MEMBER`S CHANGE OF INFORMATION FORM (MeIF)

HQP·PFF·049
MEMBER'S CHANGE OF
INFORMATION FORM (MeIF)
o
APPROPRIATE
,~
1. For change of name and/or marital status because of marriage, submit photocopy of Marriage Contract
with registry number.
2. For correction/change
of name and/or marital status for reason other than marriage, submit certified
true copy of Birth Certificate issued by the National Statistics Office (NSO), Court Order or Death
Certificate of the deceased spouse, whichever is applicable.
3. For correction of date of birth, submit certified true copy of Birth Certificate issued by the National
Statistics Office (NSO).
4. For updating of beneficiaries,
submit certified true copy of Birth Certificate
of the additional
beneficiary/ies issued by the National Statistics Office (NSO) to establish relationship with the member.
Accomplish this form in one (1) copy.
Accomplish the applicable portions to be changed only.
Type or print all entries in BLOCK/CAPITAL
LETTERS.
This form shall be submitted to any of the following:
a) Thru Employer, if employed
b) Thru on-line
c) Thru Pag-IBIG NCR/Regional branch.
CHECK
o
~
ifI!;!b
REQUIREMENTS
INSTRUCTIONS
1.
2.
3.
4.
%
~
BOX ONLY
o
1. CORRECTION
OF NAME
2. CORRECTION
OF DATE OF BIRTH
LAST NAME
o
FIRST NAME
3. CHANGE
OF MARITAL
4. CHANGE
OF FREQUENCY
NAME EXTENSION
o
STATUS
o
OF MC PAYMENT
(e.g., jr., /I, etc.)
5. UPDATING
6. CHANGE
MIDDLE
OF HEIRS
OF ADDRESS/CONTACT
NAME
DETAILS
NO MIDDLE NAME
(Check if applicab/e only)
o
RELATIONSHIP
Lot No., Block No., Phase No. House No
~------------------~------~~------------------------~~~--,
Barangay
Municipality/City
PERMANENT HOME ADDRESS
Unit/Room No., Floor
Building Name
Province/State/Country
o
o
o
o
o
o
o
o
o
Street Name
(if abroad)
Lot No, Block No., Phase No. House No
Street Name
Subdivision
(Indicate country code if abroad)
COUNTRY+AREA CODE TELEPHONE NUMBER
Home
ZIP Code
Cell phone
Subdivision
I
I
Business (Direc;-:t..:L-=in..:e!....)
I
I ~I
~I __
~
Business (Trunkline)
I
Barangay
Municipality/City
DOCUMENTS
o
o
D
Death
(if abroad)
ZIP Code
Local
'Ir---'-----' 1
__
Email Address
SUBMITTED
Birth Certificate
Marriage
Province/State/Country
_
_
Contract
D
D
Court Order
Others (P/ease specify)
Certificate
THIS FORM MA Y BE REPRODUCED.
NOT FOR SALE.
(Revised
08/2012)