Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 4 views

    MRF Codified

    Uploaded by

    MICHAEL OGSILA

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    MRF Codified

    Uploaded by

    MICHAEL OGSILA
    4 views1 page

    Original Title

    MRF_Codified

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    4 views1 page

    MRF Codified

    Uploaded by

    MICHAEL OGSILA

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Form No.

    02202024-MRF-REV
    02

    GSIS MEMBER’S REQUEST FORM (MRF)


    INSTRUCTIONS: Ensure that the request form is properly filled out and submitted to the nearest GSIS Office.
    WARNING: Direct or indirect commission of fraud, collusion, falsification, misrepresentation of facts, or any other
    kind of anomaly in the accomplishment of this form, as well as obtaining any benefit pursuant to this request shall be
    subject to administrative, civil and/or criminal action. THIS FORM IS NOT FOR SALE.

    Date: November 24, 2024


    Last Name: OGSILA First Name: MICHAEL Middle Name: Suffix
    MACAPANAS
    Date of Birth (mm/dd/yyyy) Gender Civil Status GSIS Business Partner (BP) No.
    8/6/1979 MALE MARRIED 2004219804
    Mailing Address Zip Code
    133A SAMPAGUITA ST. PERPETUAL VILLAGE, TANYAG TAGUIG CITY 1600
    Agency Name and Address
    DEPED PASAY
    Mobile Number Email Address Landline Number
    09109875553 michael.ogsila@deped.gov.ph N.A
    Instruction: Please check (  ) the applicable transaction request/s and indicate the particulars.
    GSIS Accounts Claim Transaction
    Type of Account Type of Claim
    GSIS Premium Contributions Maturity
    GSIS Loan/s Cash Surrender Value (CSV)/ Termination Value
    (TV)
    Multi-Purpose Loan (MPL) Death Claim
    Consolidated Loan (CNL) Retirement/ Separation
    GSIS Financial Assistance Loan (GFAL) Funeral Benefit
    GFAL Educational Loan Survivorship
    Emergency Loan (EML) Pre-need
    Policy Loan Edu-Child
    Others: College Education Assurance Plan (CEAP)
    Memorial
    Nature of Request: Others:
    Reconciliation of GSIS Premium
    Contributions
    (Please attach Service Record) Employees’ Compensation (EC)
    Statement of Loan Account (SOLA) Others:
    Certification of Full Payment (CFP) Nature of Request:
    GSIS Clearance Payment of Benefit RA 8291 (Future Payee)
    Certificate of No Loan/ Loan Balance Recomputation of GSIS Benefit
    Transfer of Claim Check/s to preferred Payment of Benefit (under Pre-need)
    Branch
    Details: Payment of Benefit (under EC)
    Others: Details:
    Others:

    Other Transactions
    Details of Request:

    DATA PRIVACY CONSENT


    I hereby confirm my understanding of the Privacy Policy of the GSIS pursuant to the requirements of R.A. 10173, otherwise known
    as the DPA, its Implementing Rules and Regulations and other issuances of the National Privacy Commission and consent to the
    manner of and safety measures to be observed in the collection, use, access, disclosure, processing and disposal of my personal
    and sensitive personal data by the GSIS.
    Thumb mark Printed Name and Signature of
    (if unable to Witnesses to Thumb mark:
    affix (Both witnesses must provide
    signature) photocopy of 2 valid government
    issued IDs)

    1.
    Signature over printed name

    2.

    You might also like