Property Financing Application Form

Transcription

1 1/10 u CIMB Bank Berhad (13491P) u CIMB Islamic Bank Berhad (671380H) u This is a security document for bundled application Property Financing Application Form MY PERSONAL DETAILS (MAIN APPLICANT) u Mr u Miss u Madam u Dr u Others Full Name As In NRIC : CURRENT EMPLOYMENT DETAILS Employment Type : u Salaried u SelfEmployed u Others Employment Status : u Permanent u Contract u Temporary Occupation : New I/C No. : Old I/C No. : Other Identification (complete if you do not have an NRIC) : Sex : u Male u Female Designation/Job Title : Employer s Name : Employer s Address : Date Of Birth (DD/MM/YYYY) : Nationality : u Malaysian u Others / / For NonMalaysians, What Is Your Residence Status? u NonMalaysian Resident u NonMalaysian NonResident u Permanent Resident u Malaysia My 2nd Home Race : u Malay u Chinese u Indian u Others Bumiputra : u Yes u No Marital Status : u Single u Married u Widowed u Divorced Number And Age(s) Of Dependent Children : Age(s) Highest Education Level : u Postgraduate u Professional Qualification u Degree u Diploma u Secondary u Primary u Others MY HOME ADDRESS Permanent Home Address : Employer s Tel No. : Employer s Fax No. : Length Of Service (MM/YY) : Total Working Experience (MM/YY) : / / Main Monthly Income : Other Monthly Income : R M R M Industry : Business Type : u MNC u Bursa Listed u CIMB Group u Public Ltd Company u Government Agency u Private Ltd Company u Proprietor/Partnership u Financial Institution Number Of Employees In The Company : u Less than 15 u 1550 u u More than 100 PREVIOUS EMPLOYMENT DETAILS (Complete if you have worked for your current employer for <2 years) Previous Employer s Name : Mailing Address (complete if different from above) : Previous Occupation : Length Of Service (MM/YY) : / Home Tel No. : Mobile Tel No. : Current Residence Status : u Owned Charged u Owned Not Charged u Rented u Employer s u Parents u Relatives u Company Quarters Years There : MY SPOUSE DETAILS (Complete only if your spouse is not a joint applicant/guarantor) Full Name As In NRIC / Passport : New I/C No. : Old I/C No. : Other Identification (complete if you do not have an NRIC) : Home Tel No. : Mobile Tel No. : Version 2.1

2 2/10 MY PERSONAL DETAILS (JOINT APPLICANT/GUARANTOR) u Mr u Miss u Madam u Dr u Others Full Name As In NRIC : CURRENT EMPLOYMENT DETAILS Employment Type : u Salaried u SelfEmployed u Others Employment Status : u Permanent u Contract u Temporary Occupation : New I/C No. : Old I/C No. : Other Identification (complete if you do not have an NRIC) : Sex : u Male u Female Designation/Job Title : Employer s Name : Employer s Address : Date Of Birth (DD/MM/YYYY) : Nationality : u Malaysian u Others / / For NonMalaysians, What Is Your Residence Status? u NonMalaysian Resident u NonMalaysian NonResident u Permanent Resident u Malaysia My 2nd Home Race : u Malay u Chinese u Indian u Others Bumiputra : u Yes u No Marital Status : u Single u Married u Widowed u Divorced Number And Age(s) Of Dependent Children : Age(s) Highest Education Level : u Postgraduate u Professional Qualification u Degree u Diploma u Secondary u Primary u Others Relationship with main applicant u Spouse u Child u Relative u Business Partner u Parent u Sibling u Others MY HOME ADDRESS Permanent Home Address : PREVIOUS EMPLOYMENT DETAILS (Complete if you have worked for your current employer for <2 years) Previous Employer s Name : Employer s Tel No. : Employer s Fax No. : Length Of Service (MM/YY) : Total Working Experience (MM/YY) : / / Main Monthly Income : Other Monthly Income : R M R M Industry : Business Type : u MNC u Bursa Listed u CIMB Group u Public Ltd Company u Government Agency u Private Ltd Company u Proprietor/Partnership u Financial Institution Number Of Employees In The Company : u Less than 15 u 1550 u u More than 100 Previous Occupation : Mailing Address (complete if different from above) : Length Of Service (MM/YY) : / MY SPOUSE DETAILS (Complete only if your spouse is not an Applicant) Home Tel No. : Mobile Tel No. : Current Residence Status : u Owned Charged u Owned Not Charged u Rented u Employer s u Parents u Relatives u Company Quarters Years There : Full Name As In NRIC / Passport : New I/C No. : Old I/C No. : Other Identification (complete if you do not have an NRIC) : Home Tel No. : Mobile Tel No. :

3 3/10 Applicant Name : u CIMB Bank Berhad (13491P) u CIMB Islamic Bank Berhad (671380H) Property Financing Application Details NRIC No. : FACILITY DETAILS Purpose of Facility : u Purchase u Refinance u TopUp u Cash out Owner occupied : u Yes u No Product Name : Owner s Details (if the property is owned by a 3rd party other than the applicants) Owner s Name : Relationship With Main Applicant : First time property purchase : u Yes FACILITY AMOUNT Housing/Term Loan Home/Term Financing : R M Overdraft/Cashline Others (if applicable) : (GMTA/GMTT, legal and valuation fees) : Indicative Total : Term (YY) : R M R M R M u No New I/C No. : Old I/C No. : Other Identification (complete if owner does not have an NRIC) : UNDER CONSTRUCTION PROPERTY Project Name : PROPERTY VALUE Purchase Price : Indicative Market Value : R M R M Developer s Name : Phase : Margin Of Finance (%) : GMTA/GMTT Insured/Covered Insured/Covered