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HQP-AAF-032 Application for Lease under RTO Program (ALRTOP)
Pag - Ibig application form for rent o to - own program lease
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APPLICATION FOR LEASE UNDER
THE RENT-TO-OWN PROGRAM
PROPERTY LOCATION
Property Number
Unit/Rm. No., Floor
Building Name
Lot No., Blk No., Phase No., House No.
Street Name
Barangay
Municipality/City
Province and State
Zip Code
LAST NAME
FIRST NAME
Subdivision
MEMBER-APPLICANT DATA
NAME EXTENSION
MIDDLE NAME
DATE OF BIRTH (mm/dd/yy)
Unit/Rm. No., Floor
Building Name
Lot No., Blk No., Phase No., House No.
Street Name
SEX
F
Subdivision
Barangay
ATTACH HERE
1” X 1” ID
PHOTO OF
APPLICANT
AGE
PERMANENT HOME ADDRESS
Municipality/City
Province and State
Country (if
abroad)
Zip Code
M
TIN
MARITAL STATUS
Single/
Unmarried
Married
Widow/er
PRESENT HOME ADDRESS
Unit/Rm. No., Floor
Subdivision
Building Name
Barangay
Lot No., Blk No., Phase No., House No.
Municipality/City
Province and State
Street Name
Country (if
abroad)
Zip Code
Legally
Separated
Annulled/Divorced
Unit/Rm. No., Floor
Subdivision
Building Name
Barangay
Lot No., Blk No., Phase No., House No.
Municipality/City
Years In Employment/Business
Province and State
Street Name
Country (if
abroad)
Zip Code
COUNTRY+AREA CODE TEL.
NO.
Business (Direct Line)
Cell Phone
Business (Trunk Line)
Email Address
EMPLOYER/BUSINESS ADDRESS
BUSINESS CONTACT
DETAILS
(indicate country code if
abroad)
COUNTRY+AREA CODE TEL.
NO.
Home
Employer/Business Name
PERSONAL CONTACT
DETAILS
(indicate country code if
abroad)
Email Address
Position & Department/Occupation
PREFERRED MAILING ADDRESS
Present Home Address
Employer/Business Address
Permanent Home Address
SPOUSE’S PERSONAL DATA
LAST NAME
FIRST NAME
NAME EXTENSION
MIDDLE NAME
DATE OF BIRTH
Employer/Business Name
YEARS IN EMPLOYMENT/BUSINESS
EMPLOYER /BUSINESS ADDRESS
Unit/Rm. No., Floor
Building Name
Barangay
TIN
POSITION & DEPARTMENT/OCCUPATION
Lot No., Blk No., Phase No., House No.
Municipality/City
Province and State
Street Name
Country (if abroad)
Subdivision
Zip Code
BUSINESS TEL. NO.
I hereby certify that all information given in this application is to my knowledge, true, correct, complete and updated. The signature
appearing below is genuine. I further certify that I do not have an existing housing loan with Pag-IBIG Fund, that I have not
previously availed of the Pag-IBIG Rent-to-Own (RTO) Program for at most two (2) times, and that I have not yet exercised my
option to purchase the property.
___________________________________
Signature of Member-Applicant
____________________________
Date
FOR Pag-IBIG FUND USE ONLY
CONTRIBUTIONS/HOUSING LOAN VERIFICATION
LATEST CONTRIBUTION RECORD
(Month and Year)
________________
AMOUNT
VERIFIED BY:
DATE
P______________
WITH Pag-IBIG HOUSING LOAN
Yes
No
APPROVED BY
PFR NO./DATE
DATE
BENEFICIARY OF RTO PROGRAM FOR TWO (2) TIMES
YET HAVE NOT OPT TO PURCHASE THE PROPERTY
Yes
No
DISAPPROVED BY
DATE
THIS FORM CAN BE REPRODUCED. NOT FOR SALE.
REMARKS
(October 2012)
