Osjempc Membership
Osjempc Membership
Osjempc Membership
NOTE: Please check the appropriate box for your preference in the payment of your loans and dividends.
Through the issuance of checks For credit to LBP ATM Account
PERSONAL DATA:
Name:
Present Home Address:
Date of Birth: Civil Status:
Official Station: Position:
Telephone No.: Cell Phone No. :
Name of Spouse: Occupation:
Name of Parents: (SURVIVING PARENTS ONLY)
1.
2.
Name of Dependent Children/s: (MINORS ONLY) Date of Birth
1.
2.
3.
4.
Name of Beneficiary/ies in case
the abovementioned qualified dependents are no longer available/qualified:
1.
2.
This application for membership was approved/disapproved by the Board of Directors in its
meeting held on , 20 .
Membership No.
Secretary