HOUSING PLAN APPLICATION FORM

Type of Application, kindly put check (✓)

NEW _____ DATE OF APPLICATION:

RE-AVAILMENT ______

LAST NAME FIRST NAME MIDDLE NAME GENDER CIVIL STATUS

POSITION DEPARTMENT DATE HIRED EMPLOYEE

NUMBER

PRESENT ADDRESS CONTACT NUMBER

BIRTHDATE AGE PLACE OF BIRTH

DETAILS OF THE UNIT APPLIED FOR

PROJECT:

UNIT TYPE AND UNIT NO:

EXACT LOCATION:

TOTAL CONTRACT PRICE:

________________________________ __________________________
NAME AND SIGNATURE OF EMPLOYEE RECEIVED BY HR DEPARTMENT

GT.HRD.HPA.V1.2021
 FOR HRD USE ONLY

JOB RANK: __________________________

EMPLOYMENT STATUS: _______________
YEARS OF SERVICE: ___________________
CREDIT STANDING (please specify existing loan if there is any)
a. Employee Salary Loan ____________________________________
b. Government Financial Assistance Loan ______________________
c. Others _________________________________________________

THIS IS TO CERTIFY THAT ______________________________ MEET THE NUMBERED OF YEARS OF SERVICE

RENDERED TO QUALIFY FOR THE AVAILMENT OF HOUSING PLAN.

THIS IS TO CERTIFY THAT ______________________________ HAS NOT HAVE ANY ON-GOING INFRACTIONS OR
VIOLATED PROVISIONS FROM THE CODE OF DISCIPLINE IN EMPLOYEE HANDBOOK.

_______________________________________ _____________________________________
NAME AND SIGNATURE OF HR REPRESENTATIVE NAME AND SIGNATURE OF DEPT./DIV. HEAD

FOR SALES DEPARTMENT USE ONLY

FOR PROJECT: ______________________ UNIT TYPE: ________________ UNIT NO: ___________

TOTAL CONTRACT PRICE: __________________

LESS DISCOUNT: _________________________

NET CONTRACT PRICE: ____________________

PARKING SLOT (IF APPLICABLE): ____________

ADD OTHER EXPENSES: ____________________

TOTAL MONTHLY AMORTIZATION: ___________

START OF PAYMENT:

PREPARED BY: _____________________________

NAME AND SIGNATURE AND DATE

GT.HRD.HPA.V1.2021
 FOR PAYROLL AND ACCOUNTING USE ONLY

MONTHLY SALARY: ____________________________________

ALLOWANCE (IF APPLICABLE): ___________________________

LESS: TOTAL MONTHLY AMORIZATION: ___________________

TOTAL SALARY DEDUCTION: ____________________________

_______________________________________ _______________________________________
NAME AND SIGNATURE OF PAYROLL REPRESENTATIVE NAME AND SIGNATURE OF ACCTG. REPRESENTATIVE

ACKNOWLEDGEMENT

This is to acknowledge that I have availed of the company’s housing plan in the total amount of
___________________________. This does not include other expenses which are for my account and payable to
the company cash. In view of this, I hereby authorized the company to deduct from my salary a monthly amount of
___________________________ payable to Golden Topper, Inc.

TOTAL ____________________________

Effective ___________________

It is understood that this authority shall continue to be in effect as long as I am employed with the
Company and if the said loan for still Is outstanding. Otherwise, I have to settle any unpaid obligations in
accordance with the provisions of our contract.

________________________________ ___________________
NAME AND SIGNATURE OF EMPLOYEE DATE

This is to certify that _____________________________ is was able to meet the requirements and
qualified to avail company housing plan program.

Approved by:

ALLAN L. CRISOLOGO
President

REQUIREMENTS: Three Original Copies of HPA Form, Three Copies of Valid IDs, Three Copies of Sample

GT.HRD.HPA.V1.2021
Computation of unit availed.

GT.HRD.HPA.V1.2021