AFFINBANK WORLD MASTERCARD APPLICATION FORM / BORANG PERMOHONAN AFFINBANK WORLD MASTERCARD
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- Dwight Powers
- 5 years ago
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1 Credit Card by / Kad Kredit oleh: AFFINBANK WORLD MASTERCARD APPLICATION FORM / BORANG PERMOHONAN AFFINBANK WORLD MASTERCARD Eligibility: Principal Cardmember must be 21 years old or above and 18 years old or above for Supplementary Cardmember. Minimum annual income: RM120,000 per annum. Kelayakan: Pemegang Kad Utama mestilah berumur 21 tahun ke atas dan 18 tahun ke atas untuk Pemegang Kad Tambahan. Pendapatan tahunan minimum: RM120,000 setahun. PLEDGE OF FIXED DEPOSIT / CAGARAN DEPOSIT TETAP Fixed Deposit (FD) as collateral is accepted if the applicant is unable to provide income evidence or supporting documents. Fixed Deposit (FD) will be maintained for as long as the credit card facility is available. / Deposit Tetap (FD) sebagai cagaran boleh diterima sekiranya pemohon tidak mempunyai bukti pendapatan atau dokumen-dokumen sokongan. Deposit Tetap (FD) akan kekal selagi kemudahan kad kredit masih wujud. Please complete all sections of the form in BLOCK LETTERS and tick (/) boxes where appropriate / Sila lengkapkan semua bahagian borang menggunakan HURUF BESAR dan tandakan (/) di kotak yang sesuai. ANNUAL FEES / YURAN TAHUNAN First Year / Tahun Pertama Second Year Onwards / Tahun Kedua dan Seterusnya Principal Card / Kad Utama Supplementary Card / Kad Tambahan * Annual fee for second year onwards will be waived subject to the following spend conditions: * Pengecualian Yuran tahunan tahun kedua dan seterusnya adalah tertakluk kepada syarat-syarat perbelanjaan yang berikut: Free / Percuma RM530 p.a. / setahun RM424 per p.a./ setahun RM48,000 p.a. / setahun Note: Annual fees above are inclusive of GST 6% / Nota: Yuran tahunan di atas adalah termasuk CBP 6% *Minimum spending is inclusive of retail and cash advance transactions / Perbelanjaan minimum adalah termasuk transaksi runcit dan pendahuluan tunai. PRINCIPAL CARDMEMBER PERSONAL DETAILS / DATA PERIBADI PEMEGANG KAD UTAMA Title / Gelaran : Mr. / Encik Mdm. / Puan Miss / Cik Others / Lain-lain: Full Name (As per I.C./Passport) / Nama Penuh (Seperti dalam KP/Pasport) : Name to appear on card. The name should be as per applicant s IC (maximum 19 characters) / Nama yang akan dicetak di kad. Nama ini hendaklah seperti KP pemohon (maksimum 19 huruf) : Date of Birth (DD/MM/YYYY) / Tarikh Lahir (HH/BB/TTTT) : Nationality / Kewarganegaraan : / / New I/C No. / No. K/P Baru : Old I/C No./Passport No / No. K/P Lama/No.Pasport : Others ID No. / Lain -lain No. K/P : - - Gender / Jantina : Male / Lelaki Female / Perempuan No. of Dependents / Bilangan Tangungan : Mother's Name / Nama Ibu (Required for security verification purpose / Ciri keselamatan bagi tujuan pengesahan ): Highest Education Level / Tahap Pendidikan Tertinggi : Marital Status / Status Perkahwinan : Primary / Rendah Secondary / Menengah Others / Lain-lain : Single / Bujang Married / Berkahwin College / Kolej University / Universiti Divorced / Bercerai Widow / Balu Spouse s Name (As in IC/Passport) / Nama Penuh Suami/Isteri (Seperti dalam KP/Pasport) : Spouse's Employer Full Name / Nama Penuh Majikan Suami/Isteri : Spouse s Office Telephone No. / No. Telefon Pejabat Suami/Isteri : Handphone No. / No. Telefon Bimbit : - Extension / Sambungan: Page 1 of 8
