HOUSING LOAN APPLICATION

(PRINT ALL ENTRIES IN BLOCK OR CAPITAL LETTERS)

HQP-HLF-068
(V09, 03/2024)

Pag-IBIG MID Number/RTN OF APPLICANT

Housing Account Number (HAN), if with existing HAN

LOAN PARTICULARS
PURPOSE OF LOAN	WITH EXISTING HOUSING APPLICATION
Purchase of fully developed residential lot or adjoining residential lots Purchase of a residential house and lot, townhouse or condominium unit, inclusive of a parking slot Construction or completion of a residential unit on a residential lot Home improvement Refinancing of an existing housing loan Purchase of a parking slot Purchase of residential lot plus cost of transfer of title Purchase of residential unit plus cost of transfer of title	YES NO If yes, indicate Housing Application No.
	DESIRED LOAN AMOUNT (Exclusive of the co-borrower’s desired loan amount, if any)	DESIRED LOAN TERM (Years)

	DESIRED RE-PRICING PERIOD (Year/s)	1 3 5 10 15 20 25 30
	MODE OF PAYMENT
	Salary deduction Over-the-Counter Post-Dated Checks Cash/Check	Collecting Agent Bank Developer Remittance Center

COLLATERAL
PROPERTY LOCATION (Street, Municipality, Province)				TYPE OF PROPERTY
				Rowhouse Single Detached Townhouse Single Attached Condominium Duplex
NAME OF DEVELOPER/REGISTERED TITLE HOLDER				DESCRIPTION OF IMPROVEMENTS	EXISTING	PROPOSED

TCT/OCT/CCT NO.	TAX DECLARATION NO.	LOT/UNIT NO.	BLOCK/BLDG NO.	NO. OF STOREYS	IS PROPERTY PRESENTLY MORTGAGED?
					YES NO
LAND AREA	FLOOR AREA	AGE OF HOUSE (For Purchase of a Residential Unit)		TOTAL FLOOR AREA
SQM	SQM			SQM
IS THE PROPERTY AN OFFSITE COLLATERAL?		YES NO	REASONS FOR USE OF OFFSITE COLLATERAL
If yes, use separate sheet for the offsite collateral details

BORROWER’S DATA
LAST NAME	FIRST NAME	NAME EXTENSION	MIDDLE NAME	CITIZENSHIP	DATE OF BIRTH (mm/dd/yy)	SEX
						M F
PERMANENT HOME ADDRESS							ATTACH HERE 1”x1” ID PHOTO
Unit/Room No., Floor	Building Name	Lot No., Blk No., Phase No., House No.		Street Name

MARITAL STATUS				Single/Unmarried Annulled Married Widow/er Legally Separated
Subdivision	Barangay	Municipality/City	Province and State Country (if abroad)		ZIP Code	NO. OF DEPENDENT/S

PRESENT HOME ADDRESS					BORROWER’S CONTACT DETAILS (Indicate country code if abroad) COUNTRY + AREA CODE TELEPHONE NO. Home Cell Phone
Unit/Room No., Floor	Building Name	Lot No., Blk No., Phase No., House No.		Street Name

Subdivision	Barangay	Municipality/City	Province and State Country (if abroad)		ZIP Code

HOME OWNERSHIP			YEARS OF STAY IN PRESENT HOME ADDRESS	EE SSS/GSIS ID No.		EMPLOYER’S CONTACT DETAILS (Indicate country code if abroad) COUNTRY + AREA CODE TELEPHONE NO. Business (Direct Line) Business (Trunk Line) Employer/Business Email Address
Owned Company Living w/ relatives/parents Mortgaged Rented at P /mo.
EMPLOYER/BUSINESS NAME (If self-employed)				TIN

EMPLOYER/BUSINESS ADDRESS
Unit/Room No., Floor	Building Name	Lot No., Block No., Phase No., House No.		Street Name		OCCUPATION
						Employed Self-Employed
Subdivision	Barangay	Municipality/City	Province and State Country (if abroad)		ZIP Code

