Osjempc Membership

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OSJEMPC Form No.

APPLICATION FOR MEMBERSHIP


I hereby apply for membership in the OFFICE OF THE SECRETARY OF JUSTICE EMPLOYEES’
MULTI-PURPOSE COOPERATIVE (OSJEMPC) and its MUTUAL AID BENEFIT FUND (MABF). I
agree to obey faithfully its rules and regulations as set down in its Articles of Cooperation and By-
Laws, and the decisions of the General Assembly membership meetings and those of the Board of
Directors.
I hereby pledge to:
1. Pay the membership fee of P 200.00 and initial deposit of P 200.00.
2. Pay the MABF membership of P 50.00 and P 50.00 advance contribution as
revolving fund. (MABF is not applicable to applicants 56 years old and above).
3. Pay additional P 25.00 advance contribution to the MABF for each of my
surviving parents. (For Married Members Only)
4. Contribute a monthly deposit of P (Minimum of P 200.00/month)
as my Share Capital and P 50.00 for MABF dues to be deducted from my
monthly salary.
5. Contribute additional monthly dues of P 25.00 for each of my surviving parent
to be deducted from my monthly salary. (For Married Members Only)
6. Comply with the membership and subscription agreement. For your
consideration, hereunder is my accomplished information sheet.

Date Signature over Printed Name

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

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