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    7 views12 pages

    MIPFi AppForm

    Uploaded by

    unnamed90
    form

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 12
    MAYBANK ISLAMIC PERSONAL FINANCING: APPLICATION FORM / ORANG PERMOHONAN PEMBIAYAAN PERIBADI-/ MAYBANK ISLAMIC ‘Send your Application Form to / n Borang Permel MAYBANK CARD CENTRE 7th Floor, Menara Maybank, 100 Jalan Tun Perak, 50050 Kuala Lumpur Tel1300 88 5588 (or your nearest Maybank branch / ian Maybank berdekatan ada mipryewyor FOR BANK STAFF USE / UNTUK KEGUNAAN STAF BANK Branch Date Received NAN, CIF No. im in BLOCK LETTERS. HURUF BESAR Campaign Code berusia 2 tahun danke ats, Had umur untuk perahon adalah 60 tahun. Pendapatan Teowedte pocsing leas enlos:/ Untuk meradehan poprseon ase 23) Copy of NRIC (oath sides) /Slinan Kad Pengenala 1) Latest BE form with offal tax receipt / ©) Latest 3 month salary sips Penyata ga 3 bulan yang ern 6) Latest Smonthe savings account ativtyfeurrentsccaunt statements / Ah simpanan, mn emasa 6 bulon yong tek Ifyou are sel-employe: 3) Copy of NRIC (bath sides) / 1b) Latest BE form with official tax receipt / Bo ©) Copy of Business Registration Solinan Per ng BE tern cert est uk raz ftaran Pernagaan 6) Latest 6 monthe Bark Seatemants/Pryota Gants bulan yay er Salutation /Gelaron Name a in NRICo Passport / CO w/e 1 mam ron Nama seperti Ka Pengenalan atau Posport DO mes ci 1 otters) Gender fatina Do nate jue Female Perempuon Contact Deis utr but Perhbungon House Tel No./ No Tel Rumah Nationa /Worgonegora HPN. Na Yel nb 1 maaysa 1 others taint EMal/ Ete! NRIC Ne. (New / . . Residential Adaress/ Hamat Reson No KP (ary) Posteade / Poo wena (OH i Bon State / Negeri Passport) Residential status / Tr Kedaman No. Pospor 1 own Sensi 1 tenant seve ate of Birth : : Ly Parents’ fic 8 LO Relaves’/ it Sou Tah ahi Tl others Lain Mother's Name / Noms lu Years of Occupancy, is feature for your secant when veriieation requ EaucationLevel/TohapPendion on coneten onda je pengoston Sper C1 Primary Pen 1 Diploms son ann Ey secondaty / en 1 begre / yazsh Religion/ agar Ey Masters oso Lo 1 doctors Marta tetas /TorefPerkahinan Ey Professional qualification Kelayokan Profesional 1 Single Suing 1 Marned eer 1 dow ia 1 divorced / sec No. of Dependants / lan wn, Name of Employer or Fitm / Na 4 Majin atau. ra Length of Service f Tempah Perhismota Office Address / A Designation owatan Nature of Business / ens Perniogaan Foncade Po Business Classification / Ki ity Bondar State /Nege 1 serpewani/ tas ii aN nome Sin he Office Fax No. / No. FaksPjobot, Ly Partnership /Perkongson LD Government /Kersjoan Terme of Employment / Tmo Pekerion TE mncyPudtc ised / si /Senari Av Ty conc tons Ly others stoi i Permane SECTIONA/ SEKSYEN A SECTION / SEKSYEN 8 ‘Gress Monthy Income /Pendopaton Kosar aw FT | hen tenure requested is beyond Fined Allowance / Elaun [| | etree tories income Non Fed Allowance / Eun dak Tetap ag [TT tempeh pembinyaan meleih a Commissions /Komiser ery ews feta /so “ eT | FF savings ir 02058 sinponaniroyase thers a Ce ental Income. (Pease atein tas] a ilan aa Gy Renattncome Total Jumioh a J CO ots rir Note / Not: "lease enclose evidence of income eg: ASB/FD/ FD Cert/Tenancy Agreement et, e onto: ASB/Sji in spot Sawa “Monthly Statutory Deductions / Potongen Berkanun Bulanen BPE /KUSP i Income Tx/ Coke Pendopatn (PCB) ew) SOCSO / PERKESO i Others / Lara ey "Please state in detail, og Za, cone Tox CP3E ‘Sila nyatakon dengan terperin contoh Zakt, Cok Pendopa. Total /Jumiah ee ‘Monthly Commitment Financial Institutions Related / Tanggungan Bulanan ~ jerkaiton dengen Institusi Kewengan Monthly Commitment / To Monthy Financial Payment: Bayaran Pe Term Financial / Pembiayaan Beyjongka ‘Overdraft / Overs Hite Purchase / Sewo Bel Others" / Lain lain” "Pease state in detalls 7 Sa ryatakan secra terpna Total /Jumiah syaan Buona: Please atach separate sheets if amount of monthly commitment exceed the above