purchase of Parking Lot (for vertical development)

WITH EXISTING HOUSING APPLICATION
 YES
 NO
If yes, indicate Housing Application No.
_________________________________
DESIRED LOAN AMOUNT
DESIRED LOAN TERM (Years)
DESIRED RE-PRICING PERIOD (Year/s)
 1
 3
 5
 10
 15
 20
 25  30
MODE OF PAYMENT
 Salary deduction
 Collecting Agent
 Over-the-Counter
 Bank
 Post-Dated Checks  Developer
 Cash/Check
 Remittance Center

COLLATERAL
PROPERTY LOCATION (Street, Municipality, Province)

TYPE OF PROPERTY

 Rowhouse
 Single Detached
 Single Attached  Condominium

NAME OF DEVELOPER/REGISTERED TITLE HOLDER

DESCRIPTION OF
IMPROVEMENTS

TCT/OCT/CCT NO.

TAX DECLARATION NO.

LOT/UNIT NO.

IS PROPERTY PRESENTLY
MORTGAGED?

LAND AREA/FLOOR AREA

AGE OF HOUSE (For Purchase of a
Residential Unit)

 YES

 NO

BLOCK/BLDG NO.

 Townhouse
 Duplex

EXISTING

PROPOSED

No. of
STOREYS
TOTAL FLOOR
AREA

SQM

SQM

SQM

BORROWER’S DATA
LAST NAME

FIRST NAME

NAME EXTENSION

MIDDLE NAME

CITIZENSHIP

DATE OF BIRTH (mm/dd/yy)

SEX

M F
PERMANENT HOME ADDRESS
Unit/Room No., Floor

Building Name

Lot No., Blk No., Phase No., House No.

 Single/

Street Name

Unmarried

Subdivision

Barangay

Municipality/City

Province and State Country (if abroad)

 Married
 Widow/er

ZIP Code

 Legally
Separated

 Annulled

BORROWER’S CONTACT DETAILS

PRESENT HOME ADDRESS
Unit/Room No., Floor

ATTACH HERE
1”X1”
ID PHOTO
OF APPLICANT

MARITAL STATUS

Building Name

Lot No., Block No., Phase No., House No.

For Pag-IBIG Fund
USE ONLY

(Indicate country code if abroad)

Street Name

COUNTRY + AREA CODE TELEPHONE NO.
Subdivision

Barangay

Municipality/City

Province and State Country (if abroad)
YEARS OF STAY IN
PRESENT HOME
ADDRESS

HOME OWNERSHIP
 Owned
 Company  Living w/ relatives/parents
 Mortgaged  Rented at P__________/mo.

Home

ZIP Code

MEMBERSHIP
SAVINGS

Cell Phone

EE SSS/GSIS ID No.

LOAN ENTITLEMENT

Email Address

EMPLOYER/BUSINESS NAME (If self-employed)

TIN

EMPLOYER/BUSINESS ADDRESS

OCCUPATION
 Employed
 Self-Employed

EMPLOYER’S CONTACT DETAILS
Unit/Room No., Floor

Building Name Lot No., Block No., Phase No., House No. Street Name

CERTIFIED BY

(Indicate country code if abroad)
COUNTRY + AREA CODE TELEPHONE NO.

Business (Direct Line)
Business (Trunk Line)

Subdivision

Barangay

Municipality/City

Province and State Country (if abroad)

YEARS IN
EMPLOYMENT/
BUSINESS

Employer/Business Email Address

NO. OF
DEPENDENT/S

ZIP Code

INDUSTRY
 Accounting
 Activities of Private
Households as
Employer’s &
Undifferentiated
Production Activities
of Private
Households
 Agriculture, Hunting,
Forestry & Fishing
 Basic Materials

 Business Process
Outsourcing (BPO)
 Construction
 Education & Training
 Electricity, Gas and
Water Supply
 Extra-Territorial
Organization & Bodies
 Financial Services/
Intermediation
 HR/Recruitment

 Health and Social Work;
Health and Medical Services
 Life Sciences
 Management
 Manufacturing
 Media
 Mining and Quarrying
 Other Community, Social &
Personal Service Activities
 Public Administration & Defense;
Compulsory Social Security

 Technology
 Transport, Storage
and
Communications
 Travel and Leisure
 Wholesale & Retail
Trade; Repair of
Motor Vehicles,
Motorcycles,
Personal &
Household Goods

POSITION & DEPARTMENT
PREFERRED MAILING ADDRESS
 Present Home Address
 Employer/Business Address
 Permanent Home Address

SPOUSE’S PERSONAL DATA
LAST NAME

FIRST NAME

NAME EXTENSION

CITIZENSHIP

MIDDLE NAME

Pag-IBIG MID NO./RTN

DATE OF BIRTH (mm/dd/yy)

TIN

EMPLOYER/BUSINESS NAME (If self-employed)

YEARS IN EMPLOYMENT/ BUSINESS

EMPLOYER/BUSINESS ADDRESS
Unit/Room No., Floor

Building Name

Lot No., Block No., Phase No., House No.

Subdivision

Barangay

Municipality/City

INDUSTRY
 Accounting
 Activities of Private Households
as Employer’s &
Undifferentiated Production
Activities of Private Households
 Agriculture, Hunting, Forestry &
Fishing
 Basic Materials
 Construction

Street Name

Province and State Country (if abroad)

 Business Process Outsourcing (BPO)
 Education & Training
 Electricity, Gas and Water Supply
 Extra-Territorial Organization & Bodies
 Financial Services/ Intermediation
 HR/Recruitment
 Health and Social Work;
Health and Medical Services

OCCUPATION
 Employed
 Self-Employed
ZIP Code

POSITION & DEPARTMENT

BUSINESS TEL. NO.

