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WWW - Pagibigfund.gov - PH DLForms Provident 03122012 FPF100 Employer'sChangeofInformation V01
WWW - Pagibigfund.gov - PH DLForms Provident 03122012 FPF100 Employer'sChangeofInformation V01
REQUIREMENTS
1. For change/correction of Employer/Business Name, submit certified true copy of the following, whichever is applicable: a. Single Proprietorship b. Partnership/Corporation c. Cooperative/Trade Association Certificate of Registration Certificate of Registration from Securities CDA Certificate from DTI; or & Exchange Commission (SEC); or (For Cooperative) Business/Mayors Permit Amended Articles of Partnership/ SEC Certificate of Incorporation Incorporation (For Trade Association) 2.For change of Legal Personality, submit certified true copy of the following: a. Single Proprietorship to Corporation b. Partnership to Corporation Certificate of Registration from Securities & Exchange Articles of Incorporation; and Commission (SEC); Deed of Dissolution of Partnership Articles of Incorporation; and Certificate of Cancellation as Single Proprietorship c. Other Documents HDMF reserves the right to request for additional supporting documents. 3.For change of Authorized Representative, submit Specimen Signature Form (SSF, [FPF170]) and certified true copy of the following: Board Resolution Secretarys Certificate
EMPLOYER/BUSINESS NAME
Business (Direct Line) Lot No. Block No. Phase No. House No. Street Name Business (Fax) Subdivision Barangay Business (Trunkline) ZIP Code Email Address Local
Municipality/City
Province
CERTIFICATION
I HEREBY CERTIFY THAT THE INFORMATION GIVEN AND ALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I FURTHER CERTIFY THAT MY SIGANTURE APPEARING HEREIN IS GENUINE AND AUTHENTIC.
____________________________________________________
HEAD OF OFFICE OR AUTHORIZED REPRESENTATIVE (Signature Over Printed Name)
__________________________________
DESIGNATION/POSITION
_________________________
DATE
DTI/SEC Registration Business/Mayors Permit Amended Articles of Partnership/ Incorporation/Cooperation Board Resolution
CDA Certificate SEC Certificate of Incorporation Secretarys Certificate Specimen Signature Form (SSF) Others (Please specify) __________________________
Revised 03/2011