FPF060

MEMBERSHIP REGISTRATION/REMITTANCE FORM

PRIVATE EMPLOYER

LOCAL GOVERNMENT UNIT

GOVERNMENT CONTROLLED CORP.

AGENCY BRANCH REGION

FOR PRIVATE

EMPLOYER SSS NO.

EMPLOYER
ADDRESS OF EMPLOYER

TIN

TIN

(Family Name

First Name

FOR GOVT
EMPLOYER

ZIP CODE

NAME OF EMPLOYEES

DATE OF BIRTH

YEAR

NATIONAL GOVERNMENT AGENCY

(Please read instructions at the back)

NAME OF EMPLOYER

MONTH

CODE

CODE

CODE

TELEPHONE NO/S.
CONTRIBUTIONS

EMPLOYEE

Middle Name)

EMPLOYER

TOTAL

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
No. of Employees
on this page

Total No.of Employees

if last page

PFR/VALIDATION No.

FOR Pag-IBIG USE ONLY

DATE
MM

DD

COLLECTING BANK
TICKET DATE
MM
DD

YY

RECONCILED BY

YY

AMOUNT

TOTAL FOR
THIS PAGE

GRAND TOTAL
(if last page)

CERTIFIED CORRECT BY:

P
REMARKS

SIGNATURE OVER PRINTED NAME

CHECKED BY

OFFICIAL DESIGNATION

DATE
PAGE NO.

NO. OF PAGES

NOTE: NEW REGISTRANTS SHALL PROVIDE TIN AND DATE OF BIRTH

THIS FORM CAN BE REPRODUCED. NOT FOR SALE

(Revised 12/2007)

HOW TO ACCOMPLISH THIS FORM

1.

2.

19th day
of the
month

Please
type
or
print
all
entries.

M to Q

Prepare
this form
in two (2)
copies
[three (3)
copies for
national
governme
nt
employers
]
every
end
of3.
each
calendar
month
when
making
remittance
s to
Pag-IBIG
Fund or to
any
collecting
agent

20th to
the 24th
day of
the
month

Up to P1,500.00
P1,501.00-P5,000.00
Over P5,000.00

EEs*

ERs**

TOTAL

1%
2%
2% of MC

2%
3%
2%
4%
2% of P5,000.00***

FPF060

MEMB
ERSHI
P
REGIS
TRATI
ON/RE
MITTA
NCE
FORM

R to Z
25th to
the end
of the
month

For employer
with
branch
offices, please
prepare
separate
Membership
Registration/Re
mittance Form
(MRRF)
for
each
branch
indicating
therein
their
respective
addresses.
Schedule of
Payments
Take note that
the maximum
Firs
Monthly
t
Compensation
lette
(MC) of Pagr of
IBIG
I
employeeDue
members
is
Dat
P5,000.00.
e
However, those
Employers/
with MC over
Company
P5,000.00 may
Name
declare
their
A to
actual
salary
D
levels
for
computing their
10th
monthly Pagto
IBIG
the
contribution.
14th
For purposes
day
of computing
of
the
the
mon
Employees/Em
th
ployers
E to
contribution,
L
please
be
guided by the
15th
following.
to
the

(BASIC + COLA)

PRIVATE EMPLOYER

LOCAL GOVERNMENT UNIT

GOVERNMENT CONTROLLED CORP.

NAME OF EMPLOYER

EMPLOYER SSS NO.

FOR PRIVATE

EMPLOYER

ADDRESS OF EMPLOYER

TIN

ZIP CODE

(Family Name
10

First Name

1.

11

BRANCH
CODE

REGION
CODE

TELEPHONE NO/S.
9

7
NAME OF EMPLOYEES

DATE OF BIRTH

AGENCY
CODE

FOR GOVT
EMPLOYER

6
TIN

MONTH

NATIONAL GOVERNMENT AGENCY

(Please read instructions at the back)

CONTRIBUTIONS
Middle Name)

12

EMPLOYEE

EMPLOYER

13

14

TOTAL
15

2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
No. of Employees
on this page

40.
Total No. of Employees
if last page

16

FOR Pag-IBIG USE ONLY

PFR/VALIDATION No.