space/ Sila lanpiran Helaon Company fists ‘Manthiy Payment /Ansuran 8 Total jumiah RM. NOTE / NOTA: Non-Financial Institutions relate, eg: monthly instalment Beaton den mca finance th purchase of washing machine ar funiture from “Consumer Electronics and Furniture Retales'/ mostitus Bukan gan Peruncitan Pengguna Elektrik dan Pet Please atach separate sheets if amount af monthly commitment exced the above space / il lanpiran hello tamblankatanggungan kewangan mel ang Banking References /Ryjukon Kewongan ‘count No Type of count /Fality Date Opened No Akon Tarihi PARTICULARS OF SPOUSE / BUTIR-BUTIR PASANGAN Name as in NRIC of Passport / Name and Address of Employer / Nama dan Alamat Majkan [Nama seperti dolany Kod Pengealan atau Po Prot Poi NRICNo (New) / (iy J Bandar state / No. KP (Bary) Office TelNo, a. Tel Pejabat, Designation / ow Annual Income /Pendopata INRICNo. (014) / huge RM, Passport No./ Date of Birth / EMERGENCY CONTACT/ RUJUKAN KECEMASAN (Parents/immediate Family Not Living With You bu Bpa/A Name / Noma Residential Address /Alomat Kedlaman Keluargo Yang TidokTnggolSerumah Dengan Ande) Relationship / Hubungan Postcode / Pasko iy / Bander State / Neg House TelNo./No. Tel Rumah HP No, No. Fel Bibi. BILLING ADDRESS / ALAMAT SURAT-MENYURAT Bil To/ Bi) Ke 1 Home tum LD otic Tick) one only Tandokan (sat sahaja oh] 2Amonths /bulon [] 36months /bulon [] 48 months /bulan [] 60 months /bulan [] 72months /bulon Bank has the right to approve an amount lower than requested below without notifying the applicant. Applicant shall be deemed to have accepted the amount as approved by the Bank. / 8ank berhok untuk melulustan umloh yang lebih rendah berbaing dengan yang dmohon di baal tanpa seborang nots Pemelen danggap rmenerina jumloh sepert yang tlh di Ten ef Ter) Facility Amount/ ayy Threshold Amount jumloh Ambong dAmaun Remudahan Io not agree to accept facility amount lower than / Soya dak beret Minimum faclity amounts RMS,000 and maximum amounts 8M100,000. The | _menerimajumiah kemudohan kurang davipoda: RM final fclty amount approved willbe based on the Bank's creft evaluation, / ‘Amaun kemdahan minimum adsigh RMSOO0 dan maksimum -odoiah | Approved Failty Amount / ProfeRate] *iMI00,000. Amun kemudahan yang akan duluskan adalah berdasarkan ep Jumlah Kemdahan Dialuskon kadar Keuntungan pes 3m kre oleh pba Bans ). RMS,000 to /hingge RMZ0.000 i) RM20,001 tof hing RMS0,000 ii) RMSO.001 to /hingga RMIO0,000 Purpose ofthis fait is /Tujuon Kemdahan in odoish untuk LD Education / elojaron Ly Mesa Perudotan 1 Financing Payment /8ayaran Pe 1 ausiness Purpose / Keguraan Periagoon 1 Home Renovation / Ps iayaan hsvoian Rumah D1 others Loin Disbursement Detals/ Sten Pengeluaran Wang Umportart: he aproved fd wl be ceded into Mayan Humic esol Sings Curent Account ony ont Swings Curent Account i ot alowed / al ‘Akon Peibad Simpanan /Semazo1 Maybank ifSemaso Please ick (yf you want to have the Takafl protection / sil andokan (ike anda ingnkanperine gon Teka 1 Yes. wish to enrol forthe Personal Care Taka Plan that provides coverage to my outstanding facility amount inthe event of death or total permanent sabi Tgeclre that |am above 21 and under 60 years of age. lean that have ead the brochure of Personal Care Takafu Pan and know the contribution amount 1am suppose to pay The said Personal Care Tatful brochure is also displayed in Malayan Banking Berhad's Maybank commy webste. | hereby agree to pay fr the Takatul contribution by deducting the said amount fom the fclity amount approved. /¥, sa ingin meron untuk merveriaiPean Tako Personal Care yong rmeyecian per {tas don ds bowah umur 60 tahun. Saya mengesohkan bohawa say ‘ibaa Rial Plan TokaflPerrona Care yang sama juga telah dinyatatan dln web Maybank com. my ‘membayarsumbangan Takaf dengan menolakjumah yang dinytakon dar amaun kemdahon yong diluskon memibacarilah Pela Takofal Personal Care dan mengetabujumidh sombangan ya ayan Banking Berhad Saya dengn in bers This Plan