2 RESIDENTIAL ADDRESS / MAKLUMAT KEDIAMAN Residential Address (Please do not provide P.O.Box address) / Alamat Kediaman (Sila jangan berikan alamat Peti Surat) : Postcode / Poskod : Residential Telephone No. / No. Telefon Kediaman : Handphone No. / No. Telefon Bimbit : / E-mel : - Type of Residential / Jenis Kediaman : Owned Property / Milik Sendiri Mortgage / Gadai Janji Others / Lain-lain: Renting / Menyewa Parents / Relatives / Ibu Bapa / Saudara Years There / Tempoh Menetap : ( YY/TT ) (MM /BB ) Permanent Residential Address (If different from Residential Address) / Alamat Kediaman Tetap (Jika lain dari Alamat Kediaman) : Postcode / Poskod : Telephone No. / No. Telefon : - EMPLOYMENT DETAILS / MAKLUMAT PEKERJAAN Salaried / Bergaji Self Employed / Bekerja Sendiri Unemployed / Tidak Berkerja Name of Company / Nama Syarikat : Nature of Business / Jenis Perniagaan : Office Address (Please do not provide P.O.Box address) / Alamat Pejabat (Sila jangan berikan alamat Peti Surat) : Position Held / Jawatan : Postcode / Poskod : Office Telephone No. / No. Telefon Pejabat : - Extension / Sambungan Length of Service /Tempoh Berkhidmat : ( YY/TT ) (MM /BB ) Name of Previous Company / Nama Syarikat Sebelumnya : Previous Employment Information / Maklumat Majikan Sebelumnya Nature of Business / Jenis Perniagaan : Position Held / Jawatan : Length of Service / Tempoh Berkhidmat : ( YY/TT ) (MM /BB ) Annual Income / Pendapatan Tahunan Annual Gross Income (RM)/ Other annual income, if any (RM) / Pendapatan Kasar Tahunan (RM) : Lain-lain pendapatan tahunan jika ada (RM) : Please enclose supporting document(s ) / Sila lampirkan dokumen-dokumen sokongan Page 2 of 8
3 OTHER CREDIT / CHARGE CARDS OWNED / KAD-KAD KREDIT/CAJ YANG DIMILIKI Name of Issuer / Nama Pengeluar Member since / Ahli semenjak Credit limit / Had Kredit Declaration on monthly non-bank obligation ( excluding deductions appearing on payslip), If no obligation, kindly cross out the below table / Pengisytiharan tanggungan bulanan dengan institusi bukan Bank (tidak termasuk potongan melalui gaji), Jika tiada tanggungan, sila pangkah jadual di bawah : No. Company / Syarikat NON-BANK OBLIGATION / TANGGUNGAN DENGAN INSTITUSI BUKAN BANK Type / Jenis Monthly Payment (RM) / Bayaran Bulanan (RM) MAILING ADDRESS / ALAMAT SURAT-MENYURAT To Residence / Kediaman To Office / Pejabat SUPPLEMENTARY CARDMEMBER PERSONAL DETAILS / DATA PERIBADI PEMEGANG KAD TAMBAHAN Title / Gelaran : Mr. / Encik Mdm. / Puan Miss / Cik Others / Lain-lain : Full Name (As per I.C./Passport) / Nama Penuh (Seperti dalam KP/Pasport) : Name to appear on card. The name should be as per applicant s IC (maximum 19 characters) / Nama yang akan dicetak di kad. Nama ini hendaklah seperti KP pemohon (maksimum 19 huruf) : Date of Birth (DD/MM/YYYY) / Tarikh Lahir (HH/BB/TTTT) : Nationality / Kewarganegaraan : / / New I/C No. / No. K/P Baru : Old I/C No./Passport No / No. K/P Lama/No.Pasport : Others ID No. / Lain -lain No. K/P : - - Gender / Jantina : Male / Lelaki Female / Perempuan Mother's Name / Nama Ibu ( Required for security verification purpose / Ciri keselamatan bagi tujuan pengesahan ): Relationship with Principal Cardmember / Hubungan dengan Pemegang Kad Utama : Employer's Full Name (if any) / Nama Penuh Majikan (jika ada) : Employer's Address (if any) / Alamat Majikan Pejabat (Jika ada) : Position Held / Jawatan : Postcode / Poskod : Handphone No. / No. Telefon Bimbit : / E-mel : Office Telephone No. / No. Telefon Pejabat : - Extension / Sambungan Please tick one ( ) / Sila tandakan ( ) salah satu: Sharing the Principal's credit limit / Berkongsi had kredit Pemegang Kad Utama Assign credit limit / Had kredit ditetapkan : RM Page 3 of 8
4 PRINCIPAL S PERSONAL REFERENCE / RUJUKAN PERIBADI PEMEGANG KAD UTAMA Name of Relative/Friend who does not reside together / Nama Saudara/Rakan yang tidak tinggal bersama : Relationship with Principal Cardmember / Hubungan dengan Pemegang Kad Utama : Residential Telephone No / No. Telefon Kediaman : Office Telephone No. / No. Telefon Pejabat : Handphone No. / No. Telefon Bimbit : - Extension / Sambungan II/We confirm: That all personal data that I/we have provided are all true, up-to-date and accurate. Should there be any changes to any of my/our personal data, I/we shall notify Affin Bank Group ( ABG ) immediately. I/We hereby authorise the Bank to verify the information with the Inland Revenue Board and/or whatever sources by any means that the Bank considers appropriate. That my/our borrowings