INSP IRENE C PAGELA

OIC, Retirement Claims Division

A) RETIREMENT GRATUITY – 3 YEAR LUMP SUM OR OUTRIGHT PENSION
(1 SET-2 COPIES EACH DOCUMENT)

OLD REQUIREMENTS

A. Endorsement from region

B. ATM Account Information
C. Personal Data Sheet (PDS)
D. Retirement order
E. Service record – Unit/NHQ
F. Original Appointment & Latest Appointment
G. Certificate of non-pending case
H. Ombudsman Clearance
J. Cert of Pendency/Non-Pendency
A) RETIREMENT GRATUITY – 3 YEAR LUMP SUM OR OUTRIGHT PENSION
(1 SET-2 COPIES EACH DOCUMENT)
NEW REQUIREMENTS
Claimant’s Requirements: Regional/NHQ Requirements:

A. Letter of Intent to Retire approved by A. Retirement Order;

Chief, BFP (for Optional Applicant); B. Updated Service Record;
B. ATM Account Information with C. Original and Latest Appointment; and
signature over printed name of the D. Regional/National Certificate of Non-
claimant; Pending Case;
C. Latest Personal Data Sheet (PDS)
with latest picture; REGIONAL SUBMISSION TO RBAS,
D. Ombudsman Clearance – Original BFP-NHQ
Copy; and
E. Declaration of Pendency/ Non- - List of Actual Retirees Payee (LARP) with
Pendency of Case from Civil Service Total Retirement Gratuity Computation and
Commission – Original Copy Terminal Leave Benefits Claims duly
endorsed/signed by the Regional Director;
In lieu of items D & E - Affidavit of
Undertaking (with at least 2
guarantors)
 ATM Account Information
Rank/ Name :_________________
Present Address :_________________
Landbank Account No. :_________________
Issuing Landbank Branch:_________________
Contact Number :_________________

___________________________
Signature over Printed Name
 Computation of 3 YEARS LUMP SUM/ OUTRIGHT PENSION
A. Retirement Gratuity (3yrs Lump Sum)
I. Creditable Years of Service:
YEARS MONTHS DAYS
Date of Retirement 2021 09 24
Date Entered Service 1990 08 02_
31 01 22
II. Highest Salary Received: (SINSP)
BP P 56,582.00
LP (5) 28,291.00
Total Salary: P 84,873.00
III. Computation of Total Rate:
1. 31 yrs x 2.5% = 77.00000%
2. 01 mos./12 mos.x 2.5% = 0.20833 %
3. 22 days/360% x 2.5% = 0.15278 %
Total Rate: 77.86111%
IV. Monthly Pension ( Total Salary x Total Rate)
P 84,873.00 x 77.86111% = P 66,083.06/mo.
V. THREE YEARS LUMP SUM (Monthly Pension x 36 mos.)
P 66,083.06/mo. X 36 mos. = P2,378,990.16
Computation of 3 YEARS LUMP SUM/ OUTRIGHT PENSION
Sample Computation: 2 Gaps In Service
Sample Computation (3 Gaps in Service)
B. TERMINAL/ COMMUTATION OF LEAVE CLAIM FOLDER (1 SET- 2 COPIES EACH DOCUMENT)

OLD REQUIREMENTS
A. Endorsement from Region
B. ATM Account Information
C. Personal Data Sheet (PDS)
D. Retirement Order
E. Service Record
F. Original Appointment and Latest Appointment
G. Itemized Leave Record, Application for Leave record with
Certificate of Monetization
H. Money property accountability with cert of badge Returned,
Affidavit of undertaking
I. Statement of Assets, Liabilities and Net Worth
J. Certificate of deletion
K. Certificate of cancellation (if any)
L. Loan Balances (AFPSLAI, AMWSLAI, AFPMBAI, FSMBAI, BFPMPC, BFPMBAI,
GCSMPC clearance)
 B. TERMINAL/ COMMUTATION OF LEAVE CLAIM FOLDER (1 SET- 2 COPIES EACH DOCUMENT)

Claimant’s Requirements: Regional/NHQ Requirements:

A. Letter of Intent to Retire approved by A. Bureau Order (Retirement / Resignation /
Chief, BFP (for Optional)/Letter of Dropped from the Rolls/ Transfer and
Resignation duly accepted by the Chief, Dismissal from the Service)
BFP/Regional Director (for Separated B. Updated Service Record;
from the Service); C. Certified photocopy of Initial and Latest
B. ATM Account Information with signature Appointment/Notice of Salary Adjustment
over printed name of the claimant; (NOSA)- showing the highest salary
C. Latest Personal Data Sheet (PDS) with received if the salary under the last
latest picture appointment is not the highest;
D. Application for Leave signed by the D. Itemized Leave Record with Inclusive
applicant and approved by the Regional dates duly signed by the authorized
Director/Director of Directorates or Chief signatories; and
of Support Services, BFP-NHQ; E. Computation of Terminal Leave Benefits
E. Office Clearance for Money/ Property duly signed /certified by the Accountant;
Accountability (NMPA) and/or Affidavit of F. For claimant separated from the service
Undertaking for Authority to Deduct other than compulsory/optional retirement:
Accountabilities (in affidavit form, if needed); Certificate of No Outstanding Service
F. Statement of Assets and Liabilities Obligation (NOSO) signed by Regional
(SALN) Director, Director of Directorates, Chief of
as of last date of submission of SALN; Support Services, BFP-NHQ or their
appropriate representative, and
G. Certificate of Deletion
H. Certificate of Last Payment
B. Sample Computation (TERMINAL LEAVE/ COMMUTATION OF LEAVE CLAIM)

FORMULA:

TLB = S x D x CF
TLB = Salary (BP+LP) x D-No. of Leave Credits x CF- Constant Factor (.0481927)

SINSP ( 5TH Longevity Pay)

BP - 56,582.00
LP - 28,291.00
S- 84,873.00 Salary

D- 500 Number of Leave Credits Earned

C- Constant Factor (.0481927)

TLB = P 84,873.00 x 500.000 x .0481927 = P 2,603,793.45

B. Sample Computation (TERMINAL/ COMMUTATION OF LEAVE CLAIM)
 B. Sample: TERMINAL/ COMMUTATION OF LEAVE CLAIM with Prorated Loan Balances

Prorated Computation :

1,135,960.96/50% = 567,980.48

Sample: AFPSLAI
434,931.45 Actual AFPSLAI Loan Amount
/ 708,674.82 Sum of All Loan Balances
X 50% of Claimed Amount_ (567,980.48)__

= 434,931.45 /708,674.82 x 567,980.48

AFPSLAI Prorated amount = 348,583.82

Sample: AFPMBAI
273,742.37 Actual AFPMBAI Loan Amount
/ 708,674.82 Sum of All Loan Balances
X 50% of Claimed Amount_ (567,980.48)__

= 273,743.37 /708,674.82 x 567,980.48

AFPMBAI Prorated amount = 219,396.66

 C) TOTAL PERMANENT PHYSICAL DISABILITY (TPPD) CLAIMS
C.1. SPECIAL FINANCIAL ASSISTANCE FOLDER (1 SET- 2 COPIES EACH
DOCUMENT)

Claimant’s Requirements: Regional/NHQ Requirements:

A. Letter of Intent for SFA Application; A. Investigation Report concurred by the
B. Latest Personal Data Sheet (PDS) Regional Director, Director of Directorates
with latest picture and Chief of Support Services, BFP-NHQ
C. Clinical Abstract from Attending B. Certificate of Legitimate Operation
Physician; and signed by appropriate Chief of Office;
D. Medical Certificate validated by BFP C. Updated Service Record;
Medical Officer. D. Original and Latest Appointment
E. Regional Claims Adjudication
Committee (RCAC) Resolution or Claims
Adjudication Board (CAB) Resolution; and
F. Bureau Order for Entitlement of SFA.