Term Insured/ Applicant(s) Amount (RM) Covered (Years) Reason for enhancement/cash out : u Renovation u Purchase of Consumption Goods u Other Personal Use Is the applied Overdraft/Cashline (if applicable) to be maintained in existing current account with Overdraft/Cashline facility secured by property? u Yes u No PROPERTY DETAILS Property Type : u Residential u Commercial u Land Property Description : Land Area : Built Up Area : Construction Status (if applicable) : u Completed u Under Construction Specify % Completed Source Of Property : u Developer u Vendor u Auctioned u Refinancing u Others Title Type : u Individual u Strata u Master Title Status : u Freehold u Leasehold Specify Expiry Date Of Lease : Property Address : / / Title Number : Lot Number : SubDistrict : District : % REFINANCING PROPERTY Current Financier (if applicable) : Amount Of Loan/Financing Outstanding (if applicable) : R M SECONDARY MARKET PROPERTY Vendor Name : Vendor s New I/C No. : Vendor s Old I/C No. : Vendor s Other Identification (complete if vendor does not have an NRIC) : EMERGENCY CONTACT DETAILS (FOR MAIN APPLICANT ONLY) Full Name As In NRIC : Relationship With Main Applicant : Home Tel No. : Mobile Tel No. : As financing extends beyond my/our age retirement age, I/we propose to settle/reduce the Financing via the following: u Withdrawal from EPF u Pension provisions or contracted annuity payments u Proceeds from Insurance/Takaful policy cash value u Proceeds from investments i.e. Unit Trusts/Shares u Refinancing to be undertaken by children u Other manner, please specify State :

4 4/10 Applicant Name : Amanah Saham Bumiputera Financing Application Details Enquiries : NRIC No. : No Shariah compliant equivalent product FACILITY DETAILS Facility Requested to Purchase (ASB Units) : Loan Tenure Requested : Y e a r s Requested Facility Amount to Finance GASA Premium : R M Interest Rate : Current BLR : Documentation Fee : R M Group Amanah Saham Assurance ( GASA ) (Optional) (Please tick (3) to confirm your application for GASA. Please read the important notice to applicant of GASA before confirming your application for GASA) u Yes, I wish to apply for Group Amanah Saham Assurance (GASA) which is a life insurance plan offered, underwritten and issued by Sun Life Malaysia Assurance Berhad, licensed under the Financial Service Act 2013 and regulated by Bank Negara Malaysia. The benefits of GASA applied for shall not take effect unless and until this application is approved by Sun Life Malaysia and the premium is received in full by Sun Life Malaysia during my lifetime. I am satisfied with the explanation given to me on the GASA and acknowledge and confirm that I have read and fully understood the information, benefits and exclusions under GASA which are summarized but not exhaustive in the GASA Product Disclosure Sheet. I hereby consent to the Bank disclosing the information contained in this application form to Sun Life Malaysia which will then consider my application to enroll me as their GASA life assured. If approved, then a Certificate of Insurance will be issued by Sun Life Malaysia and shall be sent by Sun Life Malaysia to me upon my enrollment as a GASA life assured. Important notice to applicant of GASA : a) Please note you are to disclose in this application form fully and faithfully all facts which you know or you ought to know, otherwise the Certificate of Insurance issued hereunder may be invalidated. b) The GASA product disclosure sheet is provided to you to summarize the benefits which are guaranteed and those which are not guaranteed and your duties as a life assured under the Certificate of Insurance issued hereunder. c) Proof of age is required prior to the payment of any benefit under the Certificate of Insurance. d) You may apply for GASA in this application form in the event that your cumulative aggregate GASA sum assured (inclusive of premium which is financed by the Bank) which is inforce and taken up in the past three (3) years and the amount of GASA sum assured (inclusive of premium which is to be financed by the Bank) under your current application, does not exceed Ringgit Malaysia Two Hundred and Fifty Thousand (RM250,000) ( the Amount ). In the event the Amount is exceeded, please note that you will have to execute and complete a Sun Life Malaysia s separate insurance proposal form to apply for GASA. e) In the event there is any shortfall between premium paid and actual premium required by Sun Life Malaysia, Sun Life Malaysia reserves the right to shorten the Policy Term based on the actual premium paid and this will be reflected in the Certificate of Insurance issued by Sun Life Malaysia and sent to you upon your enrollment as a GASA life assured. f) Please refer to the GASA Group Master Policy for the exact terms, conditions and exclusions. A copy of the Master Policy can be viewed and downloaded from Sun Life Malaysia s official website at sunlifemalaysia.com g) Sun Life Malaysia being the licensed insurer and underwriter of GASA shall undertake the full insurance obligations under the GASA. The Bank merely acts as a Distributor and is not responsible in any way for the GASA. The GASA is not a Bank product and therefore not an obligation of nor guaranteed by the Bank. h) The