This document is an application form for a multi-purpose loan from Pag-IBIG Fund. Income of aged, blind or disabled individual or couple (if individual has spouse not aged, blind or disabled, also complete Part B). 1. 2. 3. 4. 5. 6.You don't have to answer all of the questions before you submit your application, but in most cases, you will have to answer them in order to get benefits. As part of the application process, applicants will need to gather documentation for submission. IEHP is a health plan for people who have Medi-Cal in these counties: Riverside and. San Bernardino counties. Download and save the form to your device as a PDF. Open the form in Adobe Acrobat. Thank you for your interest in San Bernardino County, Department of Behavioral.