REGIONAL SUBMISSION TO DP, BFP-NHQ

- Request for SFA Release of Funds signed

by the Regional Director.
C) TOTAL PERMANENT PHYSICAL DISABILITY (TTPD) CLAIMS
C.1. SPECIAL FINANCIAL ASSISTANCE (SFA)
 C.2. TOTAL PERMANENT PHYSICAL DISABILITY BENEFITS CLAIMS FOLDER
(2 SETS -2 COPIES EACH DOCUMENT)

Claimant’s Requirements: Regional/NHQ Requirements:

A. Letter of Intent to Retire; A. Investigation Report concurred by the
B. ATM Account Information with signature Regional Director, Director of Directorates
over printed name of the claimant; and Chief of Support Services, BFP-NHQ;
C. Latest Personal Data Sheet (PDS) with B. Updated Service Record;
latest picture C. Original and Latest Appointment
D. Ombudsman Clearance – Original Copy; D. Regional Certificate of Non-Pending Case
E. Declaration of Pendency/ Non-Pendency
of Case from Civil Service Commission – (Original);
Original Copy; E. Regional Claims Adjudication Committee
(RCAC) Resolution or Claims Adjudication
-In lieu of items C & D - Affidavit of Board (CAB) Resolution; and
Undertaking (with at least 2 guarantors- F. Bureau Order (TPPD Retirement / TPPD
beneficiaries) Separation);
REGIONAL SUBMISSION TO RBAS, BFP-
F. Clinical Abstract from Attending Physician; NHQ
and - Inclusion to the List of Actual Retirees
G. Medical Certificate validated by BFP Payee (LARP)
Medical Officer.
 C.2. TOTAL PERMANENT PHYSICAL DISABILITY BENEFITS CLAIMS FOLDER
1 YEAR FULL SALARY - (1 SET -2 COPIES EACH DOCUMENT)

Computation: SFO4

Based on:
Retired Grade x 12 mos.
P38,366.00 x 12 mos.
P460,392.00= 1 YEAR FULL SALARY
 C.2. TOTAL PERMANENT PHYSICAL DISABILITY BENEFITS CLAIMs FOLDER
(1 SET -2 COPIES EACH DOCUMENT)

Computation: Last Salary Received(SFO3)

Formula= BP x 80%

=34,761.00 x 80%

=27,808.80 TPPD Monthly Pension

C.2. TOTAL PERMANENT PHYSICAL DISABILITY BENEFITS CLAIM FOLDER
(1 SET -2 COPIES EACH DOCUMENT)

Total Permanent Physical Disability Claim (TPPD)

MORE THAN 20 YEARS LESS THAN 20 YEARS

1
LUMP SUM + 1 RANK + LP LAST HELD RANK
2
1 YEAR FULL SALARY + 1 RANK + NO LP LAST HELD RANK
3
LIFETIME PENSION LAST HELD RANK LAST HELD RANK
4
TERMINAL LEAVE + 1 RANK + LP LAST HELD RANK
5
SFA + 1 RANK + LP LAST HELD RANK
DEATH AND SURVIVORSHIP CLAIMS
D.1) SPECIAL FINANCIAL ASSISTANCE FOLDER (1SET-2 COPIES EACH DOCUMENT)

Claimant’s Requirements: Regional/NHQ Requirements:

A. Letter of Intent for SFA A. Investigation Report concurred

Application; by the
B. ATM Account Information with Regional Director, Director of
signature over printed name of Directorates and Chief of
the Support Services, BFP-NHQ.
claimant; B. Latest Service Record;
C. Latest Personal Data Sheet C. Original and Latest Appointment
(PDS) D. Regional Claims Adjudication
with latest picture E. Committee (RCAC) Resolution
D. Death Certificate duly certified by or Claims Adjudication Board
(CAB) Resolution; and
LCR or PSA; F. Bureau Order (Posthumous
E. Marriage Contract duly certified Retirement / Separation).
by
Philippine Statistics Authority
(PSA) –
if married
F. Birth Certificate (of BFP and
children-if
any) duly certified by Philippine
Statistics Authority (PSA) – if
single.
 D.2) DEATH AND SURVIVORSHIP BENEFITS CLAIMS FOLDERS (3 SETS-2 COPIES
EACH DOCUMENT)
Claimant’s Requirements: Regional/NHQ Requirements:
A. Letter of Intent for Retirement Claim; A. Investigation Report concurred by the
B. ATM Account Information with signature Regional Director, Director of Directorates
over printed name of the claimant; and Chief of Support Services, BFP-NHQ.
C. Latest Personal Data Sheet (PDS) with B. Posthumous Order (Retired/ Separated);
latest picture; C. Latest Service Record;
D. Death Certificate duly certified by LCR or D. Original and Latest Appointment;
PSA; E.Regional Claims Adjudication Committee
E.Marriage Contract authenticated by PSA, (RCAC) Resolution or Claims Adjudication
if married; Board (CAB) Resolution; and
F. ID of the spouse (photocopy); F.Bureau Order (Posthumous Retirement /
G. CENOMAR of spouse; Separation); and
H. Birth Certificates of all surviving legal heirs G. Certificate of Legal Dependent(s)/
authenticated by PSA; Beneficiaries confirmed by the Chief,
I. Birth Certificate of Deceased authenticated Records Section
by PSA, if single;
J. ID of parents (photocopy);
K. Designation of next-of-kin (for single with
no living parents);
L.Mental Health Certificate from government
accredited institution for Mentally-
Incapacitated person
 GRATUITY AND BURIAL
(1 SET-2 COPIES EACH DOCUMENT)