is underwritten by FiqaTakaful Berhad (265243-0), a subsidiary of Malayan Banking Berhad (381-X) tiga Takaful Bead is registeed under the Tataful "4 and regulated by Bank Negara Malaysia, tiga Takafl Berhad located an Level, Tower C,Dataran Maybank, No Jalan Maarof, 59000 Kuala Lumpur This Plan i distributed by Malayan Barking Berhad GE1SK) and is located at Menara Maybank, 100, jalan Tun Perak, 30050 Kuala Lumpur / Pen in alga amin Tok Berhad (25624% D), eebuoh anak syarkat king Berhad (2813 K) Eso Toko Berhad didafarkan di bowah Alta Takofu 1984 dan dkowa tela oleh Bank Negara Malysa tga Takaful Berhad teletak di Ara 8, Tower C, Dataran Maybonk, No Jalan Maar impur el in ciedarkan oleh Malan B ng Berhad 1K) dan teretak dl Menara Maybank, 100, lan Tun Perak, 50080 Kuala Lumpur Note The Takaful coverage shall be taken from ether the Banks panel of Tkaful companies or such other Takaful companies of your choice approved by the Bank ‘on such terms and condone asthe Bank may stipulate, / Nota PerindungonTokafhensaigh diam sma ada darpada pone Syarikat Taku Bank ota lain syrikatTokaful plan ando yang diluluskon ele Bank mengikut term dan Sart sepet yang bole tetapkan oleh Bank Please tik (¥) where applcable in relation to the below provision: tandokan (0) pada yong berkenaln berhubung terma yang dinyetakan dl bawoh 1 confirm that none of my spouse(s. parents, chiléren and/or siblings and thelr spouses are employees of Maybank Islamic Berhad or Maayan Barking Group. / Saye ‘mengesahkan bahaw tada pasangan,vbu bapa, anak-anokdan/atau adlcberadie dan pasangan mereka yang bekeja dengan Maybank Islamic Berhad atau Kumplan Malayan Banking 1 I confirm that my spouse(s, parents, children andor siblings and their spouses are employees of Maybank Islamic Berhad or Malayan Banking Group. / Saya ‘mengesahkon baka ada ie era dan pasangan mereka yang bekerja dengan Maybonk islamic Berhad ctou Kumpulon Name Department Nama jouer ‘thereby declare that all he information given including but nt limited to information from any financings that have obtained orn the process of obtaining fom any financial and nonsinacial nsettin ls ue, sezurate and complete and have not withheld ary material facts or information n relation therete ay information given by me herein becomes inaccurate of thee are ary materal changes In anys, whether before this apolcation is approved or while tis application of fnancng = ‘ttnanding hereby undersea nat he Banc of sch changes wth meine elec | hereby farther clare a dono ave any ater tinancing rom financial or tonfinanellinstons ater than a declared herein Syadengon i mengeahian bohawo semua moblumatyang aber termasvk eto tak erhod kepada maura ‘arpa manana pembuaysan yang sa tedh peoich atau dalam proses untuk mendapatian embiayaan daria mana-man insta kewangan dan bukan hewangan “dala bear tepat dan lenge dan aya tidak menyemburyltan ope'apa feta material tau mekiumat berhuburg dengannya fk apa apa makluma yon diberitan leh Soya dalam column ini ena tdo teat ata terdopot oparapa perubahan peting dengan car apa jua, sama ada sebelim permohonan in Saskan sto eta ‘ermahonan pembioyan in belum sees, say dengan ni mengak jn antuk memekumtan pak. Baht tentang perubahan ts dengan sertarmert,Sayo dengan in megan ln bakawa sy tdk mempunys op oa pembayan an arpa sts kwangon to kan ewanan asin yang taken dalam B:tsuthorse and consent othe Bank and is epresetaie to obtain information pertaining to this apoiation fom any source, including bt not limited to re information, tom the land Reverue Bard (IR) Authors, Employes Prouden Fund @>Feer nan nstatons, Central Creat Reerence Inermaton Stem (CCRI, SME Cre Bureau, any other rect eference agence, ary ether person, indidual andor enya the Sark deems appropiate without assigning sy reson whatsoever / S30 ebe”| [ebentan dn perictuan hepato pak Ban dan lia unt merdapeton maura beratan dengan permetonan dn manesmanssunber teak att ak trad ‘pada mut ket dan Lembaga