coverage under GASA shall not take effect until Sun Life Malaysia has processed and approved your application i) Sun Life Malaysia reserves the right to reject your application and the Bank is entitled to give full refund to you without any interest in the event the application is rejected by Sun Life Malaysia and you shall not have any claim whatsoever against the Bank. j) You are obliged to accept the refund from the Bank and not to insist on the GASA cover in the event that Sun Life Malaysia has rejected your application. By signing below I hereby (a) Confirm that I (i) wish to apply for Amanah Saham Bumiputera (ASB) Financing with the Bank; and (ii) have read, understood and agree to be bound by the ASB Financing Terms and Conditions and any amendments to the same which the Bank may subsequently introduce from time to time upon giving adequate prior notice to me; (b) Authorise the Bank to debit my/our Current Account** or Savings Account** (**Delete whichever not applicable) No. : ( the Account ) with the Bank for the payment of the monthly instalment and/or interest and/or the outstanding amount due to the Bank under the ASB Financing. I/We undertake to ensure that sufficient funds are kept in the Account to meet this payment.* Where the Account is a Current Account, I/we hereby understand and agree that it shall be my/our responsibility to ensure there is sufficient funds at all times in the Account to honour cheques deposited for payment. I/we further acknowledge and agree that the Bank will not be held liable for defamation and/or for breach of contract and/or for any losses, damages, expenses, costs or charges whatsoever which may be claimed against the Bank arising from remarks placed on the returned cheque(s) by the Bank and/or upon the grounds that cheque(s) issued under the Account was returned due to insufficient funds in the Account as a result of the Bank debiting the Account pursuant to my/our above authorisation. * To complete (b) by filling in the Account number if you wish to authorise the Bank to debit the Account with the Bank for the payment of the monthly instalment and/or interest and/or the outstanding amount due to the Bank under the ASB Financing. Applicant s Signature : Full Name : New I/C No. : Date : Bank Officer s Signature : Full Name : Staff ID : Date : Branch Name : Branch Code : SLMA Authorised Representative s Signature : Full Name : Staff ID : Date : Branch Name : Branch Code :

5 5/10 CIMB Islamic Credit Card Application Details (For Main Applicant) I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE 3) : CIMB ISLAMIC CREDIT CARD u CIMB Islamic Platinum MasterCard (RM48,000 min income p.a.) u CIMB Islamic Gold MasterCard (RM24,000 min income p.a.) u CIMB Islamic PETRONAS Gold MasterCard (RM24,000 min income p.a.) COMPLIMENTARY CIMB Touch n Go Zing CARD (for CIMB Islamic PETRONAS Gold MasterCard only) Note : Additional credit cards will share a combined credit limit. MY PERSONAL DETAILS Name To Appear On Card (Not More Than 19 Letters) : Mother s Maiden Name : Transaction Alert Services Alert me if transaction exceeds (The Bank s default value applies if left blank) u RM1,000 u RM2,000 u RM3,000 u RM5,000 u I wish to unsubscribe from Transaction Alert Services (By checking this box you will stop receiving any Transaction Alerts for you CIMB Islamic Credit Card CIMB Touch n Go Zing AUTOMATIC RELOAD AMOUNT CIMB Touch n Go Zing Card (Touch n Go card linked to CIMB Islamic Bank Credit Card) u I would like to have the CIMB Touch n Go Zing Card with the following automatic reload amount Principal Card u RM100 u RM200 u RM300 Note: If the auto reload amount is not specified, CIMB Islamic Bank will automatically set the default reload amount to RM100. ACCESS TO ATM AND CIMB CLICKS INTERNET BANKING u Yes, I wish to apply for a credit card PIN to access ATM and CIMB Clicks MY BILLING DELIVERY INSTRUCTIONS Please send my/our Statement(s) for the credit card(s) selected above and all my/our other credit cards that I/we have with the Bank to my/our . I/We agree to be bound by CIMB Islamic Bank s Terms and Conditions for Statement Delivery available at CIMB Islamic Bank s website in respect of all my/our credit card statements requested to be sent to me/us by . u I/We do not wish to receive my/our Statement by Statement Delivery. Please send the hardcopies of my/our Statement to my/our : u Home u Office MY CARD DELIVERY INSTRUCTIONS Please Send My Card To : u Home u Office u For My Collection at CIMB Islamic Bank Branch** ** CIMB Islamic Bank branches colocated at all CIMB Bank branches nationwide. CIMB Islamic Credit Card Application Details (For Joint Applicant) I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE 3) : CIMB ISLAMIC CREDIT CARD u CIMB Islamic Platinum MasterCard (RM48,000 min income p.a.) u CIMB Islamic Gold MasterCard (RM24,000 min income p.a.) u CIMB Islamic PETRONAS Gold MasterCard (RM24,000 min income p.a.) COMPLIMENTARY CIMB Touch n Go Zing CARD (for CIMB Islamic PETRONAS Gold MasterCard only) Note : Additional credit cards will share a combined credit limit. MY PERSONAL DETAILS Name To Appear On Card (Not More Than 19 Letters) : Mother s Maiden Name : Transaction Alert Services Alert me if transaction exceeds (The Bank s default value