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Referrer
Referrer

Branch Code:
Name:

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APPENDIX D

NOTE: ALL FIELDS ARE COMPULSORY.

o Mr.

Mrs.

Ms.

Others (Please specify):

Name
IC or Passport Number:
_ Email Address:
_ Handphone No.:

Maybankinvestl Maybankinvest-i Account Number (If any) :

I hereby instruct Maybank Investment Bank Berhad to automatically purchase the following stocks
marked with [X] in accordance to this application form and its accompanying Terms & Conditions: '

Please tick X (where applicable)

o New Application

Additional stock picks

o AMBANK BHD (1015)

DIGI BHD

Cancel: Stock Name 1

(6947)*

o DRB HCOM BHD (1619)*

BHD

o GENM BHD (4715)

o GAMUDA BHD (5398)*

0 MAYBANKBHD (1155)

TIMECOMBHD (5031)*

(4863)*
Note: (*) Shariah compliance stock

o 1 LOT
o Monthly

3 LOT

Purchases

5 LOT

o Quarterly

o OTHERS

Purchases

I hereby declare that I have read and accepted the accompanying Terms and Conditions by execution
of this Application Form, in addition to the terms and conditions of my Cash Trading Account.
Yours faithfully

Verified by

Client Signature:
Client Name:
Date:

Signature:
Name:
Date:

'.

'.

..

.
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