from all sources within Malaysia do not exceed in aggregate RM200,000 (applicable to non-malaysians only). That the transactions to be effected using the credit card account and monies of funds to be used for repayment of the credit card account are neither obtained from any unlawful source nor related to any unlawful activities as defined under the Anti-Money Laundering and Anti-Terrorism Financing Act Saya/Kami mengesahkan: Bahawa semua maklumat peribadi yang saya/kami berikan adalah semuanya benar, yang terkini dan betul. Sekiranya terdapat perubahan terhadap mana-mana maklumat peribadi saya/kami, saya/kami akan memberi notis dengan segera kepada Kumpulan Affin Bank ( ABG ). Saya/Kami dengan ini memberikan kuasa kepada Bank untuk mengesahkan kenyataan ini daripada Lembaga Hasil Dalam Negeri dan/atau mana-mana sumber yang pihak Bank fikirkan sesuai. DECLARATION / PERAKUAN I/We 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) database maintained by BNM. I/We agree that my/our signing of the AFFINBANK World MasterCard shall constitute my/our acceptance of my/our agreement to be bound by the Terms and Conditions contained in the AFFINBANK World MasterCard Terms and Conditions that will be sent or given to me/us with the AFFINBANK World MasterCard, in the event that my/our application herein is approved. I/We further agree that the Principal Cardmember shall be responsible for all liabilities and obligations of the Principal Cardmember as well as those of the Supplementary Cardmember(s). The Supplementary Cardmember however, shall only be responsible for his/her own liabilities and obligation. Bahawa pinjaman saya/kami daripada sumber-sumber di Malaysia tidak melebihi RM200,000 (untuk bukan rakyat Malaysia sahaja). Bahawa urus niaga menggunakan akaun kad kredit dan wang atau dana yang digunakan untuk pembayaran balik akaun kad kredit tidak diperolehi daripada mana-mana sumber yang menyalahi undang-undang atau berkaitan dengan aktiviti-aktiviti yang menyalahi undang-undang seperti yang telah dikenal pasti di bawah Akta Pencegahan Pengubahan Wang Haram dan Pencegahan Pembiayaan Keganasan Saya/Kami mengakui bahawa adalah menjadi syarat Bank Negara Malaysia (BNM) bahawa semua maklumat yang berkaitan dengan permohonan ini, sama ada berjaya atau tidak, mesti dikemaskinikan dan/atau dihantar ke Sistem Maklumat Kad Kredit (CCRIS), iaitu pangkalan data yang dikendalikan oleh BNM. Saya/Kami bersetuju bahawa sebaik sahaja saya/kami menandatangani/menggunakan Kad AFFINBANK World MasterCard, saya/kami adalah terikat kepada Terma dan Syarat yang termaktub di dalam Terma dan Syarat AFFINBANK World MasterCard di mana satu salinan akan diberikan atau dihantar kepada saya/kami dengan Kad AFFINBANK World MasterCard saya/kami apabila permohonan ini diluluskan. Saya/Kami seterusnya bersetuju bahawa Ahli Kad Utama hendaklah bertangungjawab terhadap semua liabiliti dan obligasi Ahli Kad Utama serta Ahli (ahli-ahli) Kad Tambahan. Walaubagaimanapun, Ahli Kad Tambahan akan hanya bertanggungjawab terhadap liabiliti dan obligasinya sendiri. CONSENT FOR CREDIT CHECKS / KEBENARAN BAGI PENYEMAKAN KREDIT I/We hereby authorize ABG to disclose my/our personal data (as defined under the Personal Data Protection Act 2010) to any credit reporting agency in Malaysia to conduct credit checks on me/us from time to time in connection with the application, distribution and provision of products and/or services, regardless of the relationship between me/us and ABG may have been terminated and/or an event of default had occurred. I/We agree that the purpose indicated by ABG of a legitimate interest to request for my/our report shall be sufficient and adequate proof of a valid purpose within the meaning of the Credit Reporting Agencies Act I/We hereby give my/our consent to CTOS,FIS, CCRIS and other credit reporting agency, a registered credit reference agency under the Credit Reporting Agencies Act 2010, to release my/our credit report to ABG