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HQP-HLF-450 Checklist of Requirements -Home Rehabilitation/Reconstruction Loan

Pag - Ibig checklist for home rehabilitation/reconstruction loan application for members affected by calamity

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HQP-HLF-450

HOME REHABILITATION/RECONSTRUCTION LOAN APPLICATION
 Express

 Regular

Housing Loan (HL) Account Number, if with existing HL

Pag-IBIG MID Number/RTN

(PRINT ALL ENTRIES IN BLOCK OR CAPITAL LETTERS)

LOAN PARTICULARS
PURPOSE OF LOAN

WITH EXISTING HL APPLICATION

DESIRED LOAN AMOUNT
 Construction/Completion of a
Residential Unit
 Home Improvement
 Purchase of a Fully Developed
Lot and Construction of
Residential Unit
 Purchase of a Residential Unit
with Home Improvement

 Purchase of Residential House and Lot,
Townhouse or Condominium Unit
 Rehabilitation/Construction of a damaged
Residential Unit
 Rehabilitation/Construction of a
Residential Unit Mortgage with or
assigned to the Fund

 YES

MODE OF PAYMENT
 Salary deduction
 Over-the-Counter
 Post-Dated Check
 Cash/Check

 NO

If yes, indicate HL Application No.

DESIRED LOAN TERM (No. of years)

___________________________

 Collecting Agent
 Bank
 Developer
 Remittance Center

DESIRED RE-PRICING PERIOD
(Years)
 3

 5

 10

 20

 25

 30

 15

COLLATERAL
TYPE OF PROPERTY
 Rowhouse
 Townhouse

PROPERTY LOCATION (Street, Municipality, Province)

 Condominium

 Single Attached  Single Detached  Duplex
NAME OF REGISTERED TITLE HOLDER/DEVELOPER

DESCRIPTION OF
IMPROVEMENTS

TCT/OCT/CCT NO.

TAX DECLARATION NO.

LOT/UNIT NO.

IS PROPERTY PRESENTLY
MORTGAGED?

LAND AREA

AGE OF HOUSE (For Purchase of a
Residential Unit)

 YES

 NO

BLOCK/BLDG NO.

EXISTING

PROPOSED

No. of
STOREYS
TOTAL FLOOR AREA

SQM

SQM

SQM

BORROWER’S/BUYER’S DATA
LAST NAME

SEX

M

FIRST NAME

F

NAME EXTENSION

MIDDLE NAME

CITIZENSHIP







DATE OF BIRTH (mm/dd/yy)

EE SSS/GSIS ID No.

TIN

MARITAL STATUS

NO. OF DEPENDENT/S

PERMANENT HOME ADDRESS

Single/Unmarried
Married
Widow/er
Legally Separated
Annulled

ATTACH HERE
1”X1”
ID PHOTO
OF APPLICANT

CONTACT DETAILS (Indicate country

Unit/Room No., Floor

Building Name

Lot No., Blk No., Phase No., House No.

Subdivision

Barangay

Municipality/City

Street Name

code if abroad)
COUNTRY + AREA CODE TELEPHONE NO.

Province and State Country (if abroad)

Zip Code

PRESENT HOME ADDRESS
Unit/Room No., Floor

Building Name

Subdivision

Lot No., Block No., Phase No., House No.

Barangay

Municipality/City

Cell Phone

Street Name

Province and State Country (if abroad)

HOME OWNERSHIP
 Owned
 Company
 Living w/ relatives/parents
EMPLOYER/BUSINESS NAME (If self-employed)

 Mortgaged

Home

Zip Code

 Rented at P__________/mo.
Pag-IBIG EMPLOYER ID No.

Email Address

CONTACT DETAILS (Indicate country
code if abroad)
COUNTRY + AREA CODE TELEPHONE NO.