MAILING ADDRESS/CONTACT DETAIL			ALTERNATE MAILING ADDRESS
Email Address			Present Home Address Permanent Home Address Employer/Business Address
INDUSTRY					PREFERRED TIME TO BE CONTACTED (For Employer)
Accounting Basic Materials Health and Social Work; Health and Medical Services Technology Activities of Private Households as Employer’s & Undifferentiated Production Activities of Private Households Construction Life Sciences Transport, Storage and Communications Agriculture, Hunting, Forestry & Fishing Business Process Outsourcing (BPO) Management Travel and Leisure Education & Training Manufacturing Wholesale & Retail Trade; Repair of Motor Vehicles, Motorcycles, Personal & Household Goods Electricity, Gas and Water Supply Media Extra-Territorial Organization & Bodies Mining and Quarrying Financial Services/ Intermediation Other Community, Social & Personal Service Activities HR/Recruitment Public Administration & Defense; Compulsory Social Security
POSITION & DEPARTMENT						YEARS IN EMPLOYMENT/ BUSINESS

HQP-HLF-068
(V09, 03/2024)

SPOUSE’S PERSONAL DATA
LAST NAME	FIRST NAME	NAME EXTENSION	MIDDLE NAME	Pag-IBIG MID NO./RTN	CITIZENSHIP	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.		Street Name

OCCUPATION			POSITION & DEPARTMENT		BUSINESS TEL. NO.
Employed Self-Employed
Subdivision	Barangay	Municipality/City	Province and State Country (if abroad)		ZIP Code	INDUSTRY

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)
ISSUER NAME	CARD TYPE (e.g. Visa/Mastercard)	CARD EXPIRY (mm/yyyy)	CREDIT LIMIT

REAL ESTATE OWNED
LOCATION	TYPE OF PROPERTY	ACQUISITION COST	MARKET VALUE	MORTGAGE BALANCE	RENTAL INCOME

OUTSTANDING CREDITS/LOAN AVAILMENTS
Creditor & Address	Security	Type	Maturity Date
		Amount/Balance	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? YesNo

If Yes, please indicate the nature, plaintiff, amount involved and the status.

Do you have past due obligations? YesNo

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? YesNo

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? YesNo

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.

HQP-HLF-068
(V09, 03/2024)

SELLER’S DATA
LAST NAME	FIRST NAME	NAME EXTENSION	MIDDLE NAME	Pag-IBIG MID NO./RTN	TIN

Unit/Room No., Floor	Building Name	Lot No., Blk No., Phase No., House No.		Street Name	CONTACT NUMBER

Subdivision	Barangay	Municipality/City	Province and State Country (if abroad)		ZIP Code	EMAIL ADDRESS

SELLER’S DATA (IF SELLER IS DEVELOPER/INSTITUTION)
DEVELOPER/INSTITUTION NAME			EMPLOYER ID NO.		TIN

Unit/Room No., Floor	Building Name	Lot No., Blk No., Phase No., House No.		Street Name	CONTACT NUMBER

Subdivision	Barangay	Municipality/City	Province and State Country (if abroad)		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 indicated in the Housing Loan Application is to my/our knowledge, true, correct, complete, and updated. The signature/s appearing above my/our printed name/names below is/are genuine.

I/We authorize 1) Pag-IBIG Fund or its duly authorized representative to verify necessary information or data (i.e., certificate of employment, pay slips and income tax return) with the concerned government agencies or third parties including banks and other financial institutions from whom Pag-IBIG Fund had obtained information; 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; and to send me/us updates about my/our housing loan application/account via SMS/text, email, mail or other available means of communication; and 2) CIC to share my/our credit data with accessing entities, special accessing entities, outsource entities and data subjects, in accordance with the Implementing Rules and Regulations of Republic Act No. 9510.

I/We authorize Pag-IBIG Fund to share my/our personal information and other details of my/our loan account with other government agencies and third parties, as may be necessary in the management of my/our account/s and for collection purposes, subject to the limits under Republic Act No. 10173 (Data Privacy Act of 2012), and its Implementing Rules and Regulations. Further, I/we promise to notify Pag-IBIG Fund of any amendments or changes in my/our personal information indicated herein.

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 including the relevant employment/income information that shall be provided by my/our employer.

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 be bound by the current and general policies of Pag-IBIG Fund and those that the Pag-IBIG Fund may adopt in the future, that may have relation to or in any way affect my/our loan.

I/We understand that the processing/service/filing fee, notarial and all other fees pertaining to the registration of mortgage on property shall be for my/our account.

SIGNATURE OVER PRINTED NAME OF BORROWER		SIGNATURE OVER PRINTED NAME OF SPOUSE
DATE		DATE

THIS FORM CAN BE REPRODUCED. NOT FOR SALE.