PFF053 MembersContributionRemittanceForm V02-Fillable
PFF053 MembersContributionRemittanceForm V02-Fillable
PFF053 MembersContributionRemittanceForm V02-Fillable
MEMBER'S CONTRIBUTION
REMITTANCE FORM (MCRF)
NOTE: PLEASE READ INSTRUCTIONS
EMPLOYER/BUSINESS
NAME
123456789
AT THE BACK.
A COMPANY
EMPLOYER/BUSINESS ADDRESS
Unit/Room No" Floor
Building Name
Street Name
Municipality/City
Province/State/Country
ZIP Code
METRO MANILA
Subdivision
Barangay
(if abroad)
METRO MANILA
Pag-IBIG
MID
No.lRTN
ACCOUNT
NO,
NA
1234567890
NAME OF MEMBERS
MEMBERSHIP
PROGRAM
Last Name
First Name
DELA CRUZ
JUAN
MEMBERSHIP
Name Ext.
(Jr. 1/1, etc.)
Middle Name
II
PERIOD
COVERED
MONTHLY
COMPENSATION
DEC 2013
~TIlii. �~,i'
,tW'
c_fw;i,x
>i'
.;"X,g;
EE
SHARE
ER
SHARE
REMARKS
TOTAL
NONE
100
100
200
1" 10000
1" 10000
1" 10000
1"20000
."i~.R,~~I~i~
CE~D,~~~~iL~~:
'11",'
1~~,'jr$~
. .,~ti!t"'~!
fW
CONTRIBUTIONS
<M?
'"
*&";1,,.
'Ii.
I hereby certify under pain of perjury 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 signature appearing herein is genuine and authentic,
OWNER
DESIGNATION/POSITION
(Revised
7/2012)
CONTRIBUTION RATE
EMPLOYEE
EMPLOYER
TOTAL
1%
2%
2%
2%
3%
4%
f.
MEMBER'> CONTRfBUTION
.";:l"r ... ;.~u.
'.:~:-'
0'.
,.~<O' .. ~,
.r-
~1'"
.~~
I..
.....
""~j;C7."'C
~I!.
.
:;;0;
'~u.~.;._.,;;';1
'\''''
Pag-IBIG Employer's
Number.
Employer/Business
Employer/Business
Address - indicate UniURoom No., Floor,
Building Name or Lot No., Block No., Phase No. or House No. and
Street Name, Subdivision, Barangay, Municipality/City, Province,
and ZIP Code.
Pag-IBIG MID No.lRTN - indicate the member's assigned Pag-IBIG
Membership Identification (MID) Number or Registration Tracking
Number (RTN)
Account
No. - indicate
the member's
Number per Membership Program.
R!2MITTANCfJ::QRM(MGRf)
assigned
Account
NOTE: In accomplishing
the Account Number column, for
Pag-IBIG I contributions,
indicate MID Number or RTN; for
Pag-IBIG II, indicate the assigned Account Number; for
MP2, indicate
the system-generated
Account
Number
provided after successful enrollment.
Membership Program - indicate if MC remittance is for Pag-IBIG I,
Pag-IBIG " or Modified Pag-IBIG II program.
Name of Members - indicate member's complete name in the
following format: Last Name, First Name, Name Extension (Jr., III,
etc.), Middle Name
Period Covered - indicate the applicable month and year of MC
remittance in the following format (YYYYMM).
Monthly Compensation
- refer to the basic salary and other
allowances, where basic salary includes, but is not limited to, fees,
salaries, wages, and similar items received in a month. Accomplish
this portion only when remitting the member's initial membership
contribution or if there are changes in monthly compensation of the
member.
Membership
Contributions
-~icate
the amount of employee
contributions
under columJl-:.-,.\jQ) the amount of employer
contributions under column , apd.,!he total amount of employee
and employer contributions under\.:11J. Do not round-off nor drop
centavos .
Remarks - accomplish this portion only to report changes in the
employee's/member's
employment status and to update any
information
regarding
the employee/member.
Indicate
the
appropriate code and effectivity date in the following format
(mm/dd/yy) on the space provided for. Please refer to the following
codes and examples:
N
L
RS
RT
o
o
Newly Hired
Leave Without Pay/AWOL
Resigned/Separated
Retired
- Deceased
- Others, please specify reason
Examples
1.N: 1/4/2012
2. L: 1/21/2012
3. RS: 1/3/2012
4.D: 1/14/2012
Indicate the total amount due and employer contributions per page
Indicate the grand total amount due and employer contributions
if this is the last page.
Employer Certification
- to be accomplished and duly signed by
the Head of Office/Authorized Representative.
15
-:;::;"'-:O-~7:~r~:N.':;
~~-:-,,~:~:-.:.'-~~~~~:
.. '
$;:~;:.;,..",--:r=.~
.."'_ -
.,,=_..._:.
~_u.~~
---~-----