and/or their legal representatives for the purposes of enabling the processing of a facility or transaction and any related processes arising there from including but not limited to credit evaluation, monitoring, credit reviews and debt recovery purposes (hereinafter referred to as legitimate interests ), offered by ABG to me/us or to a party to whom I/we have agreed to guarantee from time to time. Where ABG requires any such processing to be further processed by its Head Office or any processing centre located outside Malaysia, I/we hereby give my/our consent to CTOS,FIS, CCRIS and other credit reporting agencies to make such disclosure of my/our credit report to such locations outside Malaysia. I/We shall indemnify and keep ABG fully indemnified against all costs, losses, damages, fees (including solicitor-client fees on a full indemnity basis) of whatsoever nature and description and howsoever arising/incurred/suffered by ABG acting or having acted on this consent. Saya/Kami dengan ini memberi kuasa kepada ABG untuk mendedahkan maklumat peribadi saya/kami ( seperti yang ditakrifkan di bawah Akta Perlindungan Data Peribadi 2010) kepada mana-mana agensi pelaporan kredit di Malaysia untuk melakukan semakan kredit ke atas saya/kami dari semasa ke semasa berkaitan dengan permohonan, pengagihan dan peruntukan produk dan/atau perkhidmatan, tanpa mengambil kira perhubungan di antara saya/kami dan ABG telah ditamatkan dan/atau di dalam keadaan di mana pengingkaran telah berlaku. Page 4 of 8
5 Saya/Kami bersetuju bahawa tujuan dinyatakan oleh ABG berkenaan kepentingan sah untuk meminta laporan saya/kami adalah mencukupi dan merupakan bukti yang memadai bagi tujuan sah selaras dengan pengertian dalam Akta Agensi Pelaporan Kredit Saya/Kami dengan ini memberi kebenaran saya/kami kepada CTOS, FIS, CCRIS dan lain-lain agensi pelaporan kredit, agensi rujukan kredit berdaftar di bawah Akta Agensi Pelaporan Kredit 2010, untuk memberi laporan kredit saya/kami kepada ABG dan /atau kepada wakil-wakil mereka yang sah bagi maksud membolehkan pemprosesan kemudahan atau transaksi dan apa-apa proses yang berkaitan yang timbul daripadanya termasuk tetapi tidak terhad kepada penilaian kredit, pemantauan, semakan kredit dan tujuan tuntutan semula hutang (selepas ini dirujuk sebagai kepentingan sah ), yang ditawarkan oleh ABG kepada saya/kami atau kepada pihak yang mana saya/kami bersetuju menjamin dari semasa ke semasa. Dimana ABG memerlukan pemprosesan tersebut untuk diproses lebih lanjut oleh Ibu Pejabat atau mana-mana pusat pemprosesan yang terletak di luar Malaysia, saya/kami dengan ini memberi kebenaran saya/kami kepada CTOS, FIS, CCRIS dan lain-lain agensi pelaporan kredit untuk membuat pendedahan laporan kredit saya/kami di kawasan di luar Malaysia tersebut. Saya/Kami hendaklah menanggung rugi pihak Bank dan memastikan Bank ditanggung rugi sepenuhnya terhadap semua kos-kos, kerosakankerosakan, yuran-yuran (termasuk yuran-yuran peguam-pelanggan atas dasar tanggung rugi sepenuhnya) di atas apa jua keadaan dan deskripsi dan walau macamanapun timbul/ditanggung/dialami oleh tindakan ABG atau tindakan terhadap kebenaran ini. CONSENT FOR DIRECT MARKETING AND OTHERS / KEBENARAN UNTUK PEMASARAN LANGSUNG DAN LAIN-LAIN In order to process this application and subsequently to continue performing the contractual agreements entered between me/us and ABG, ABG may obtain and disclose my/our personal data in accordance with ABG s Privacy Notice which is available on the website at or has otherwise been made available to me/us and confirm my/our agreement to the same. By signing this form, I/we am/are declaring that I/we have read, understood and agreed to be subject to the ABG s Privacy Notice and expressly consenting to and authorising ABG : (a) To request and/or to obtain all the personal information and data in this form for the purpose of processing this application; (b) (c) (a) Untuk meminta dan/atau untuk mendapatkan segala maklumat