Business (Direct Line)
EMPLOYER/BUSINESS ADDRESS
Unit/Room No., Floor

Building Name

Lot No., Block No., Phase No., House No.,

Subdivision

Barangay

Municipality/City

OCCUPATION
 Employed
 Self-Employed

Province and State Country (if abroad)

POSITION & DEPARTMENT

Business (Trunk Line)

Street Name

Employer/Business Email Address

Zip Code

YEARS IN EMPLOYMENT/ BUSINESS

PREFERRED MAILING ADDRESS
 Present Home Address
 Employer/Business Address
 Permanent Home Address

SPOUSE’S PERSONAL DATA
LAST NAME

FIRST NAME

CITIZENSHIP

NAME EXTENSION

DATE OF BIRTH (mm/dd/yy)

MIDDLE NAME

TIN

OCCUPATION
 Employed
 Self-Employed
YEARS IN EMPLOYMENT/ BUSINESS

EMPLOYER/BUSINESS NAME (If self-employed)
EMPLOYER/BUSINESS ADDRESS

POSITION & DEPARTMENT

Unit/Room No., Floor

Building Name

Lot No., Block No., Phase No., House No.

Subdivision

Barangay

Municipality/City

Street Name

Province and State Country (if abroad)

Zip Code

BUSINESS TEL. NO.

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

(V02, 06/2016)

REAL ESTATE OWNED
LOCATION

TYPE OF PROPERTY

ACQUISITION COST

MARKET VALUE

MORTGAGE
BALANCE

RENTAL INCOME

OUTSTANDING CREDITS/LOAN AVAILMENTS
Creditor & Address

Security

Mo. Amortization

Type

Maturity Date

Amount/Balance

Security

Maturity Date

Amount/Balance
Creditor & Address

Mo. Amortization

Type

Security

Maturity Date

Amount/Balance
Creditor & Address

Type

Mo. Amortization

MISCELLANEOUS
(Answer the following questions with YES or NO. If your answer is YES, please elaborate on the details as required)
Are there past or pending cases against you?  Yes
 No
If yes, please indicate the nature, plaintiff, amount involved and the status.
Do you have past due obligations?  Yes
 No
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?  Yes
 No
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?  Yes
 No
If yes, please indicate the condition/diagnosis.

LOAN AND CREDIT REFERENCES
BANK/FINANCIAL INSTITUTION

ADDRESS

PURPOSE

HIGHEST
AMOUNT OWED

SECURITY

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.

SOURCE OF Pag-IBIG FUND HOME REHABILITATION/RECONSTRUCTION LOAN PROGRAM 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 I/we are victim/s and resident/s of calamity-stricken areas affected by calamity.
I/We certify that the foregoing information/statement is to my/our knowledge, true, correct, complete, and updated. The signature/s appearing below is/are
genuine. I/We authorize Pag-IBIG Fund or its duly authorized representative: 1) to verify necessary information or data (i.e., certificate of employment, pay slips and
income tax return) with the concerned government agencies, any other or third parties including banks and other financial institutions from whom Pag-IBIG Fund had
obtained information; 2) to submit and disclose to any credit information service providers that may be commissioned/subscribed by Pag-IBIG Fund whether positive or
negative information relating to my/our housing application/account and any updates or corrections thereof; and 3) to send me/us updates about my/our housing loan
application/account via SMS/text, email, mail or other available means of communication.
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.
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 PagIBIG 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 pay Pag-IBIG Fund the corresponding processing fees and appraisal fees, if applicable.

____________________________________
SIGNATURE OF BORROWER/BUYER

____________________________________
SIGNATURE OF SPOUSE

____________________________________
DATE

____________________________________
DATE

For Pag-IBIG Fund USE ONLY
DATE FILED

RESIDENT OF CALAMITY STRICKEN
AREA?

DATE INSPECTED:

INSPECTED BY:

REMARKS ON INSPECTION

CERTIFIED BY:

VERIFIED BY:

REMARKS

 Yes

PROOF OF DAMAGED PROPERTY
SUBMITTED

 No

THIS FORM CAN BE REPRODUCED. NOT FOR SALE.
 
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