For Change/Correction of Name or Change of Status/Benefciaries

1. 1.
BEFORE PRESENT
LAST NAME FIRST NAME MIDDLE NAME LAST NAME FIRST NAME MIDDLE NAME
I N S T R U C T I O N S
HDMF
M2-2
MEMBER'S CHANGE OF INFORMATION
CHANGE OF BENEFICIARY/IES
NAME DATE OF BIRTH
FOR HDMF USE ONLY
SIGNATURE OF MEMBER DATE HDMF ID No.
RELATIONSHIP ADDRESS
THIS FORM CAN BE REPRODUCED. NOT FOR SALE
I HEREBY CERTIFY THAT THE FORE GO ING STATE MENTS ARE TRUE
AND COR RECT TO THE BEST OF MY KNOWL EDGE.

Received by Date
Rectifed by Date
Processed by Date Date
Date
Received by Date
Imakinilya o ilimbag ang bawat sagot.
Isagawa ito sa dalawang (2) kopya. Ang una at pangalawang kopya ay
ibigay sa tagapag-empleyo upang ito ay maipadala sa Pag-IBIG Fund
-NCR Branch/Re gion al or Extension Offce.
Kung ang pagbabago ay sa pangalan or sa "Civil Status" dahil
sa pag-aasawa, magbigay ng kopya ng "Marriage Contract", kung ang
pagbabago sa pangalan ay hindi dahil sa pag-aasawa, magbigay ng
kopya ng "Certifed True Copy" ng "Court Order" o Birth Certifcate.
Type or print all entries.
Accomplish this form in two (2) copies. The original and the second copy of
this form should be coursed thru your employer for submission to Pag-IBIG
Fund - NCR Branch/Regional or Extension Offce.
For change in name and/or civil status because of mar riage, submit a copy
of Marriage Contract, for change in name (for reason other than mar riage),
sub mit a cer ti fed true copy of "Court Order" or Birth Cer tif cate.
2.
3.
2.
3.