peribadi dan maklumat di dalam borang ini bagi tujuan memproses permohonan ini; (b) (c) To the disclosure of my/our personal information within ABG for the purpose of facilitating the business, operations, services and other purposes of ABG; and To collect and process my/our sensitive personal data for the purpose of this application (where applicable). Bagi memproses permohonan ini dan seterusnya untuk terus melaksanakan perjanjian kontrak diantara saya/kami dan ABG, ABG boleh mendapatkan dan mendedahkan data peribadi saya/kami menurut Notis Privasi ABG yang mana boleh didapati di laman sesawang atau sebaliknya telah diberikan kepada saya/kami dan saya/kami dengan ini mengesahkan kepada penjanjian yang sama. Dengan menandatangani borang ini, saya/kami dengan ini mengisytiharkan bahawa saya/kami telah membaca dan bersetuju untuk tertakluk kepada Notis Privasi ABG dan membenarkan dan memberi kuasa kepada ABG: Untuk mendedahkan maklumat peribadi saya/kami di dalam ABG bagi tujuan untuk memudahkan perniagaan, operasi, perkhidmatan dan lain-lain tujuan ABG; dan Untuk mengumpul dan memproses maklumat peribadi sensitif saya/kami bagi tujuan pemohonan ini (jika berkenaan). To the extent that ABG intends to disclose my/our information for the purpose of strategic alliances, marketing or promotional purposes ( marketing purposes ) whether for internal products or services (ABG only) or external products or services (ABG s strategic partners/alliances), my/our choice is as per my/our selection below (please tick): Setakat mana ABG berhasrat untuk mendedahkan maklumat saya/kami bagi tujuan perikatan strategik, pemasaran atau tujuan promosi ( tujuan pemasaran ) samada untuk produk-produk atau perkhidmatan perkhidmatan dalaman (ABG sahaja) atau produk-produk dan perkhidmatan - perkhidmatan luaran (rakan strategik/ pakatan ABG), pilihan saya/kami adalah seperti di bawah (sila tandakan): Yes, I/we expressly agree to the disclosure of my/our personal data for marketing purposes (opt-in) / Ya, saya/kami bersetujuan kepada pendedahan data peribadi saya/kami bagi tujuan pemasaran (ikut serta) No, I/we do not agree to the disclosure of my/our personal data for marketing purposes (opt-out) / Tidak, saya/kami tidak bersetuju kepada pendedahan maklumat peribadi saya/kami bagi tujuan pemasaran (tidak ikut serta) Note: For existing customer, previous choice remains unless indicated otherwise above. Nota: Bagi pelanggan sedia ada, pilihan sebelumnya adalah kekal melainkan jika dinyatakan sebaliknya di atas. Disclosure / Pendedahan I/We consent to the disclosure of any documents and information relating to my/our accounts or affairs to the Bank, its officers and agents and to all such persons and for all such purposes as set out in relevant Sections of the Financial Services Act 2013 (FSA). Saya / Kami bersetuju dengan pendedahan apa-apa dokumen dan maklumat yang berhubungan dengan akaun atau perihal saya / kami kepada Bank, pegawai-pegawainya dan ejen-ejen dan kepada semua orang tersebut dan bagi segala maksud seperti yang dinyatakan dalam seksyen-seksyen berkaitan dalam Akta Perkhidmatan Kewangan 2013 (FSA). Declaration / Perakuan I/We understood that all references to BAFIA in the subsequent contractual agreements entered between me/us and ABG shall refer to the FSA and all guidance, standards or prescriptions or to be issued by Bank Negara Malaysia (BNM) at any time and from time to time. I/We confirm that I/we have not withheld any information which may prejudice my/our loan/financing application or have a bearing on ABG s financing/loan decision including but not limited to contravention of the Guidelines on Credit Transactions and Exposures with Connected Parties' issued by BNM and/or any other applicable guidance, standards or prescriptions issued or to be issued by BNM with respect to the same. I/We declare that I/we have not committed or is involved in any act of bankruptcy or is adjudged as bankrupt or is involved in any unlawful activities as defined under the provision of Anti-Money Laundering and Anti-Terrorism Financing Act 2001 (including all amendments thereof) or any other related acts or regulations. Saya / Kami memahami bahawa semua rujukan kepada BAFIA dalam perjanjian kontrak berikutnya di antara saya / kami dan ABG hendaklah merujuk kepada FSA dan semua panduan, piawaian atau preskripsi yang dikeluarkan atau akan dikeluarkan oleh Bank Negara Malaysia (BNM) pada bila-bila masa dan dari semasa ke semasa. Page 5 of 8
