MSVS Form PDF
MSVS Form PDF
MSVS Form PDF
Date Filed: __________ MSVS No. ______________ Date Filed: __________ MSVS No. ______________
Last Name First Name Middle Name Maiden Name Last Name First Name Middle Name Maiden Name
(For married women) (For married women)
Status Status
Single Married Widow/er Legally Annulled Single Married Widow/er Legally Annulled
Separated Separated
For AFP Branch of Service Serial/Account No. For AFP Branch of Service Serial/Account No.
Employee Employee
For DECS Division Code Station Code Employee No. For DECS Division Code Station Code Employee No.
Employee Employee
LOAN PURPOSE LOAN PURPOSE
Additional Loan Purchase of Pag-IBIG acquired Additional Loan Purchase of Pag-IBIG acquired
properties properties
Home Improvement Home Improvement
Purchase of a Residential Unit Purchase of a Residential Unit
House Construction Purchase of Townhouse and House Construction Purchase of Townhouse and
Purchase of a Fully Developed Lot Condominium Unit, inclusive of parking Purchase of a Fully Developed Lot Condominium Unit, inclusive of parking
slot slot
Purchase of Lot and Construction of Refinancing of an existing mortgage Purchase of Lot and Construction Refinancing of an existing mortgage
a Residential Unit loan of a Residential Unit loan
EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP EMPLOYMENT HISTORY FROM DATE OF Pag-IBIG MEMBERSHIP
NAME OF EMPLOYER/ADDRESS FROM (Mo./Yr.) TO (Mo./Yr.) NAME OF EMPLOYER/ADDRESS FROM (Mo./Yr.) TO (Mo./Yr.)
Member's Member's
Signature Signature
FOR Pag-IBIG FUND USE ONLY FOR Pag-IBIG FUND USE ONLY
COUNSELLED/PRE-QUALIFIED BY (Counseling Section/Servicing Section) Date COUNSELLED/PRE-QUALIFIED BY (Counseling Section/Servicing Section) Date
LATEST CONTRIBUTION RECORD Total No. of LATEST CONTRIBUTION RECORD Total No. of
Month/Year PFR No./Date Amount Contributions Month/Year PFR No./Date Amount Contributions
For Provident Benefits Division For Servicing Department/Section For Provident Benefits Division For Servicing Department/Section
Attachments Attachments
Certificate of Remittance Latest Payslip Certificate of Remittance Latest Payslip