DATE
MM

AMOUNT

DD

COLLECTING BANK
TICKET DATE
MM

RECONCILED BY
DD

YY

TOTAL FOR
THIS PAGE
GRAND TOTAL
(if last page)

18
19

P
P

P
P

P
P

CERTIFIED CORRECT BY:

REMARKS

SIGNATURE OVER PRINTED NAME

CHECKED BY

OFFICIAL DESIGNATION

DATE
PAGE NO.NO. OF PAGES

20

NOTE: NEW REGISTRANTS

SHALL PROVIDE TIN AND DATE
OF BIRTH

MONTHLY COMPENSATION

YY

17

T
H
I
S
F
O
R
M
C
A
N
B
E
R
E
P
R
O
D
U
C

21

ED.
NOT
FOR
SALE

*EEs Employees
share

t.
For
local
government
and
controlled
corporation
s,
remit
employees
share
together
with
employers
counterpart

**ERs Employers
share

1**
The
employe
r
may
match
his
employe
es
contribut
ions
based
on their
higher
MC
If
the
employer
provides
only
the
mandatory
counterpart,
which is up
to P100.00,
the
employee
has
the
option
to
shoulder
the
ER
counterpart
for
the
portion
of
his MC over
P5,000.00

4.

5.

(3%)
penalty per
month
of
the amount
payable
from
the
date
the
contribution
s fall due
until
paid
(Sec. 22 of
PD 1752)

Put an X
mark
to
indicate
employer
classification.

When making
remittances to
Pag-IBIG
Fund, indicate
the applicable
month
and
year
of
contribution.

Print name of
the employer.

For
private
employers,
indicate your
Employer
SSS ID No.

For
government
employers,
indicate your
Agency,

For national
government
agencies,
indicate the
employee
and
employer
contribution
s in the
report
but
remit
only
the
employees
share. The
employers
share will be
to
the
Department
of
Budget
and
Managemen

Non-payment
of
contributions
shall subject
the employer
to a three
percent

Branch
and
Region
Codes.

e
the
correct Tax
Identificatio
n No. (TIN)
of
your
employees
to
ensure
the
contribution
s
are
credited to
their
respective
accounts.

Print the
full
address
of
the
employe
r.

For
employ
er with
branch
offices,
please
prepar
e
separat
e
MRRF
for
each
branch
indicati
ng
therein
their
respect
ive
addres
ses.

11

12

Indicate
employees
birth date in
numeric
format.
Example
March 20,
1956,
shall
be written as
03/20/56.
List

total amount
of employee
and employer
contributions.

16

Indicate the
number
of
employees
listed in this
page.

17

Indicate

18

Indicate the
total amount
of employee
contribution
s
(under
column 13 ),
the
total
amount of
employer
contribution
s
(under
column 14 )
and the total
amount of
employee
and
employer
contribution
s
(under
column 15 )
for
this
page.

the

name of your
employees.
This may be
for

the

purpose

of

registering
your
employees
for Pag-IBIG
membership

or

Indicate
employers
Tax
Identification
No. (TIN)

contributions

13

Indicate
the zip
code.

Indicate
14
the
telephon
e
number/
s of the
employe
r.

Indicat

19

10

for

remitting

15

Indicate the
amount of
employee
contribution
s. Do not
round
of
nor
drop
centavos.
Indicate the
amount of
employer
counterpart
contribution
s. Do not
round
of
nor
drop
centavos.
Indicate

the

the

total number
of employees
listed if this is
the last page
of the listing.

20

21

Indicate the
grand total
of employee
contribution
s
(under
column 13 ),
the
grand
total
of
employer
contribution
s
(under
column 14 )
and
the
grand total
of employee
and
employer
contribution
s
(under
column 15 )
if this is the
last page.
Indicate the
number
of
this page.
Indicate the
total number
of pages of
this listing.