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BSN R&R Request Form

This document is a rescheduling and restructuring request form for various loan and financing accounts. It requests applicant information like name, address, contact details. It asks the applicant to select the type of facility they want to reschedule or restructure from options like microfinance, housing loan, personal loan, or hire purchase. The applicant must also select a reason for application such as reduced income, job loss, or other reasons. The new monthly installment amount is requested. The applicant must declare whether their loan is under rehabilitation or they are bankrupt. For company applications, it is declared that business is affected by restrictions and repayment difficulties. Required supporting documents are listed.

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ROS AMIRA IZAYU ISMAIL
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353 views2 pages

BSN R&R Request Form

This document is a rescheduling and restructuring request form for various loan and financing accounts. It requests applicant information like name, address, contact details. It asks the applicant to select the type of facility they want to reschedule or restructure from options like microfinance, housing loan, personal loan, or hire purchase. The applicant must also select a reason for application such as reduced income, job loss, or other reasons. The new monthly installment amount is requested. The applicant must declare whether their loan is under rehabilitation or they are bankrupt. For company applications, it is declared that business is affected by restrictions and repayment difficulties. Required supporting documents are listed.

Uploaded by

ROS AMIRA IZAYU ISMAIL
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

RESHEDULING AND RESTR UCTURING REQUEST FORM

APPLICANT INFORMATION
Full Name (as per NRIC/PP):
Current address:

NRIC/Passport no: Tel No:


Email Address:

RESHEDULING AND RESTRUCTURING REQUEST(S)


Facility (X to select):
Micro Finance Account 1: Account 2:

Housing Loan/Financing Account 1: Account 2:

Personal Loan/Financing Account 1: Account 2:

Hire Purchase Account 1: Account 2:

REASON FOR APPLICATION

Reason (X to select):

Reduction in Income

Reduction in Household Income

Loss Job

Others (please specify):

New Monthly Instalment Requested: RM

Self-Declaration (for Individual Application)


☐ By submitting this form, I hereby declare that;
 My loan/ financing is presently not under rehabilitation with Credit Counselling and Debt Management
Agency (AKPK);
 I am not undischarged bankrupt or subject to a bankrupt proceeding; and
 I do not have guarantor/ joint borrower for my loan/ financing; OR I have obtained consent from the
guarantor/ joint borrower for this application.

I understand that where required, I need to sign relevant document to complete the legal documentation,
including those related to guarantors or joint accounts and/ or variation agreements for Hire Purchase or
fixed rate loan/ financing.

1
RESHEDULING AND RESTR UCTURING REQUEST FORM
Self-Declaration (for Company Application)
☐ By submitting this form, I hereby declare that;
 The Company’s business is affected by the movement restrictions and I have difficulties meeting my
repayment/ payment obligations;
 The Company is not wound up or subject to an existing winding up petition/ notice;
 The Company’s loan/ financing is presently not under rehabilitation with Credit Co unselling and Debt
Management Agency (AKPK);
 I declare that I am the duly authorized/ empowered director/ partner/ sole-proprietor to request for
opt-in of the above package; and
 I do not have a guarantor/ joint borrower for my loan/ financing; my guarantor is CGC/ SJPP; OR I
have obtained consent from the guarantor/ joint borrower for this application.

I understand that where required, I need to sign relevant documents to complete the legal documentation,
including those related to guarantors or joint a ccounts and/or variation agreements for Hire Purchase/ Fixed
rate loan/financing;

REQUESTED BY :
I acknowledged the above details are accurate and in order.

________________________________
(Customer’s signature)
Date :

The request submitted is still subject to Bank’s approval. Supporting documents required:
□ Copy IC
□ Additional supporting documents ( if required by the BSN)

Please forward complete document to r&r@bsn.com.my.

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