applies if left blank) u RM1,000 u RM2,000 u RM3,000 u RM5,000 u I wish to unsubscribe from Transaction Alert Services (By checking this box you will stop receiving any Transaction Alerts for you CIMB Islamic Credit Card CIMB Touch n Go Zing AUTOMATIC RELOAD AMOUNT CIMB Touch n Go Zing Card (Touch n Go card linked to CIMB Islamic Bank Credit Card) u I would like to have the CIMB Touch n Go Zing Card with the following automatic reload amount Principal Card u RM100 u RM200 u RM300 Note: If the auto reload amount is not specified, CIMB Islamic Bank will automatically set the default reload amount to RM100. ACCESS TO ATM AND CIMB CLICKS INTERNET BANKING u Yes, I wish to apply for a credit card PIN to access ATM and CIMB Clicks MY BILLING DELIVERY INSTRUCTIONS Please send my/our Statement(s) for the credit card(s) selected above and all my/our other credit cards that I/we have with the Bank to my/our . I/We agree to be bound by CIMB Islamic Bank s Terms and Conditions for Statement Delivery available at CIMB Islamic Bank s website in respect of all my/our credit card statements requested to be sent to me/us by . u I/We do not wish to receive my/our Statement by Statement Delivery. Please send the hardcopies of my/our Statement to my/our : u Home u Office MY CARD DELIVERY INSTRUCTIONS Please Send My Card To : u Home u Office u For My Collection at CIMB Islamic Bank Branch** ** CIMB Islamic Bank branches colocated at all CIMB Bank branches nationwide.

6 6/10 CIMB Bank Credit Card Application Details (For Main Applicant) I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE 3) : CIMB PREMIER CARD COLLECTION u CIMB WORLD MasterCard (RM200,000 min income p.a.) u CIMB Visa Signature (RM100,000 min income p.a.) CIMB SMART DRIVERS CARDS u CIMB PETRONAS Platinum MasterCard (RM48,000 min income p.a.) u CIMB PETRONAS Gold MasterCard (RM24,000 min income p.a.) CIMB CREDIT CARDS u CIMB Platinum MasterCard (RM48,000 min income p.a.) u CIMB Gold MasterCard (RM24,000 min income p.a.) u CIMB Visa Platinum (RM48,000 min income p.a.) u CIMB Visa Gold (RM24,000 min income p.a.) CIMB CASH REBATE CARD u CIMB Cash Rebate Platinum MasterCard (RM36,000 min income p.a.) COMPLIMENTARY CIMB Touch n Go Zing CARD (for CIMB PETRONAS Platinum MasterCard / CIMB PETRONAS Gold MasterCard & CIMB Cash Rebate Platinum MasterCard only) Note : Additional credit cards will share a combined credit limit. MY PERSONAL DETAILS Name To Appear On Card (Not More Than 19 Letters) : Mother s Maiden Name : Transaction Alert Services Alert me if transaction exceeds (The Bank s default value applies if left blank) u RM1,000 u RM2,000 u RM3,000 u RM5,000 u I wish to unsubscribe from Transaction Alert Services (By checking this box you will stop receiving any Transaction Alerts for your CIMB Bank Credit Card CIMB Touch n Go Zing AUTOMATIC RELOAD AMOUNT CIMB Touch n Go Zing Card (Touch n Go card linked to CIMB Bank Credit Card) u I would like to have the CIMB Touch n Go Zing Card with the following automatic reload amount Principal Card u RM100 u RM200 u RM300 Note: If the auto reload amount is not specified, CIMB Bank will automatically set the default reload amount to RM100. ACCESS TO ATM AND CIMB CLICKS INTERNET BANKING u Yes, I wish to apply for a credit card PIN to access ATM and CIMB Clicks MY BILLING DELIVERY INSTRUCTIONS Please send my/our Statement(s) for the credit card(s) selected above and all my/our other credit cards that I have with the Bank to my/our . I/We agree to be bound by CIMB Bank s Terms and Conditions for Statement Delivery available at CIMB Bank s website in respect of all my/our credit card statements requested to be sent to me/us by . u I/We do not wish to receive my/our Statement by Statement Delivery. Please send the hardcopies of my/our Statement to my/our : u Home u Office MY CARD DELIVERY INSTRUCTIONS Please Send My Card To : u Home u Office u For My Collection at CIMB Bank Branch CIMB Bank Credit Card Application Details (For Joint Applicant) I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE 3) : CIMB PREMIER CARD COLLECTION u CIMB WORLD MasterCard (RM200,000 min income p.a.) u CIMB Visa Signature (RM100,000 min income p.a.) CIMB SMART DRIVERS CARDS u CIMB PETRONAS Platinum MasterCard (RM48,000 min income p.a.) u CIMB PETRONAS Gold MasterCard (RM24,000 min income p.a.) CIMB CREDIT CARDS u CIMB Platinum MasterCard (RM48,000 min income p.a.) u CIMB Gold MasterCard (RM24,000 min income p.a.) u CIMB Visa Platinum (RM48,000 min income p.a.) u CIMB Visa Gold (RM24,000 min income p.a.) CIMB CASH REBATE CARD u CIMB Cash Rebate Platinum MasterCard (RM36,000 min income p.a.) COMPLIMENTARY CIMB Touch n Go Zing CARD (for CIMB PETRONAS Platinum MasterCard / CIMB PETRONAS Gold MasterCard & CIMB Cash Rebate Platinum MasterCard only) Note : Additional credit cards will share a combined credit limit. MY PERSONAL DETAILS Name To Appear On Card (Not More Than 19 Letters) : Mother s Maiden Name : Transaction Alert Services Alert me if transaction exceeds (The Bank s default value applies if left blank) u RM1,000 u RM2,000 u RM3,000 u RM5,000 u I wish to unsubscribe from Transaction Alert Services (By checking this box you will stop receiving any Transaction Alerts for your CIMB Bank Credit Card CIMB Touch n Go Zing AUTOMATIC