CUSTOMER PARTICULAR EDIT FORM (CPE)

Cancellation with
Refund Only Fund Transfer Only Change Order Details
Fund Transfer
Action
Change Ownership Rental to Outright
( ) Change Promotion
(Out/Ins/MatureRen with (< 24 months for order Prefix= "0","1")
(for active case only)
complete installation) (< 36 months for order Prefix= "2")

CUSTOMER DETAILS
ORDER NO. 6161428

CUSTOMER NAME AFIFAH BINTI BAHAROM

CURRENT
MAILING (BILLING)
ADDRESS NEW

CURRENT
INSTALLATION ADDRESS
NEW

CURRENT CURRENT
CONTACT NO. CONTACT NO.
(Mobile) NEW (House/Office) NEW

CURRENT CURRENT
APPLICATION TYPE PRODUCT
NEW NEW

FOR REFUND (To register name only)

PAYMENT TYPE □ Outright □ Installment □ Rental □ RPF □ Others: WOR _____________________
PAY TO AMOUNT (RM)

BANK NAME BANK ACC NO.

FOR FUND TRANSFER (To register name only)

PAYMENT TYPE □ Outright □ Installment □ Rental □ RPF □ Others
TR NO. WOR NO.

NEW SOF/ORDER NO. CUSTOMER NAME

Definition and supporting document attached
Adjustment (Only overpaid/ customer request)
CCP/System Auto Cancel -SOF (Old & New), TR, Payment slip, RFD
CCP Reject, Change Application Type -SOF (Old & New), TR, Payment slip
Wrongly Information (Admin, Sales Person, Finance) -TR (with signature), other supporting doc (optional)
*Other (Internal use) -Supporting doc (SOF (Old & New), TR, Payment slip, RFD)
REASON Need CCP Approval

FOR OFFICE USE

Order Status : q ACTIVE q FAILED q COMPLETE Promotion Code : ___________________

Order Key in Date: ____________________ Installation Date : ___________________
OCR Number: OCR ______________________ Date & Time: __________________ Reverse WOR No. : ___________________
Order Cancelled By: ______________________ Date & Time: __________________ New WOR No. : ___________________

REQUESTED BY APPROVED BY RECEIVED BY BRANCH CHOP RECEIVED

Position CODY

Signature

Name CHEA SHING LIK

Date 09/11/2023 Name & Signature

Ver.SSD23032021