6 Saya / Kami mengesahkan bahawa saya / kami tidak menyembunyikan apa-apa maklumat yang boleh menjejaskan pinjaman / permohonan pembiayaan saya / kami atau mempunyai kaitan dengan keputusan pembiayaan / pinjaman ABG termasuk tetapi tidak terhad kepada pelanggaran 'Garis Panduan mengenai Urus Niaga Kredit dan Pendedahan dengan Pihak Yang Berkaitan yang dikeluarkan oleh BNM dan / atau mana-mana panduan lain yang berkenaan, piawaian atau preskripsi yang dikeluarkan atau yang akan dikeluarkan oleh BNM berkenaan dengan yang sama. Saya / Kami mengesahkan bahawa saya / kami tidak melakukan atau terlibat dalam apa-apa perbuatan kebankrapan atau dihukumkan sebagai bankrap atau terlibat dalam apa-apa aktiviti menyalahi undang-undang seperti yang ditakrifkan di bawah peruntukan Akta Pencegahan Pengubahan Wang Haram dan Pencegahan Pembiayaan Keganasan 2001 (termasuk semua pindaan yang berkenaan) atau apa-apa tindakan yang berkaitan atau peraturanperaturan lain. I/We hereby further declare that (no declaration from the applicant denotes that this declaration is not applicable). Saya / Kami dengan ini mengisytiharkan selanjutnya bahawa (tiada pengakuan daripada pemohon menandakan bahawa pengakuan ini tidak berkenaan). I am a staff of ABG / Saya adalah kakitangan ABG To the best of my knowledge, I have close relative(s)* employed under ABG / Sepanjang pengetahuan saya, saya mempunyai saudara terdekat* yang bekerja di bawah ABG The particulars are as below:/ Butir-butir adalah seperti di bawah: Name / Nama NRIC No. / No. Kad Pengenalan Relationship / Hubungan * Close relative(s) include spouse of staff and dependents of spouse, child (including step child and adopted child), parent(s), brother or sister and their spouses and any other dependents and persons who may influence/be influenced by the staff or as defined under the BNM s Guidelines on Credit Transactions and Exposures with Connected Parties. * Saudara terdekat termasuk pasangan kakitangan dan tanggungan suami atau isteri, anak (termasuk anak tiri dan anak angkat), ibu bapa, saudara lelaki atau perempuan dan suami atau isteri mereka dan mana-mana orang tanggungan dan orang lain yang mungkin mempengaruhi / dipengaruhi oleh kakitangan atau sebagaimana yang ditakrifkan di bawah Garis Panduan BNM mengenai Urus Niaga Kredit dan Pendedahan dengan Pihak Yang Berkaitan. I/We further understood that any sum set out in this application or in the subsequent agreement or otherwise payable by any party hereto to any other party pursuant to this application or subsequent agreement shall be deemed to be exclusive of any Goods and Services Tax ( GST ) or tax of similar nature which is chargeable on the supply (or supplies) for which such sum is (the whole or part of) the consideration for GST purposes. ABG s charges shall exclude tax that would be imposed in the future (including but not limited to GST). Upon implementation of the GST, ABG will be entitled to recover from me/us any GST that ABG are required by law to collect. Saya / Kami juga memahami bahawa apa-apa jumlah yang dinyatakan dalam permohonan ini atau dalam perjanjian yang berikutnya atau dibayar oleh mana-mana pihak kepada mana-mana pihak lain di bawah permohonan ini atau perjanjian yang kemudiannya hendaklah disifatkan sebagai tidak termasuk sebarang Cukai Barang dan Perkhidmatan ("CBP") atau cukai yang serupa yang mana dikenakan ke atas pembekalan (atau bekalan) yang mana jumlah wang tersebut (keseluruhan atau