 Life Sciences
Accounting
 Management
 Manufacturing
 Media
 Mining and Quarrying
 Other Community, Social & Personal Service Activities
 Public Administration & Defense; Compulsory Social
Security

 Technology
 Transport, Storage and
Communications
 Travel and Leisure
 Wholesale & Retail Trade;
Repair of Motor Vehicles,
Motorcycles, Personal &
Household Goods

HQP-HLF-068
(V06, 06/2017)

BANK ACCOUNTS (Indicate your 3 most active)
BANK

BRANCH/ADDRESS

TYPE OF ACCOUNT

ACCOUNT NO.

DATE OPENED

AVE. BALANCE

CREDIT CARDS OWNED (Indicate your 3 most active)
CARD TYPE
(e.g. Visa/Mastercard)

ISSUER NAME

CARD EXPIRY
(mm/yyyy)

CREDIT LIMIT

REAL ESTATE OWNED
LOCATION

TYPE OF PROPERTY

ACQUISITION COST

MORTGAGE
BALANCE

MARKET VALUE

RENTAL
INCOME

OUTSTANDING CREDITS/LOAN AVAILMENTS
Creditor & Address

Security

Mo. Amortization

Type

Maturity Date

Amount/Balance

Security

Maturity Date

Amount/Balance
Creditor & Address

Mo. Amortization

Type

Security

Maturity Date

Amount/Balance
Creditor & Address

Type

Mo. Amortization

MISCELLANEOUS
(Answer the following questions with YES or NO. If your answer is YES, please elaborate the details as required)
Are there past or pending cases against you?  Yes
 No
If Yes, please indicate the nature, plaintiff, amount involved and the status.
Do you have past due obligations?  Yes
 No
If yes, please indicate the creditor’s name, nature, amount involved and due date.
Was your bank account ever closed because of mishandling or issuance of bouncing checks?  Yes
 No
If yes, please indicate the bank’s name, nature amount and date.
Have you ever been diagnosed, treated or given medical advice by a physician or other health care provider?  Yes
 No
If yes, please indicate the condition/diagnosis.

LOAN AND CREDIT REFERENCES
BANK/FINANCIAL INSTITUTION

ADDRESS

PURPOSE

SECURITY

HIGHEST
AMOUNT OWED

PRESENT
BALANCE

DATE
OBTAINED

DATE FULLY
PAID

TRADE REFERENCES (For Self-Employed Only)
NAME OF SUPPLIER

ADDRESS

TEL. NO.

CHARACTER REFERENCES
NAME

ADDRESS

TEL. NO.

SELLER’S DATA
LAST NAME

FIRST NAME

Unit/Room No., Floor
Subdivision

Building Name
Barangay

NAME EXTENSION

Lot No., Blk No., Phase No., House No.
Municipality/City

MIDDLE NAME

Pag-IBIG MID NO./RTN

Street Name

Province and State Country (if abroad)

TIN

CONTACT NUMBER
ZIP Code

EMAIL ADDRESS

SOURCE OF Pag-IBIG FUND HOUSING LOAN INFORMATION
 TV Ad

 Radio Ad

 Pag-IBIG Fund Personnel

 Flyer/Poster/Brochure

 Employer

 Newspaper/Magazine Ad

 Website

 Agency

 Pag-IBIG Fund Branch

 Real Estate Developer

 Seller of the Property

 Others (pls. specify) ______________

CERTIFICATION
I/We certify that the foregoing information/statement is to my/our knowledge, true, correct, complete, and updated. The signature/s appearing below is/are
genuine. I/We authorize Pag-IBIG Fund or its duly authorized representative: 1) to verify necessary information or data (i.e., certificate of employment, pay slips and
income tax return) with the concerned government agencies, any other or third parties including banks and other financial institutions from whom Pag-IBIG Fund had
obtained information; 2) to regularly submit and disclose my/our credit data (as defined under Republic Act No. 9510 and its Implementing Rules and Regulations) to
Credit Information Corporation (CIC) as well as any updates or corrections thereof; 3) to share my/our credit data with other lenders authorized by the CIC, and credit
reporting agencies duly accredited by the CIC; and 4) to send me/us updates about my/our housing loan application/account via SMS/text, email, mail or other
available means of communication.
I/We hereby further waive confidentiality rules and laws as applicable to establish correctness, validity, and authenticity of documents that would help facilitate
the processing and evaluation of my/our application.
I/We hereby agree that any misrepresentation of a material fact is a ground for disapproval of the application, cancellation of the loan, and shall be a cause for
the total outstanding obligation to be due and demandable and shall be subject to other sanctions provided in existing Pag-IBIG Fund guidelines. I/We agree to notify
Pag-IBIG Fund of any material change affecting the information contained herein. I/We agree that all information obtained by Pag-IBIG Fund shall remain its property
whether or not the loan is granted.
I/We further agree to pay Pag-IBIG Fund the corresponding non-refundable processing fee and appraisal fee.
I/We understand that should my/our application be approved, notarial and all other fees pertaining to the registration of mortgage on property shall be for my/our
account.

____________________________________
SIGNATURE OF BORROWER

____________________________________
SIGNATURE OF SPOUSE

____________________________________
DATE

____________________________________
DATE

THIS FORM CAN BE REPRODUCED. NOT FOR SALE.
 
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