Scribd Logo
Upload

Welcome to Scribd!

  • AppForm - General

    Uploaded by

    Carlos Santanos
    10 views4 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    10 views4 pages

    AppForm - General

    Uploaded by

    Carlos Santanos

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 4
    Cen B EEA) @2 visa Borang Permohonan KAD-i BANK ISLAM / BANK ISLAM CARD-i Application Form Sa lengkaptan den hartarkan barang ii besetadokune-dokamen yang dperskan (dak akan dkembaikan) ke: / Please camolte and send this frm and documents required non-reternab) to: Pusat Kad Bank islam, Aas 6, ma Bank eam, Jalan Durgun, Sulit Damansara, £0400 Kuala Lumpur atau cusjuigicauangan Bank elem yang berdkatan/ Or viet ‘eo nearest Sank lam aren oD suMBen / SOURCE ODE OoOOboo Kod Cawangan CSA/ Branch /OSA Code OOO Paks /Ked Pakage Cole YW oDpoU WWsiat/Kodejen/sattio/AgetGose |] eee denis tad / Card Type Pe buna jnimam/ Mastercard Visa Pat ‘vas 009 oO fas! ott e000 oo sik asi azo oo ELAYAKANUNUR / AGE REQUIREMENT Ferrohon Kai Utara mest berumur 21 tan ke ata dan pemobon Kad Tambatan ‘mectleh beramar 18 tahun be sas. / Principal Card Apalcant mst be 21 years and atowe and Suplreniany Card pica must be 18,yeasard abe. BUTIRAN PERIBADI / PERSONAL DETA/ [Dlenanr ar (evan aca [Joa ms (Clann eve (Ginryoakn’ Pease pe) aia eer Jeti tab] porn ee ana neh Kad een Ps Nee as IPs etran / Toe ama ana terra pata Kad (iak melt 19 hand) Name to anrearon Cord nc more than 19churactes) CoOoSoooo0Cb000000303 Cltireroee Com vee Cen No KP (Baru / NRC No. ow) 000000 - O00 - 0000 wieum ewe COOUIIL0 vorepot/Pesotme CIO OOONUOU00 Borgen Roce Stas Pekawinan rt Saas [Lasiane:snoe —(_] tetarin aries (Cesreera overced F] ea wionea DiTanggungan/ No.of Dependarts —_Kewarganegaraan /Nationalty Tat ean seo Lovt Clneningan’ seeimcay [] sw certente [pa Optoma (Cliezan oreo [taansorama tasers [7] 01 cocoate ‘anax Fura (la angan wnekan alana war rege alu Pet Swat Feat Ps) /| Permanent Ades (eased no provide averse or PO. Box Aes) Poss / Pastoave [ego Meneta Years There. No. Tol Rumah / Heme To. No. Tol Bint Handphone No. Emel/ mal, 03-26 900 900 www.bankislam.com.my Neget / State [DOKUMEN PENTING YANG DPERLUKAN //MPORTANT DOCUMENTS REQUIRED Unik mamudean prprsesan, sla setakan:/T expe processing please ends 17 Salnan ad pengsnaian (open dan bolstan clan paspot unt pomaton Kad ‘same den Frnohan Ka Tembahan ka ata). Copy o FIC eth sites) / passport for Prins and Seplemertary Car apoicans (teptcatie) Salman penyata ga 9 balan yang tek atu. / Copy fetes months’ pay sips 1 Salman bong EA tas penyale KS ala Copy ites! fm or EF staenen cc 7 Salnan torang 9/24/49 atau sainan Syl Pendafaran Pemigaan dan slnan pena ‘ark bla rk pk bekera sedi dan Boran 8 derganbuktpembayara cuka. 1 Copy of form 9/24/69 or Business Registration Cerficate and 6 mants' bank statement sft empoyed wih te lates 8 For en tax payment recent. ‘oluren tamtahan munakin dnina serasa pirpenssan,Ketluan tera kepada Denia kre leh Bank dan Bank bertak unk mendiak pemohanan tena sarang ‘sar. Unk pemohaan yang tdak teriva,cokumen yang disertkan fdek akan (Siembalkan éan alan dnusnatkan. / Addons documents mye requested cing precessing. Approvals sutetto te cet vauzton ofthe Bank ard he ark as eight oto see anyresson fr dig. The supporting diamant nsveest apoiation wil be destroyed andnotretmedto customer. Penoton yang tak menpuny bull perdapaan, tapi menepat Kelayakan mur ‘minimum, Skehenial mensepstizn sejumih amaun ke dam Aan Pera Bias, yang menyama dengan jamin Had Penbiayzan Kad yang dipoton, Anaun ‘rebut hendekeh sino eam akan seariang rasa, ean] Kad: Ban sam tesehut a The Aoplcant who fs unable f provide any income evence. ut mets te minum ape ‘ecuimentisrequired 'o cepasting Genera ImesmentAccont. n amcunequhalent {a thecad fnanchg lit anpted The copst inthe General lnestnent Accaut-ishll be maintained fr as ong asthe Bark lan Cartel act. Panama suat-neayrat/Choce obilng adress Aumay/tone ———[_] abit Oe Fo Rodan estes Tie Ma er Ova outage One by Pats Sts /Meragnd [7] Svar Main sak /Enpoye ed Lanner (Sia nyaatan Peas se) ‘lamat Tet (a fargangundkan aaa ua negara Pet Surat Plat Ps) Peamanent Adress peese dot prove oversea or PO, Box Adress) Poskod/Postoode ‘Negeri /State No Tel. /Te Mo, "Nama bw / Maths Wade ame (Uni adalah untuk pergesahan jca ipeiukan Tis Is Tor security werleation wen requir BBUTIRAN PEKERJAAN/PERNIAGAAN / DETAILS OF EMPLOYMENT/BUSINESS Naa Syaska/ Mame of Company. ‘Aamat (ia angen guekan alana! ar nger atau Pet Surat Pjabat Pos) / Permanent Actress pvaso dot provids ovrsocs er PO. Bor Ares) Foskes /Fetode Jian Destin Ne T/T ho Santingan/ Extra Tea abet ean Bt net not er eset / Tipe of npoyment een emaront—(] Kt oneact Someta Tenay JmisPeniagann/ treo Bsiess Nisha ermagen Buses Csseaten [Ly sect Sot Papin [Dang / Parner Sevan Bata Prva ted eran / Government Lani Others BANKCSLAM Negeri Ste Pendapatan Tenunan / Permiagaan (AM) / Annual / Business income (RW) Lain-lin Pendapatan (RM) / Ofer Income (A). Bilangan Kad Krodit/ Kad Cj yang cms / Number of Credit Cards)! Charge Car held POR (lbu bapa, adik-beradik atau saudara-mera yang tidak tinggal sorumah ‘dengan anda/ Parents, siblings or relatives not living with you) Nama/ Name Petaian/ Relish. No.Tel. Rumah / Home Tl Ho. No.Tel Pejebat / Ofc Te. No, No.Te. Bimoit/ Hangame No. RUTIRAN PASANGAN / DETAILS OF SPOUSE Nama/ Name No KP (aru) / MAIC No. (Mew) 000000 - 00-0000 No. KP (lama) / eve. r9 JO OO000 Wo. Pesport/RassportNe. TO OO0O00 Nana Sark / Name of Compay. Jawatan/ Designation, Mo.Te Peebat fice Tel Mo. Wo.Te Bmoit/Harapnone Wo. ‘etran Tite [] Encik Mr] Puan /Masam [_] cies (Cusinstain otters (Sta nyetakan/ Pease spect) antina / Gender [) Lelaki ‘Mate [—] Peremouan / Female ‘ewan ag Nama yang trtera pada Kad (idak melebihi 19 huruf)/ ‘Name to appear on Gerd (not move than 19 characters) OOOOOOOOOooo0oO00e000 “ahi! Dai of Birth (Da oto (eaten aontn (tahun Yar Wo. KP (lamay/ ewe. ory {JL OOOO Wo. KE Ear) / NIC No. Men OOOO - 00-0000 MoT Te No. Wo.Te, emo Harapnone na Pertaian Dengan Ani Kad ama / Relationship To Principal Cardmemder ira bu (Urtuk Tuan Pengesshen | Nother’ Maiden Name Fer Vrication Purpose ‘a rocTren greg sepa ara ‘ee cgsenery Sotto eae ab Re rot Tadatangan Pemohon Kad Tabehan/ Signature of Stoplementary Card Aolicant Tank Date: Eimub cnt aay Eure 1. PENGAKUAN AHL! KAD UTAMA / ‘DECLARATION BY PRINCIPAL CARDMEMBER Pngaluan dri Aili Kad Utama berhubung dengan gris panduan Bank Negara Nalaysia bagi urusniana dan pendedahan kiedt dengen pihak berkaitan/ ‘Declaration by Principal Cardmember in connection with Bank Negara Malaysia idelnes on credit ransactons and exposures wih connected parties. ‘Saya aalah secrang kaktangan Bank sam. / Jama staf of Bank ian, Pada pengetahuan saya, saudara terdkat saya seperti di bawah adalah ‘merupakaa kaktangan Bank san atau merupakanperiamin say. To fhe best ‘of my knowledge, my clese reat as mentioned bel f employed by Bank ‘sam or is acing as my guarantor Maklumat saudera terdekat yang merupakan keki‘angan Bank Islam. / Fartculars of my clase relative employed by Bank islam. Nama! hae No. KP (Bary / NAIC. er Poel "O10 - Oooo Pertalian TRletionsnip Berindak sebagai Penjamin/ Acting as Guarantor (Sle nyataken YA atau TIOAK/ Please indicate YES or NO) 2 PENGAKUAN MAKLUMAT DECLARATION OF FORMATION “saya meagesatkan tahawa maka yang saya berkan in fash Desay, saih don leegean Says dengan I momen kash hapada Bank leary Malayia Berhad ("Bark Ian) uluk rendaratian ara-apa maklimat tentang saya cada majkan sya maranara situs ceveoa, Kets Pew Lenten Yas Daan Neg dan fa nara cumbryang itin seiaGh Sk sla. Soya up nengesadkn bance bs bapa dana anak er, ak beraak saya én pasangan masng mein Duka raktargan Bank sam Mla} Baad canal ak sharkaty, Saye 2a fertckl fepade Terme rat Sjraturuk Peblaygan tat Bark am (TermaTera éan Sparc Syarat Kad") don sega pindan-pndaan ke atasnya pac ‘maz ear along soar dengan pongluran atau dorgquncan Ka ka) Bank aan. Soya stouseya bese banawa Aa Ca Usa sdaah bertanggunjanad tad sua fabian blgasi Abi Kad Utama seta Aah) ad Tambafan. Wala bgeimanepun Ahi-al) Xa Temtahan Nanya akan betarggundiawabtethadag lit din oblgasinya seri. Saye juga beseuj bahava Bank ism memgunyai hax untuk Melus au mendlak manz-rana femotoran saya ‘apa member apa-apa sad Saye far bana Kao kas) Bark sam skate eral Macrae Bank sam TertelucRepade mane-rana pamoatlancengan nts aval dan Gkembalan stl

    You might also like