sebahagian daripadanya) balasan bagi tujuan CBP. Caj-caj yang dikenakan oleh ABG hendaklah tidak termasuk cukai yang akan dikenakan pada masa akan datang (termasuk tetapi tidak terhad kepada CBP). Apabila CBP dilaksanakan, ABG berhak untuk mendapatkan daripada saya / kami apa-apa CBP sebagaimana dikehendaki oleh undang-undang. I/We further understand that:- (a) ABG s acceptance of my/our application herein does not constitute approval and if approved by ABG, it is subject to revision, reduction or cancellation at any time at ABG s absolute discretion without stating any reasons whatsoever; (b) I/we understand that ABG reserves the right to decline an application without giving any reasons. (c) (d) Saya / Kami seterusnya memahami bahawa:- (a) penerimaan permohonan saya / kami oleh ABG di dalam ini tidak menjaminkan kelulusan dan jika diluluskan oleh ABG, ia tertakluk kepada penilaian semula, pengurangan atau pembatalan pada bila-bila masa mengikut budi bicara mutlak ABG tanpa menyatakan apa-apa sebab sekalipun; (b) (c) (d) all other terms and conditions not specifically mentioned above are to be incorporated in the AFFINBANK World MasterCard Terms and Conditions; and this application and supporting documents remain ABG s property regardless whether the application is approved or rejected by ABG. In the event of any inconsistency(ies), conflict(s), ambiguity(ies) or discrepancy(ies) between the rules and regulations herein and any other agreements, mandates, terms or conditions relating to my/our account with ABG or the translated Bahasa Malaysia version, the rules and regulations herein in the English language shall prevail.notwithstanding the aforementioned where request is made by the me/us for the Bahasa Malaysia version, ABG shall provide the same to me/us and if the application is entered into on this basis, then the Bahasa Malaysia version shall prevail. I/We have read and understood the above terms and conditions for this application. I/We hereby undertake and agree to be bound by ABG s terms and conditions as mentioned herein and the said terms and conditions shall form part and parcel of the security documents executed in ABG s favour. saya/kami memahami bahawa ABG berhak untuk menolak permohonan tanpa memberi sebarang sebab. semua terma dan syarat lain yang tidak disebut secara khusus di atas hendaklah dimasukkan di dalam Terma dan Syarat AFFINBANK World MasterCard; dan permohonan dan dokumen-dokumen sokongan akan kekal sebagai harta ABG tanpa mengira sama ada permohonan diluluskan atau ditolak oleh ABG. Sekiranya terdapat apa-apa ketidakselarasan, konflik, kesamaran atau percanggahan di antara garis panduan dan peraturan-peraturan di dalam ini dan apa-apa perjanjian, mandat, terma atau syarat yang berhubungan dengan akaun saya / kami dengan ABG atau penterjemahan dalam versi Bahasa Malaysia, garis panduan dan peraturan-peraturan di dalam ini dalam Bahasa Inggeris akan diguna pakai. Walau apa pun yang dinyatakan di atas di mana permintaan dibuat oleh saya / kami untuk versi Bahasa Malaysia, ABG hendaklah memberikannya kepada saya / kami dan jika permohonan itu dibuat atas dasar ini, maka versi Bahasa Malaysia hendaklah dipakai. Page 6 of 8
7 Saya / Kami telah membaca dan memahami terma dan syarat di atas untuk permohonan ini. Saya / Kami dengan ini mengakujanji dan bersetuju untuk terikat dengan terma-terma dan syarat-syarat ABG sebagai yang dinyatakan di sini dan terma-terma dan syarat-syarat tersebut akan menjadi sebahagian daripada dokumen-dokumen keselamatan dilaksanakan bagi pihak ABG. DECLARATION ON PRODUCT DISCLOSURE SHEET / PERAKUAN MENGENAI LEMBARAN MAKLUMAT PRODUK I/We have read and understood the information, fees and charges as stated in the Product Disclosure Sheet and agree to abide to its terms and conditions. / Saya/Kami telah membaca dan memahami sepenuhnya maklumat, yuran dan caj-caj yang tertera di dalam Lembaran Maklumat Produk dan bersetuju untuk mematuhi terma dan syarat