RELOAD AMOUNT CIMB Touch n Go Zing Card (Touch n Go card linked to CIMB Bank Credit Card) u I would like to have the CIMB Touch n Go Zing Card with the following automatic reload amount Principal Card u RM100 u RM200 u RM300 Note: If the auto reload amount is not specified, CIMB Bank will automatically set the default reload amount to RM100. ACCESS TO ATM AND CIMB CLICKS INTERNET BANKING u Yes, I wish to apply for a credit card PIN to access ATM and CIMB Clicks MY BILLING DELIVERY INSTRUCTIONS Please send my/our Statement(s) for the credit card(s) selected above and all my/our other credit cards that I have with the Bank to my/our . I/We agree to be bound by CIMB Bank s Terms and Conditions for Statement Delivery available at CIMB Bank s website in respect of all my/our credit card statements requested to be sent to me/us by . u I/We do not wish to receive my/our Statement by Statement Delivery. Please send the hardcopies of my/our Statement to my/our : u Home u Office MY CARD DELIVERY INSTRUCTIONS Please Send My Card To : u Home u Office u For My Collection at CIMB Bank Branch

7 7/10 Cash Plus Personal Loan Application Details LOAN REQUEST Amount : R M, Tenure (MM) : Note: All fees will be deducted from the loan amount. * Payment mode : Monthly * Interest rate : Fixed Rate or any rate offered by Bank. AUTHORIZATION I give the Bank my irrevocable authorization to debit the monthly instalments on or before each monthly instalment due date and any other charges related to this Facility from my CIMB Bank Berhad account indicated below ( the Account ) I undertake to ensure that sufficient funds are kept in the Account to meet this payment. I hereby understand and agree that where the Account indicated my me is a current account, it shall be my responsibility to ensure there is sufficient funds at all times in the Account to honour cheques deposited for payment. I further acknowledge and agree that the Bank will not be held liable for defamation and / or for breach of contract and or for any losses damages expenses costs or charges whatsoever which may be claimed against the Bank arising from remarks place on the returned cheque(s) by the Bank and or upon the grounds that cheque(s) issued under the Account was returned due to insufficient funds in the Account as a result of the Bank debiting the Account pursuant to my above authorization. DOCUMENTS ENCLOSED Which of the following documents are you providing with this form? ALL APPLICANTS u Copy of applicant s NRIC/Passport u Latest 3 months bank statements u Latest EA Form/Form B with proof of tax payment/epf Statement u Sale and purchase agreement OR booking receipt OR copy of title deed u Valuation report (if available) u Latest loan/financing statement (if refinancing) u Copy of ASB passbook/asnb Unit Trust System (UTS) balance inquiry statement SALARIED APPLICANTS u Latest 3 months salary slip u Letter from employer SELF EMPLOYED APPLICANTS u Profit and loss statement u Business registration A & D OR Forms 24 & 49 DECLARATION/DISCLOSURE BY APPLICANT** In addition to my application for Property Financing, I hereby acknowledge that I am applying for the following products in this application form : Products Main Applicant s Initial Joint Applicant s Initial CIMB Cash Plus Personal Loan CIMB Islamic Credit Card CIMB Bank Credit Card (Conventional) CIMB Bank Amanah Saham Bumiputera Financing ** This declaration shall apply to all CIMB Bank Berhad and/or CIMB Islamic Bank Berhad, as the case may be, ( the Bank ) product(s) which you apply for as stated in this application form and above table. The Bank refers to CIMB Bank Berhad and/or CIMB Islamic Bank Berhad, as the case may be, being the licensed financial institution offerring the loan/financing product(s) referred to in this application form. For All products: (i) I/We declare that I/we have/do not have outstanding debt payment obligation from banks and nonbanks (e.g. cooperative building societies, credit companies and merchants that provide credit sales) Particulars of the main applicant s outstanding debt payment obligation are as follows (no declaration from the main applicant denotes that this declaration is not applicable) : No. Name of Entity Amount of Outstanding Debt (RM) Monthly Instalment Amount (RM) 1 2 Particulars of the joint applicant s (if applicable) outstanding debt payment obligation are as follows (no declaration from the joint applicant denotes that this declaration is not applicable) : No. Name of Entity Amount of Outstanding Debt (RM) Monthly Instalment Amount (RM) 1 2

