FINANCIAL ASSISTANCE APPLICATION

NAME: ___________________________________________________________

POSITION: ___________________________________________________________

OFFIC E ADDRESS:___________________________________________________________

CITY ADDRESS: ___________________________________________________________

PRO’L ADDRESS: ___________________________________________________________

TEL/CELL NOS: ___________________________________________________________

DATE OF BIRTH: ___________________________________________________________

DATE OF APPOINTMENT W/ THE NAT’L PROSECUTION SERVICE: _________________

DATE OF PLP MEMBERSHIP: _______________________________________________

PURPOSE: _________________________________________________________________

_________________________________________________________________

_________________________________________________________________

AMOUNT NEEDED: _____________________________________________________

CERTIFICATION OF NO PENDING CRIMINAL /ADMIN CASES: ____________________

_______________________________________________________________________

_______________________________________________________________________

PLP LOAN BALANCES, IF ANY : _________________________________________

TAKE HOME PAY: ___________________________________________________________

LEAVE CREDITS AVAILABLE: _______________________________________________

_______________________________________________

___________________________
SIGNATURE

___________________________
DATE ACCOMPLISHED

To facilitate remittance of proceeds, please deposit to ________________________________

(Bank)

_______________________________ _________________________________
Branch Account Number

___________________________
SIGNATURE
 PROSECUTORS LEAGUE OF THE PHILIPPINES (PLP)
c/o Department of Justice Padre Faura St. Ermita, Manila

_______________________
Date

AUTHORITY TO DEDUCT FROM MONTHLY SALARY

In accordance with the terms and conditions of the PLP Financial Program availed from
the Prosecutors’ league of the Philippines (PLP) Inc., with address at Padre Faura St. Ermita,
Manila. I hereby authorized the Department f Justice to deduct from my monthly payroll the
amount of PESOS:_______________________________________________(P____________)
for a period of undertaking and the sum of PESOS:___________________________________
(P________________) and to remit the same to the PLP in payment for said facility.

It is understood that this Authority shall continue to be effective as long as I am employed

with the DOJ and until my obligations have been fully paid. In the event of my early severance
from the DOJ, the remaining balance of my obligations under the Program shall be paid for in
full or shall de deducted in full from whatever money receivable due me from the DOJ/GSIS.

I further authorize the DOJ Accounting Department to deduct in full whatever balance I
may have from my earned leave credits and/or terminal leave and to withhold the processing of
my CLEARNCE until I have fully complied with the aforementioned financial obligation.

In witness whereof, I have hereunto set my hand on this _________ day of _________
20________.

_____________________________
Signature over printed name
of member/ Prosecutor

_____________________________
Position/Office

Subscribed and Sworn to before me this ___________day of ___________, 20__________

at __________________________, Philippines.

__________________________

______________________________
CO-MAKER

APPROVED:

_________________ __________________ _________________ ________________

 REVISED 2016

SCHEDULE OF PAYMENT (P60,000.00)

FINANCIAL ASSISTANCE PROGRAM

INTS. NO. AMOUNT INTEREST PRINCIPAL BALANCE

60,000.00
1 2,725.00 225.00 2,500.00 57,500.00
2 2,725.00 225.00 2,500.00 55,500.00
3 2,725.00 225.00 2,500.00 52,500.00
4 2,725.00 225.00 2,500.00 50,000.00
5 2,725.00 225.00 2,500.00 47,500.00
6 2,725.00 225.00 2,500.00 45,000.00
7 2,725.00 225.00 2,500.00 42,500.00
8 2,725.00 225.00 2,500.00 40,000.00
9 2,725.00 225.00 2,500.00 37,500.00
10 2,725.00 225.00 2,500.00 35,000.00
11 2,725.00 225.00 2,500.00 32,500.00
12 2,725.00 225.00 2,500.00 30,000.00
13 2,725.00 225.00 2,500.00 27,500.00
14 2,725.00 225.00 2,500.00 25,000.00
15 2,725.00 225.00 2,500.00 22,500.00
16 2,725.00 225.00 2,500.00 20,000.00
17 2,725.00 225.00 2,500.00 17,500.00
18 2,725.00 225.00 2,500.00 15,000.00
19 2,725.00 225.00 2,500.00 12,500.00
20 2,725.00 225.00 2,500.00 10,000.00
21 2,725.00 225.00 2,500.00 7,500.00
22 2,725.00 225.00 2,500.00 5,000.00
23 2,725.00 225.00 2,500.00 2,500.00
24 2,725.00 225.00 2,500.00 0

N.B. 3.5% OF THE PRINCIPAL IS IMPOSED AS SERVICE CHARGE BRINGING THE

NET PROCEEDS TO Php 57,900.00.