berkaitan dengannya. Signature of Principal Card Applicant / Tandatangan Pemohon Kad Utama Date / Tarikh : Date / Tarikh : FOR BANK USE ONLY / UNTUK KEGUNAAN BANK SAHAJA Signature of Supplementary Card Applicant / Tandatangan Pemohon Kad Tambahan Name of agent / Staff / Nama Ejen / Kakitangan Staff PS No. / No. PS Kakitangan Referral PS No. / No. PS Perujuk For Cards Business Department use only / Untuk kegunaan Jabatan Perniagaan Kad Vetted by / Disemak oleh Input by / Dimasukkan oleh Checked by / Diperiksa oleh Team Code / Kod Kumpulan Delivery Channel / Saluran Serahan Branch Code / Kod Cawangan Source Code / Kod Sumber Promotion Program / Promosi Program Page 7 of 8
8 Form 9, Form 24 & Form 49 or Business Registration Certificate, and Latest BE Form/B Form with tax payment receipt, and any the following documents: Latest 3 months company s account statement, or DOCUMENTS / DOKUMEN-DOKUMEN Documents required (please select based on current occupation category) / Dokumen-dokumen yang diperlukan (berdasarkan kategori pekerjaan sekarang) Self Employed Bekerja Sendiri Copy of IC / Passport, including supplementary applicant (both sides) Salinan KP / Pasport termasuk pemohon kad tambahan ( depan & belakang) Photocopy of Visa with 1 year validity period(both sides) Salinan Visa dengan tempoh sah 1 tahun (depan dan belakang) Self Employed (Bank s customer of more than 6 months) Form 9, 24 & Form 49 or Business Registration Certificate Bekerja Sendiri (Pelanggan Bank selama lebih 6 bulan) Borang 9, 24 & Borang 49 atau Sijil Pendaftaran Perniagaan Self Employed (Non Bank customer) Latest Profit & Loss Account statement Bekerja Sendiri (Bukan pelanggan Bank) Borang 9, Borang 24 & Borang 49 atau Sijil Pendaftaran Perniagaan, dan Borang BE/Borang B terkini disertai resit bayaran cukai pendapatan, dan salah satu daripada dokumen-dokumen berikut: Salinan terkini 3 bulan penyata akaun syarikat,atau Penyata Akaun Untung Rugi terkini Salaried Employee Kakitangan Bergaji Copy of IC / Passport, including supplementary applicant (both sides) Salinan KP / Pasport termasuk pemohon kad tambahan ( depan & belakang) Photocopy of Visa with 1 year validity period(both sides) Salinan Visa dengan tempoh sah 1 tahun (depan dan belakang) Latest 1 month salary slip (compulsory), and any one of the following documents: Copy of latest EPF statement,or Copy of latest 1 month bank account statement where the salary is credited, or Latest BE Form/ B Form with tax payment receipt 1 bulan penyata gaji terkini (wajib), dan salah satu daripada dokumen-dokumen berikut: Salinan terkini penyata KWSP, atau Salinan terkini 1 bulan penyata akaun bank dimana gaji dikreditkan, atau Borang BE/Borang B terkini disertai resit bayaran cukai pendapatan Note: For Non-Malaysian Fixed deposit (FD) to be pledged for credit card facility Nota: Untuk bukan-rakyat Malaysia,Deposit Tetap (FD) diperlukan sebagai cagaran bagi kemudahan kad kredit Salinan KP / Pasport termasuk pemohon kad tambahan ( depan & belakang) Please note that the enclosed documents are non-returnable. For security purpose, please cross all the documents submitted. Commission Earner Pendapatan Komisen Copy of IC / Passport, including supplementary applicant (both sides) Photocopy of Visa with 1 year validity period(both sides) Salinan Visa dengan tempoh sah 1 tahun (depan dan belakang) Latest 6 months commission statements, and 6 bulan penyata komisen terkini, dan Copy of latest 6 months account statement where the commission is credited, or Salinan terkini 6 bulan penyata akaun bank dimana komisen dikreditkan,atau Latest EA Form/ BE Form with tax payment receipt and E-Filing acknowledgement EA/Borang BE terkini disertai resit bayaran cukai pendapatan dan akuan penerimaan E-Filing Sila ambil perhatian bahawa dokumen yang dilampirkan tidak akan dikembalikan. Bagi tujuan keselamatan, sila palangkan semua dokumen dokumen yang dihantar Page 8 of 8
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