Has Oalam Nege, Kump Yong Smpanon Pera (MSP) sus nt kewangon yg a Stem Maduro Ruka Kredit Psat (CERI), Keio SE. manarmona agen juan re ind a/c en yong dango bersession oleh pak Bank ana per menyeakan sebarang ean. ‘The Bank s expressly authorized wo discuss with my present employe egarding tis application, Pihak Barkdbehuara untuk membircarghan permatanan in berioma {aval cmpy th the Banks equrementn respect my applation andl understand hathe Bn ofr ofthe fnancing sabe subject othe Bank peroring the necessary verfiation/ Saja aton meratuh’ sega keperluan pak Bank untuk permohonan say dan soya memahany bahtwa tran pembiayaon oleh pk Ban ‘xalohtertaok kepada pengesahon yang diprlakan sek pikak Sank D. expressly concent to snd authors the Bank diclose o Bank Negara Malaysia, any other reultny authors, bodies suchas CAGAMAS ad debt callection agents, ary personG) nor outside Malaysia including bl not nied to companies within th growpa the Bank, whether suc roupf companies ate esding sated, caryingon busines, Incorporated or constituted within or aude Malaysia, including but not mite to the respecte agents, authorised, maintain ané storing records (afll or otherwise), at “nyeime and without ablty any information ad parcels (nancial or there) resting to myfour afar and accounts, fancng snd cenduct thereat or such purposes ss the Bankdcems itor appropriate / Saye member lebecran dan member oats erode pak Bank untuk mendeahton ope kiana Sa ution (ewargon oa aan) arg Lean dengan ura don akan ay, pembiayoan dn prgendaon, kepada Bark Negara Malaysia pak pk buns, bodarodan seer CAGAMUS. Gen pemurgut tan ‘manamona indi diam otu dor Malaya tera tap tid erhad kepada syankatsyorae ala Kumpsion ark sma ofa kumpulon srt tebe meet ‘menolntanpemogoon dperbadankanotou dtubuhkan& dala tay ar Malaya eras tet tik trod kepada erg trent, en yang ber asa, memelhar dan ‘meryipan refed rhod feng oan ii) paca mas erent don tanpa abt bag tua yang nggap zea oeh pho Sank E Thereby agree and consent forthe Sank request for and to obtain al the perzonal nformtion and dataset forth inthis form fo the purpose of processing his, ‘pplication and also forall ler purposes that ae necessary and equited in Felatin othe fac ly requested for by me herein. also declare Wat al personal formation {pddataset orth herein are allt upto date and accurate and shoul there be any charges to ary pevsonalinformatono dataset forth herel| shall undertake to no the Bank immediately.) Says dengon in beset dn membenoran pik Bark ant meminga dan mendapdtan semua maklaat don dat perbal yong dnyetatan dalam ‘orang in bagi tua remprosesprmeonan in dan ugo unt semua tun an yng pela dan ekehendk berhubung dengan Kemudahan yong mt lh sye dalam ‘orang Say jge mengiyorkan ahaa semua malunat dan dota peribod yang dinyaakan dlom borong in adoah ben tern dan tat dan sekrany erdapat apa 2p berabahan kepada apa-opa malumat ata dato penbodi yang sytakan dalam borang naa bray antul membentahu pha Ban dengan egea. thereby undertake to inform the Bark and my guarantor) and my immediate family members (parents, spouses ana children) ae related to any resent or future ‘emplyeets) ofthe Bank or the drector() ofthe Banc / Dengan inl saya mengokuJanakzh memberitahu pak Banko say don penjamin saya dan fh Relaarga terdeket ‘(br bopo, ua ter don anacana berk dengn plea Bonk atau pengaah Bank pada mora sarong ato pade masa depan Git am notin detauit on any accounts with the Bane of ather financial institulions or ender ay Tegal impediments, Saya (ak gaol untuk membuat pembayoran terhadap mano mana okaun Bank atau insta insti Kewangan yang ra atau di dalam mana mana uusan undang und, Uthis Spalieston form and all supporting document tat were fubmiteed tothe Bank sna be the sole property ofthe Bank and the Bank entitled to retain the same Inge of wthr my aplaton t pprovr jected bythe Bank org pratoran aon ss aun isrganon hdd eadsp B

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