__________________________________
SIGNATURE OVER PRINTED NAME
OF A MEMBER/PROSECUTOR
 REVISED 2016

SCHEDULE OF PAYMENT (P100,000.00)

FINANCIAL ASSISTANCE PROGRAM

INTS. NO. AMOUNT INTEREST PRINCIPAL BALANCE

100,000.00
1 4,542.00 375.00 4,167.00 95,833.00
2 4,542.00 375.00 4,167.00 91,666.00
3 4,542.00 375.00 4,167.00 87,499.00
4 4,542.00 375.00 4,167.00 83,332.00
5 4,542.00 375.00 4,167.00 79,165.00
6 4,542.00 375.00 4,167.00 74,998.00
7 4,542.00 375.00 4,167.00 70,831.00
8 4,542.00 375.00 4,167.00 66,664.00
9 4,542.00 375.00 4,167.00 62,497.00
10 4,542.00 375.00 4,167.00 58,330.00
11 4,542.00 375.00 4,167.00 54,163.00
12 4,542.00 375.00 4,167.00 49,996.00
13 4,542.00 375.00 4,167.00 45,829.00
14 4,542.00 375.00 4,167.00 41,662.00
15 4,542.00 375.00 4,167.00 37,495.00
16 4,542.00 375.00 4,167.00 33,328.00
17 4,542.00 375.00 4,167.00 29,161.00
18 4,542.00 375.00 4,167.00 24,994.00
19 4,542.00 375.00 4,167.00 20,827.00
20 4,542.00 375.00 4,167.00 16,660.00
21 4,542.00 375.00 4,167.00 12,493.00
22 4,542.00 375.00 4,167.00 8,326.00
23 4,542.00 375.00 4,167.00 4,159.00
24 4,542.00 375.00 4,159.00 0

N.B. 3.5% OF THE PRINCIPAL IS IMPOSED AS SERVICE CHARGE BRINGING THE

NET PROCEEDS TO Php 96,500.00.

__________________________________
SIGNATURE OVER PRINTED NAME
OF A MEMBER/PROSECUTOR
 REVISED 2016

SCHEDULE OF PAYMENT (P150,000.00)

FINANCIAL ASSISTANCE PROGRAM

INTS. NO. AMOUNT INTEREST PRINCIPAL BALANCE

150,000.00
1 6,812.50 562.50 6,250.00 143,750.00
2 6,812.50 562.50 6,250.00 137,500.00
3 6,812.50 562.50 6,250.00 131,250.00
4 6,812.50 562.50 6,250.00 125,000.00
5 6,812.50 562.50 6,250.00 118,750.00
6 6,812.50 562.50 6,250.00 112,500.00
7 6,812.50 562.50 6,250.00 106,250.00
8 6,812.50 562.50 6,250.00 100,000.00
9 6,812.50 562.50 6,250.00 93,750.00
10 6,812.50 562.50 6,250.00 87,500.00
11 6,812.50 562.50 6,250.00 81,250.00
12 6,812.50 562.50 6,250.00 75,000.00
13 6,812.50 562.50 6,250.00 68,750.00
14 6,812.50 562.50 6,250.00 62,500.00
15 6,812.50 562.50 6,250.00 56,250.00
16 6,812.50 562.50 6,250.00 50,000.00
17 6,812.50 562.50 6,250.00 43,750.00
18 6,812.50 562.50 6,250.00 37,500.00
19 6,812.50 562.50 6,250.00 31,250.00
20 6,812.50 562.50 6,250.00 25,000.00
21 6,812.50 562.50 6,250.00 18,750.00
22 6,812.50 562.50 6,250.00 12,500.00
23 6,812.50 562.50 6,250.00 6,250.00
24 6,812.50 562.50 6,250.00 0

N.B. 3.5% OF THE PRINCIPAL IS IMPOSED AS SERVICE CHARGE BRINGING THE

NET PROCEEDS TO Php 144,750.00

___________________________________
SIGNATURE OVER PRINTED NAME
OF A MEMBER/PROSECUTOR