8 8/10 Applicant Name : NRIC No. : DECLARATION/DISCLOSURE BY APPLICANT**... continued (ii) I/We declare that the information furnished in this form are completely true and accurate and I/we have not withheld any information which may prejudice my/our financing/loan application or have a bearing on your financing decision. (iii) I/We hereby authorize you or your representative to obtain information relating to this information from any source. (iv) Application(s) remains the Bank property regardless of whether the facility is approved and the Bank reserves the right to reject the application(s) at its sole discretion without any reasons whatsoever. (v) I/We have not committed any act of bankruptcy and/or been adjudged a bankrupt. (vi) I/We shall comply with the Bank requirements in respect of my/our loan/financing application and understand that the Bank s offer of the loan/ financing shall be subject to the Bank performing any necessary verification. (vii) I/We confirm that the Bank is authorized to verify and/or make any checks and/or obtain any information and/or confirmation, with or from any credit reference agencies, including but not limited to CCRIS, FIS and/or any other agencies and/or from any financial institution, on me/us and/or any other person, individual and/or entity as the Bank may deem fit, for any purposes which the Bank deems fit. (viii) In connection with the Bank Negara Guidelines on Credit Transactions and Exposures with Connected Parties, I/we hereby declare that (no declaration from the applicant(s) denotes that this declaration is not applicable) : u I am a staff of the CIMB Group 1 u To the best of my knowledge, I have close relative(s) 2 employed under the CIMB Group or particulars of my close relatives in CIMB Group and whether they have asked as my guarantor Name I/C / Passport No. Relationship Acted As Guarantor (Indicate Yes or No) u Yes u Yes u No u No (ix) Subject to the provisions below which (i) prohibit disclosure of information to Group Companies if objected to by me/us; and (ii) require my/our express consent for disclosure of information to third parties for the stated purposes, I/we hereby agree and authorise the Bank to disclose to any of its agents, service providers, auditors, legal counsel, professional advisors, security providers and guarantors in or outside Malaysia and to companies within the group of the Bank as well as companies within the group of CIMB Group Holdings Berhad, the Bank s ultimate holding company ( the Group Companies ) whether such Group Companies are residing, situated, carrying on business, incorporated or constituted within or outside Malaysia any information relating to me/us, my/our affairs and/or any accounts maintained by me/us with the Bank for facilitating the business, operations, facilities and services of or granted or provided by the Bank and/or the Group Companies to their customers. Disclosure to Group Companies shall be for facilitating the operations, businesses, crossselling and other purposes of the Bank and/or the Group Companies provided always that disclosure for cross selling purposes shall not be effected if such disclosure is objected by me/us by contacting the Bank at the following telephone number or address (which may be changed by the Bank from time to time by notice to me/us): 19th Floor, Menara Bumiputra Commerce, 11 Jalan Raja Laut, Kuala Lumpur, Tel No.: Further, where the Bank intends to share my/our information (excluding information relating to my/our affairs or account) with third parties for strategic alliances, marketing and promotional purposes, u I/ We hereby give my/our consent to the above disclosure to third parties. u I/ We do not consent to the giving of the above disclosure to third parties. (x) I/We also acknowledge that it is a requirement by Bank Negara Malaysia ( BNM ) that all information relating to this application, whether successful or otherwise must be updated and/or transmitted to the Central Credit Reference Information System ( CCRIS ), a database maintained by BNM. (xi) CIMB Touch n Go Zing Card In addition to the declaration where I have confirmed that any credit card issued to me shall be subject to the Bank s Cardmember Agreement, I also agree to abide by the terms and conditions of the Touch n Go Zing Card (hereinafter collectively referred to as the Card ) and any other terms and conditions imposed by Touch n Go Sdn. Bhd. (hereinafter referred to as TNGSB ) and/or the Bank from time to time in respect of the use of the Touch n Go features of the Card. I am aware the Card has an automatic reload amount of RM100, RM200 or RM300 and that the automatic reload fee of RM1.50, RM2.00 or RM3.00 respectively is payable. Where the Card is a CIMB Touch n Go Visa, the automatic reload fee is waived. I confirm and irrevocably authorize the Bank to debit my CIMB Bank/CIMB Islamic Bank Credit Card account, as the case may be, for each reload and automatic reload fee (where chargeable) whenever the account balance drops to RM50 and below. In the event that I cancel my Card and my Card has an account balance at the point of cancellation, such balance will be refunded, upon request, to my CIMB Bank/CIMB Islamic Bank Credit Card account and the processing fee of RM5 will be debited from my CIMB Bank/CIMB Islamic Credit Card Account for such refund. In the event that my Card does not have any account balance when I cancel my Card, no processing fee will be charged. A RM10 fee is also chargeable for new Card replacements. By signing and/or using the Card I agree to be bound by the terms and conditions imposed by the Card and other variations or amendments thereof. I understand that the Zing Card remains the property of TNGSB, as the case may be, upon request. (xii) COMPLIMENTARY CIMB Touch n Go Zing CARD (for CIMB PETRONAS Platinum MasterCard / CIMB PETRONAS Gold MasterCard & CIMB Cash Rebate Platinum MasterCard only) (Touch n Go Card linked to CIMB Bank/CIMB Islamic