Member'S Change of Information Form (Mcif) : 2. (Last Name, First Name, Name Extension, Middle Name)

HQP-PFF-049
(V05, 03/2018)
MEMBER’S CHANGE OF Pag-IBIG MID NUMBER

INFORMATION FORM (MCIF)
INSTRUCTIONS: PLEASE READ LIST OF SUPPORTING DOCUMENTS AT THE BACK. ACCOMPLISH AND SUBMIT THIS FORM IN ONE (1) COPY, PRINT ALL ENTRIES IN
BLOCK OR CAPITAL LETTERS.
CHECK THE APPROPRIATE BOX AND ACCOMPLISH ONLY THE APPLICABLE PORTION/S TO BE CHANGED/UPDATED
Change of Membership Category Change of Marital Status Updating of Heirs
Change/Correction of Name Change of Address/Contact Details Others (Please specify)
Correction of Date of Birth Change of Employment Details _____________________
LAST NAME FIRST NAME NAME EXTENSION (e.g., Jr., II) MIDDLE NAME
1. CHANGE OF MEMBERSHIP CATEGORY

FROM TO
2. CHANGE/CORRECTION OF NAME (Last Name, First Name, Name Extension, Middle Name)
FROM TO
3. CORRECTION OF DATE OF BIRTH

FROM (mm/dd/yyyy) TO (mm/dd/yyyy)
4. CHANGE OF MARITAL STATUS

FROM TO
SPOUSE Last Name First Name Name Extension Middle Name No Middle Name DATE OF BIRTH (mm/dd/yyyy)
(For Married Status)
5. CHANGE OF ADDRESS/CONTACT DETAILS (Please accomplish portions to be changed only)

PRESENT HOME ADDRESS (Indicate country code if abroad)
Unit/Room No. Floor Bldg. Name Lot No. Block No. Phase No. House No. Street Name Subdivision COUNTRY+AREA CODE TELEPHONE NUMBER
Home
Barangay Municipality/City Province/State/Country (if abroad) Zip Code Cellphone
PERMANENT HOME ADDRESS Business (Direct Line)

Unit/Room No. Floor Bldg. Name Lot No. Block No. Phase No. House No. Street Name Subdivision
Business (Trunk Line)

Barangay Municipality/City Province/State/Country (if abroad) Zip Code
Email Address
PREFERRED MAILING ADDRESS Permanent Home Address
Present Home Address Employer/Business Address
6. CHANGE OF EMPLOYMENT DETAILS

EMPLOYER/BUSINESS NAME
EMPLOYER/BUSINESS ADDRESS
Unit/Room No., Floor Building Name Lot No. Block No. Phase No. House No.
Street Name Subdivision Barangay Municipality/City Province Zip Code
7. UPDATING OF HEIRS (Please use separate sheet, if necessary)

LAST NAME FIRST NAME NAME EXTENSION MIDDLE NAME NO MIDDLE NAME RELATIONSHIP DATE OF BIRTH ADDITION/DELETION
(e.g. Jr., II) (Check if applicable only) (mm/dd/yyyy)
8. OTHERS (Please specify)

FROM TO
CERTIFICATION
I HEREBY CERTIFY THAT THE INFORMATION GIVEN AND ALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT.
___________________________________ ________________
Signature over Printed Name of Member Date

THIS PORTION IS FOR Pag-IBIG USE ONLY
RECEIVED BY DATE APPROVED BY DATE
THIS FORM MAY BE REPRODUCED. NOT FOR SALE.

HQP-PFF-049
(V05, 03/2018)
CHECKLIST OF REQUIREMENTS
BASIC REQUIREMENTS
1. Member’s Change of Information Form (MCIF, HQP-PFF-049)

2. At least two (2) valid IDs

Company ID

Passport, issued by the Philippine or Foreign Government

Driver’s License

Professional Regulation Commission (PRC) ID

Social Security System (SSS) Card/UMID Card

Government Services Insurance System (GSIS) e-card

Government Office and GOCC ID (e.g. AFP ID, Pag-IBIG Loyalty Card)

Integrated Bar of the Philippines (IBP) ID

Senior Citizen Card

Overseas Workers Welfare Administration (OWWA) ID

Overseas Filipino Worker (OFW) ID

Seafarer’s Identification and Record Book (SIRB)

Postal ID

Voter’s ID
ADDITIONAL REQUIREMENTS
A. CHANGE OF MEMBERSHIP CATEGORY

1. Certificate of Employment (for Job Order Employees)
2. Notarized Affidavit of Earnings (for Self-employed member)
B. CHANGE/CORRECTION OF NAME For

change in name due to marriage:
1. Marriage Contract with Registry Number issued by Philippine Statistics Authority (PSA, formerly known as NSO)
For change in name (for reason other than marriage):

1. Birth Certificate issued by the PSA (formerly known as NSO)
2. Court Order granting petition for change of name.
C. CORRECTION OF DATE OF BIRTH

1. Birth Certificate issued by PSA (formerly known as NSO)
D. CHANGE OF MARITAL STATUS
For single to married:


Marriage Contract with Registry Number issued by PSA (formerly known as NSO)
For married to single (legally married to reported spouse)

Court Order
For married to single (due to erroneous encoding)

Certificate of No Marriage(CENOMAR) issued by PSA (formerly known as NSO)
For married to widowed

Death Certificate of deceased spouse issued by PSA (formerly known as NSO)
E. CORRECTION OF PLACE OF BIRTH/MOTHER’S MAIDEN NAME/GENDER (Due to erroneous encoding)
1. Birth Certificate issued by PSA (formerly known as NSO)
NOTES:
a. Please submit photocopy of the documents depending on the information to be changed/updated. The Certified True Copy of the said
documents shall be presented for authentication.
b. If filing thru Authorized Representative, please submit the following:
- At least two (2) valid IDs of Representative
- At least two (2) valid IDs of Member
- Authorization Letter

Member'S Change of Information Form (Mcif) : 2. (Last Name, First Name, Name Extension, Middle Name)

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HQP-PFF-049

MEMBER’S CHANGE OF Pag-IBIG MID NUMBER

1. CHANGE OF MEMBERSHIP CATEGORY

3. CORRECTION OF DATE OF BIRTH

4. CHANGE OF MARITAL STATUS

5. CHANGE OF ADDRESS/CONTACT DETAILS (Please accomplish portions to be changed only)

Barangay Municipality/City Province/State/Country (if abroad) Zip Code Cellphone

PERMANENT HOME ADDRESS Business (Direct Line)

Business (Trunk Line)

6. CHANGE OF EMPLOYMENT DETAILS

Street Name Subdivision Barangay Municipality/City Province Zip Code

7. UPDATING OF HEIRS (Please use separate sheet, if necessary)

8. OTHERS (Please specify)

Signature over Printed Name of Member Date

THIS FORM MAY BE REPRODUCED. NOT FOR SALE.

1. Member’s Change of Information Form (MCIF, HQP-PFF-049)

A. CHANGE OF MEMBERSHIP CATEGORY

B. CHANGE/CORRECTION OF NAME For

For change in name (for reason other than marriage):

C. CORRECTION OF DATE OF BIRTH

D. CHANGE OF MARITAL STATUS

For single to married:

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