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    Availment Request Form: Bank Details

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    Chris Iero-Way
    The document is an availment request form for Loyola Plans Consolidated, Inc. It requests information from customers such as their name, address, contact details, bank account information, and the type of request whether it is for cash surrender value, unrendered service, buyback, etc. It certifies that the details provided are true and correct and reminds customers to attach required documents like the certificate of full payment and valid ID copy.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Availment Request Form: Bank Details

    Uploaded by

    Chris Iero-Way
    10K views1 page
    The document is an availment request form for Loyola Plans Consolidated, Inc. It requests information from customers such as their name, address, contact details, bank account information, and the type of request whether it is for cash surrender value, unrendered service, buyback, etc. It certifies that the details provided are true and correct and reminds customers to attach required documents like the certificate of full payment and valid ID copy.

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    The document is an availment request form for Loyola Plans Consolidated, Inc. It requests information from customers such as their name, address, contact details, bank account information, and the type of request whether it is for cash surrender value, unrendered service, buyback, etc. It certifies that the details provided are true and correct and reminds customers to attach required documents like the certificate of full payment and valid ID copy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10K views1 page

    Availment Request Form: Bank Details

    Uploaded by

    Chris Iero-Way
    The document is an availment request form for Loyola Plans Consolidated, Inc. It requests information from customers such as their name, address, contact details, bank account information, and the type of request whether it is for cash surrender value, unrendered service, buyback, etc. It certifies that the details provided are true and correct and reminds customers to attach required documents like the certificate of full payment and valid ID copy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Penthouse Floor, Virra 1 Condominium 500 P. Burgos Street, Makati City, Philippines Tel. Nos.

    (632) 892-6061-63: (632) 892-6072 to 73 and 817-0000


    Website: http://www.loyolaplans.com Email: inquiry@loyolaplans.com

    AVAILMENT REQUEST FORM


    Date Filed: Form No.: ARF000000004584

    Cash Surrender Value Unrendered Service Buyback Excess MSB

    Timeplan Maturity Benefit Educ Plan Benefit Termlife Others:_______________

    Planholder's Name (Last Name, First Name, M.I.) Contract Number:

    Address: CFP Number:

    Email Address: Cell / Mobile Number: Landline Number:

    Viber / FB Messenger / WhatsApp: Please fill up all fields.


    Incomplete information may lead
    to delay of processing.

    BANK DETAILS:
    Please deposit my check/s to this bank account.

    Bank Name: Bank Branch: Account Type:


    Savings Check

    Account Name: Account No:

    I hereby certify that all details stated above are true and correct.

    Requested by: Reminder:


    Please attach the original copy of the Certificate of
    Full Payment and photocopy of valid ID with picture
    and signature.
    ________________________ Thank you,
    Signature over Printed Name Loyola Plans Consolidated, Inc.

    In compliance with the Data Privacy Act of 2012, disclosure of personal information by the Planholder under this form is voluntary. The collection of
    the Planholder's information is to facilitate the processing of the availment request by the Planholder and enable the Customer Service to handle
    customer-related concerns and other services related to the said request. All information provided by the Planholder shall be classified as
    confidential information. The Planholder holds the company free and harmless from any liability that may arise from any transfer, disclosure,
    processing, collection, use, storage or destruction of said information.

    FOR LOYOLA OFFICE USE ONLY:


    Received by: Checked by: Noted by:

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