HLF182 ApplicationFullRiskBasedPricing V03
HLF182 ApplicationFullRiskBasedPricing V03
HLF182 ApplicationFullRiskBasedPricing V03
LOAN PARTICULARS
Conversion to Full Risk-Based Pricing Model AVAILED OF RESTRUCTURING? DESIRED RE-PRICING PERIOD (in years) MODE OF PAYMENT Collecting Agent
Changed in Fixed Pricing Period Yes No 3 5 10 15 20 25 Salary Deduction Bank
Over-the-Counter Developer
WITH PDC WITHOUT PDC WITH ADDITIONAL LOAN? IF WITH ADDITIONAL LOAN, RE-PRICING SHALL BE APPLIED ON? Cash/Check Remittance
Yes No Original Loan only Both loans Additional Loan only Post-Dated Checks Center
PROPERTY LOCATION
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
BORROWER’S DATA
LAST NAME FIRST NAME EXTENSION NAME MIDDLE NAME CITIZENSHIP DATE OF BIRTH (mm/dd/yy) SEX
M F
Subdivision Barangay Municipality/City Province and State Country (if abroad) Zip Code Cell Phone
Email Address
HOME OWNERSHIP YEARS OF STAY IN PRESENT HOME EE SSS/GSIS ID No.
Owned Company Living w/ relatives/parents ADDRESS
Mortgaged Rented at P__________/mo. CONTACT DETAILS (Indicate country code if
OCCUPATION EMPLOYER/BUSINESS NAME (If self-employed) TIN abroad)
Employed COUNTRY + AREA CODE TELEPHONE NO.
Self-Employed Business (Direct Line)
EMPLOYER/BUSINESS ADDRESS
Unit/Room No., Floor Building Name Lot No., Block No., Phase No., House No Street Name Business (Trunk Line)
Subdivision Barangay Municipality/City Province and State Country (if abroad) Zip Code Employer/Business Email Address
CERTIFICATION
I/We certify that the foregoing information/statement 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 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 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 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 the application has been granted or not.
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 shall be for my/our account.
_____________________________________________ ___________________________________________
SIGNATURE OF BORROWER OVER PRINTED NAME SIGNATURE OF SPOUSE OVER PRINTED NAME
____________________________________ ____________________________________
DATE DATE
FOR PAG-IBIG FUND USE ONLY
COMPLIES ELIGIBILITY REQUIREMENT YES NO
VERIFIED BY DATE APPROVED BY DATE DISAPPROVED BY DATE
REMARKS
B. HOW TO FILE
1. Duly accomplished Application for Conversion to Full Risk-Based Pricing Model (HQP-HLF 182, 2 copies).
2. Updated Real Estate Tax Receipt for Land and Building (photocopy).
3. Special Power of Attorney and two (2) valid ID cards each of the Principal and Attorney-In-Fact (If borrower,
borrower spouse, co-borrower and co-borrower spouse, if any, cannot file personally)
Note: Notarized SPA for an OFW, prior to date of departure or for an OFW member in abroad, a notarized SPA
by a Philippine Consular Officer, or by a local notary (of the country where the member is working) but
duly authenticated by the Philippine Consulate.
4. For changed of marital status, photocopy of the following:
a. Single to married
Marriage Contract with Registry Number issued by Philippine Statistics Authority (PSA)
b. Married to single
Court Order
c. Widowed
Death Certificate of deceased spouse
NOTE: IN ALL INSTANCES WHEREIN PHOTOCOPIES ARE SUBMITTED, THE ORIGINAL DOCUMENT MUST
BE PRESENTED FOR AUTHENTICATION.