Common Contracts
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APPLICATION FOR PENALTY CONDONATION UNDER R.A. 9679October 30th, 2018
EMPLOYER/BUSINESS NAME Pag-IBIG EMPLOYER ID No./ REGISTRATION TRACKING NUMBER EMPLOYER/BUSINESS ADDRESS DATE FILED DATE OF REGISTRATION WITH CONCERNED AGENCIES (SEC/DTI/CDA) PAYMENT SCHEMEFULL PAYMENT PLAN OF PAYMENT START OF BUSINESS OPERATION m m d d y y y y REASON/S FOR FAILURE TO REGISTER COVERED EMPLOYEES AND/OR REMIT THE REQUIRED MEMBERSHIP SAVINGS TELEPHONE NUMBER WITH PREVIOUS AVAILMENT OF PENALTY DISCOUNT?YES NO APPLICATION AGREEMENT I hereby certify that I have read and understood the contents hereof, including the guidelines and instructions indicated at the back portion of this form. I further certify that all information I have indicated herein and statements declared in the payroll, remittance form and other documents submitted to the Fund are true and correct to the best of my knowledge and belief, and that my signature appearing herein is genuine and authentic. I shall abide with the applicable Guidelines on penalty condonation, and those that the Pag-IBIG Fund may pro
