FOR BANK USE ONLY

Staff Name :_____________________

Branch :_____________________

i-RAKYAT COMMERCE APPLICATION FORM

A. COMPANY DETAILS

Company / Cooperative Society Name : ____________________________________________________________________________________________________________________________________________________________

Business Reg / Ref No : ____________________________________________________________________________________________________________________________________________________________

Mailing Address : ____________________________________________________________________________________________________________________________________________________________

B. CONTACT PERSON

1. Name (Mr/Mrs/Ms) :_____________________________________________________________ 2. Name (Mr/Mrs/Ms) : __________________________________________________

Designation : ____________________________________________________________ Designation : __________________________________________________

Telephone No :_________________________ Mobile No : ________________________ Telephone No : __________________ Mobile No: __________________

Email Address :____________________________________________________________ Email Address : __________________________________________________

Note : The Bank will give notification on any matters related to Dekstop Banking to the contact person (s) specified as above.

C. DESIGNATED ACCOUNT(S) FOR ACCESS TO DEKSTOP BANKING

Users to access all accounts Users to access specific account(s) (Please refer to Section E)
Account Number : Account Number :
1) 6)

2) 7)

3) 8)

4) 9)

5) 10)

D. ACCOUNT TO BE DEBITED FOR FEES & CHARGES

Debiting Account (MYR) for Fees & Charges Standard Subscription Fees & Charges : RM100 (per token**)
** refers to user(s) listed in Section E ** inclusive of GST
√ Please setup the User access as per Section E below

E. USERS** - ACCESS & PROFILE (PLEASE TICK √ WHERE APPLICABLE) (Please make copies of this page before filling up if more applicants involved).

Role Modules
(select either one)
Payments-Own

Payment-Third
Party Transfer

Group
IBG Payment

Name
Management

Autopay
IC No (New)/Passport Email and Mobile Number ( Example : A,
Authoriser

Data Entry

(as per IC/Passport)

Superuser

Telegrafic
Payment-

B, etc)
Transfer

Transfer
Account
Viewer

No.
F. iRAKYAT COMMERCE AUTHORISATION CONDITION SCHEDULE (Please make copies of this page before filling up if more applicants involved).

Authorisation Limit Authorising Condition Notes

Example:RM500,000 and below Example : A (Anyone from group A)

Example : No limit Example A+B (Jointly anyone from group A+B)

G.DECLARATION BY APPLICANT (Please make copies of this page before filling up if more applicants involved).

I/We hereby
i. confirm that by signing this Application Form, I/we accept and agree to be bound by the Terms and Conditions of Subscription and Access to Dekstop Banking including any amendments, supplements and additions
thereto made from time to time by the Bank, which is made available via www.irakyat.com.my.
ii. confirm that all the information provided by us in this Application Form are true, correct and not misleading.
iii. authorise the Bank to issue user pin(s) and token(s) to the Authorised User(s), where applicable.
iv. undertake to return the token(s) to the Bank as may be required by the Bank.
v. reserve bank the right to levy GST on taxable supply at a prescribe rate and I/we agree to pay the amount of GST.

____________________________ ____________________________ ____________________________ ____________________________

Authorised Person Authorised Person Authorised Person Authorised Person
Name: Name : Name : Name :
Date : Date : Date : Date :

SUPPORTING DOCUMENTATION
Please enclose the following : (Please tick √ )

1. Certified True Copy of photocopied NRIC/Passport of Authorised User(s) by either Company/Cooperative Society Director or Bank Officer. Please DO NOT certify own NRIC/Passport.

2. Where the applicant is a company, to provide Extract of Resolution as per Appendix 1 or in such form or substance acceptable to the Bank.

3. Where the applicant is other than a company, to provide such supporting documents as the Bank may require.

Please mail the completed form to : Virtual Banking Department

15th Floor, Menara 1, Menara Kembar Bank Rakyat,
No. 33, Jalan Rakyat, 50470 Kuala Lumpur.
Tel No : 1-300-80-5454