Computation: Based on Rank last held(FO3)

A.Gratuity (BP x 12 mos.)

=32,114.00 x 12 mos. = 385,368.00

B. Burial Expenses (BP x 3 mos.)

=32,114.00 x 3 mos. = 96,342.00

A+B = 481,710.00 Gratuity and Burial Expenses

 5 YEARS MONTHLY PENSION
(1 SET-2 COPIES EACH DOCUMENT)

Computation: Based on Rank last held(FO3)

= 32,114.00 x 80% = 25,691.20 5-yrs mo. pension

 MONTHLY SURVIVORSHIP PENSION
(Less than 20 years in Service)
( 1 SET-2 COPIES EACH DOCUMENT)

Computation:

=Total Salary (BP+LP) x 50%

 MONTHLY SURVIVORSHIP PENSION
(More than 20 years in Service)
(1 SET - 2 COPIES EACH DOCUMENT)

SURVIVORSHIP PENSION

=Total Salary (BP+LP) x Total Rate x 75%

 D.3) TERMINAL/ COMMUTATION OF LEAVE CLAIM (DEATH)
(1 SET – 2 copies each)
Claimant’s Requirements: Regional/NHQ Requirement:
A. Letter of Intent for Retirement Claim; A. Investigation Report concurred by the
B. ATM Account Information with signature Regional Director, Director of Directorates
over printed name of the claimant; and Chief of Support Services, BFP-NHQ.
C. Latest Personal Data Sheet (PDS) with B. Latest Service Record;
latest picture; C. Original and Latest Appointment;
D. Death Certificate duly certified by LCR or D. Regional Claims Adjudication Committee
PSA; (RCAC) Resolution or Claims Adjudication
E. Marriage Contract authenticated by PSA, Board (CAB) Resolution; and
if married; E. Bureau Order (Posthumous Retirement /
F. ID of the spouse (photocopy) Separation); and
G. Birth Certificates of all surviving legal heirs F. Certificate of Legal Dependent(s)/
authenticated by PSA; Beneficiaries confirmed by the Chief,
H. Birth Certificate of Deceased Records Section;
authenticated by PSA, if single; G. Itemized Leave Record with Inclusive
I. ID of parents (photocopy); dates duly signed by the authorized
J. Designation of next-of-kin (for single with signatories; and
no living parents); H. Certificate of Monetization from Regional
K. Application for Leave signed by any of the Office/BFP-NHQ.
beneficiaries and approved by the
Regional Director
D. Computation of Overpayment D. Computation of Overpayment

Date of Death (January 15, 2021) Date of Death (January 15, 2021)
Salary Received (January 1-31, 2021) Salary Received (January 1-31, 2021)
Overpayment 15-31 January 2021 Overpayment 15-31 January 2021
Deletion: February 2021 Deletion: March 2021

Overpayment Overpayment
=15-31 January 2021 =15-31 January 2021
=17/31 x Gross Pay =17/31 x Gross Pay
=44,180.23 = 44,180.23 ( Feb 2021)
= 80,563.94 March 2021
=124,744.17 Overpayment for Feb and March
 DEATH BENEFITS CLAIM
DIFFERENT CLAIMS MORE THAN 20 YEARS LESS THAN 20 YEARS

GRATUITY AND BURIAL LAST HELD RANK LAST HELD RANK

5 YEARS PENSION LAST HELD RANK LAST HELD RANK

SFA SAME RANK + LP LAST HELD RANK

SURVIVORSHIP + 1 RANK + LP LAST HELD RANK

+ 1 RANK + LP LAST HELD RANK

TERMINAL LEAVE + LP