Bank credit card) I/We acknowledge that the complimentary CIMB Touch n Go Zing Card with the automatic reload amount of RM100 is issued to me/us. In addition to the declaration where I have confirmed that my credit card issued to me shall be subject to CIMB Bank/CIMB Islamic Bank Cardmember Agreement, I also agree to abide by the terms and conditions of the Touch n Go Zing Card (hereinafter referred to as the Card ) and any other terms and conditions imposed by Touch n Go Sdn. Bhd. (hereinafter referred to as TNGSB ) and/or CIMB Bank / CIMB Islamic Bank (hereinafter referred to as the Bank ) from time to time in respect of the use of the Touch n Go features of the Card. I am aware that the Touch n Go Zing Card has an automatic reload amount of RM100 and that the automatic reload fee of RM1.50 is payable. I confirm and irrevocably authorize the Bank to debit my CIMB Bank /CIMB Islamic Bank Credit Card account for each reload and automatic reload fee (where chargeable) whenever the account balance drops to RM50 and below. In the event that I cancel my Card and my Card has an account balance at the point of cancellation, such balance will be refunded, upon request, to my CIMB Bank/CIMB Islamic Bank Credit Card account and the processing fee of RM5 will be debited from my CIMB Bank/CIMB Islamic Credit Card Account for such refund. In the event that my Card does not have any account balance when I cancel my Card, no processing fee will be charged. A RM10 fee is also chargeable for new Card replacements. By signing and/or using the Card I agree to be bound by

9 9/10 DECLARATION/DISCLOSURE BY APPLICANT**... continued the terms and conditions imposed by the Card and other variations or amendments thereof. I understand that the Touch n Go Zing Card remains the property of TNGSB and must be returned to TNGSB and/or the Bank, as the case may be, upon request. (xiii) For Cash Plus Personal Loan The right to reject the application at its sole discretion without stating any reasons. The Bank is hereby expressly authorized to discuss with my previous, current and future employers regarding this application and/or my payment record. I hereby declare that I am not a bankrupt and there is no ongoing legal action against me presently. I have read and understood the Terms and Conditions ( Terms ) of the Conventional Cash Plus Personal Loan ( Facility ) which are attached to this Application Form and make the offer for the Facility contained in this Application Form on these Terms. This Application Form, the Disbursement Notice and the Terms shall govern the Facility. I acknowledge that the Bank is deemed to have accepted my offer when the Facility applied for is credited to my personal account maintained (or to be opened by me) with the Bank. If the Bank does not accept my offer but instead offers me the Facility of a different amount, interest rate and/or tenure, as the case may be, I may accept the Bank s counter offer verbally or by utilizing the Facility offered by the Bank which has been credited to my personal account, whichever happens earlier. Any difference between the Facility amount, interest rate or tenure applied for and the amount, interest rate or tenure finally approved and offered by the Bank shall not affect the validity of the Terms. I agree that any agreement, confirmation, declaration, consent or undertaking given by me verbally or by any electronic method shall be legal and binding on me. (xiv) For Cash Plus Assurance (Compulsory) u Yes, I wish to take part in the Cash Plus Assurance ( CPA ) which is underwritten by Sun Life Malaysia Assurance Berhad (formerly known as CIMB Aviva Assurance Berhad) ( the company ), licensed and regulated by Bank Negara Malaysia. I hereby declare that I am between the age of 21 and 60 years old, in good health and free from any physical impairment or deformity. I also declare that I have not been suffering from or have not received or expect to receive any treatment for any symptoms, medical condition or disabilities, cancer, tumour, heart condition, stroke, HIV infection or related conditions. I understand that in the event of an early settlement of my loan, my coverage can be given up for a surrender value as determined by the company. I also understand that the surrender value, if any, will be less than the premium paid. I agree to waive the right over any surrender value that is less than or equal to RM20. I am satisfied with the explanation given to me by the authorised representative on the product and declare that I have read and understood the information, benefits and exclusions under CPA which are summarized but not exhaustive in the CPA Product Disclosure Sheet. I hereby consent to CIMB Bank sharing the information contained in this application form with the company which will then consider my application to enroll me as the life assured for CPA. A Certificate of Insurance will be issued by the company and shall be sent by the company to me upon my enrollment as a CPA life assured. IMPORTANT NOTES : a) Please ensure you declare the above fully and faithfully all the facts relating thereto that you know or you ought to know otherwise the insurance coverage issued hereunder may be voided by the company. Please note that the declaration is a continuing one and continues until the insurance coverage is actually provided. If there are any changes to your circumstances after the date of your declaration which will affect the truth of the declaration until the time the company grants you the insurance coverage, please ensure that you disclose such changes to the company otherwise the insurance coverage issued hereunder may be voided by the company. b) Proof of age is required prior to the payment of benefit under the policy. c) The product disclosure sheet of this product is provided as part of this application form, for you to pay particular attention to benefits which are guaranteed and not guaranteed and your duties as life assured under the Certificate of Insurance. d) The aggregate sum assured of CPA for each life assured shall not exceed RM200,000. e) The single premium for the coverage will be deducted from the loan amount. The premium deducted from the loan amount shall be made known via the loan disbursement letter of CIMB Bank Berhad. f) Please refer to the master policy for the exact terms, conditions and exclusions. A copy of the master policy can be viewed and download from the the company s official website at g) The company being the licensed insurer and underwriter of CPA shall undertake the full obligations under the CPA. CIMB Bank merely acts as a Distributor and is not responsible for the CPA. The CPA is not a CIMB Bank product and therefore not an obligation of / nor guaranteed by CIMB Bank or any of its affiliates or subsidiaries. (xv) For Credit Card I/We hereby request the Bank to issue, upon approval of this application, the credit card(s) which I/we have indicated. I/We acknowledge that the use of the credit card(s) issued to me/us shall be subject to the Bank s Cardholder Terms and Conditions ( Cardmember Agreement ) which will be sent to me/us with the credit card(s) upon the approval of this application, and I/we further agree to be bound by the terms and conditions set forth in the Cardmember Agreement upon issuance or use of the credit card(s). I, the Principal Applicant further agree to accept joint and several liability for all amounts incurred arising from the use of the principal and/or Supplementary credit card(s) issued pursuant to this application or at any time thereafter at my and/or the Supplementary Applicant s request. I/We further understand that the Bank shall not hold the Supplementary Applicant jointly and severally liable for the debts or amounts incurred by the Principal Applicant or other Supplementary Applicant(s). I/We understand that the credit card(s) when issued shall at all times remain the property of the Bank and must be duly returned upon request by the Bank. I/We further agree to accept liability for all amount incurred arising from the use of my/our credit card(s) issued pursuant to this application or at any time thereafter at my/our request. 1 CIMB Group means CIMB Bank Berhad or CIMB Islamic Bank Berhad or CIMB Investment Bank Berhad or other subsidiaries or companies controlled by the aforesaid respective banking institutions. 2 Close relative(s) include parents / spouse of staff including the spouse s dependents / children / spouse of the children / brother and sister / spouse of brother / sister and any other dependents and persons who may influence / be influenced by the staff. I hereby confirm having read, understood and retained a copy of Product Disclosure Sheet that explains the benefits and my duties to my application for the Product(s) that I/we applied for. For Property Financing, the Product Disclosure Sheet will be given together with the Letter Offer. I am aware the full terms and conditions of the product(s) that I applied for is/are also available in: Cash Plus Personal Loan : Cash Plus Assurance : CIMB Islamic Credit Card : CIMB Credit Card : u I/We hereby acknowledge that I/we have accessed and/or read the Privacy Notice issued by CIMB Group (which is available at all CIMB branches as well as the CIMB website at or otherwise made available to me/us) and confirm my agreement to the same.

10 10/10 VOLUNTARY DECLARATION/ DISCLOSURE BY APPLICANT (i) I/We declare that I/we have/do not have contingent liabilities with any other party(ies). Where I/we have contingent liabilities, particulars of my contingent liabilities are as follows : No. Name of Entity Maximum Amount of Contingent Liabilities (RM) (where ascertainable) 1 2 Main Applicant s Signature : Date : Joint Applicant s Signature : Date : BANK USE ONLY For Property / ASB Financing Salesperson Name : Salesperson I/D : Sales Team/Branch Code : Referrer Name : Referrer I/D : GMTA/GMTT : u Yes Self finance u Yes Bank financed u No Free Moving Costs : u Yes u No For Credit Card / Credit Cardi Staff I/D : Branch No. : For Cash Plus Personal Loan Staff I/D : Branch No. : Applicant Name : SD Doc No. NRIC No. : FOR CASH PLUS PERSONAL LOAN ONLY FOR CIMB BANK BERHAD USE ONLY UNTUK KEGUNAAN CIMB BANK BERHAD SAHAJA FOR CIMB BANK BERHAD (CREDIT ADMINISTRATION) USE ONLY UNTUK KEGUNAAN CIMB BANK BERHAD (PENTADBIRAN KREDIT SAHAJA) Date Initial Loan Amount Tenure RM Months Document Completed Interest Rate Instalment Amount RM ACCOUNT TO BE CREDITED : LDI Instructed SIGNATORIES Stamping Date : D D / M M / Y Y Y Y