i-biz Muamalat Application Form Borang Permohonan Aplikasi i-biz Muamalat A Enquiry (E) Subscription Type / Jenis Langganan Please mark the box(es) below with x / Sila isi kotak di bawah dengan x Payment (P) Bulk Payment / Payroll (BPP) Foreign Telegraphic Transfer (FTT) Full Mode (FM) B Company/Organisation Information (Principal Applicant) Maklumat Organisasi / Syarikat (Pemohon Prinsipal) Company/Organisation Nama Syarikat/Organisasi Company/Organisation Registration Number Nombor Pendaftaran Full Address Alamat Penuh Telephone Number and Fax Nombor Telefon dan Fax Contact Person Individu untuk Dihubungi Emel Branch Cawangan Telefon: 1 2 Fax: C List of Principal Account(s) to be accessed Senarai Akaun Prisipal untuk di akses C1 C4 C2 C5 C3 C6 Please attach account list if number of accounts is more than the fields above. Sila kepilkan senarai akaun jika bilangan akaun melebihi ruangan di atas D List of Subsidaries Account(s) to be accessed Senarai Akaun Subsidari untuk di akses D1 D4 D2 D5 D3 D6 * Not for P, BPP, FTT and FM / Bukan tujuan P, BPP, FTT dan FM If the account belongs to subsidiary or related, please include Board Resolutions to allow the account to be viewed by the Principal Applicant. Jika akaun milik subsidari atau yang berkait, sila sertakan Resolusi Ahli Lembaga Pengarah bagi membenarkan akaun tersebut diliihat oleh Pemohon Prinsipal.
E Authorised User(s) Information Maklumat Pengguna yang sah User, and Mobile Nama Pengguna & Emel dan Telefon Bimbit Nombor KP/Passport IC/Passport Number Access to Account (C/ D) Akses Akaun (C / D) User Functions Fungsi Pengguna Viewer Maker* Checker Auhoriser* *Mandatory for P, BPP, FTT & FM mode / Mandatori untuk mod P, BPP, FTT & FM Please attach user list if number of users more than the fields above Sila kepilkan senarai pengguna jika bilangan pengguna melebihi ruangan di atas Bank or Self Manage? Bank atau Urus Sendiri?* Bank Manage Self Manage F F1 *If Bank Manage, proceed to G section / Jika Bank Uruskan, teruskan ke seksyen G Corporate Self Manage Information* Maklumat Urus Sendiri Korporat User & Nama Pengguna & Emel NRIC/Passport Number Nombor KP /Passport Mobile Telefon Bimbit Admin User Functions Fungsi Pengguna Authoriser F2 F3 F4 F5 F6 * Minimum 1 Admin and 1 Authoriser.Maximum 3 Admin and 3 Authoriser Minimum 1 Admin dan 1 Pengesah.Maksimum 3 Admin dan 3 Pengesah
SECTION G AND H FOR P, BPP, FTT AND FM MODE ONLY * BAHAGIAN G & H UNTUK MOD P, BPP, FTT DAN FM SAHAJA * G User Authorisation Group Assignation Kemasukan Pengguna ke dalam Kumpulan Pemberi Kebenaran A B C D E H Transaction Limit and Transaction Authorization Had Transaksi dan Kebenaran Transaksi Transaction Limit (up to RM) Had Transaksi (sehingga RM) Number of authorisation required from each group Jumlah kebenaran yang diperlukan dari setiap kumpulan A B C D E H1 H2 H3 H4 H5 Approval by hierarchy / Kelulusan berhierarki *If Transaction Limit and Authorisation differed between P and BPP/FTT, kindly attached another copy for this section. *Jika terdapat perbezaan Had Transaksi dan Kebenaran antara P dan BPP/FTT, sila kepilkan salinan lain untuk seksyen ini. Do you have the following facilities with us? Please indicate below. Trade facility Autopay
I Maklumat Caj Perkhidmatan Service Charge Information No Subscription Type Jenis Langganan 1 Enquiry (E) 2 P, FTT, BPP & FM Charge Type Jenis Caj Bulanan Monthly Bulanan Monthly Charge (RM) Caj (RM) 40.00 20.00 For Non Enquiry (E) subscription, IVEST smart card/usb token is required for each Authoriser Bagi langganan selain Enquiry (E), USB token IVEST diperlukan bagi setiap Pelulus. Per Transaction Charges and per SMS Notification Charge Caj Per Transaksi dan Caj Per Notifikasi SMS No Charge Type Jenis Caj Per Transaction Charge (RM) Caj Per Transaksi (RM) 1 Pay to Bank Muamalat Bayar ke Akaun Bank Muamalat Free / Percuma 2 Pay to IBG / Bayar ke IBG RM0.10 3 Pay to RENTAS / Bayar ke RENTAS RM5.00 4 Pay to Foreign Telegraphic Transfer (FTT) Pembayaran Foreign Telegraphic Transfer RM20.00 3 SMS Notification / Notifikasi SMS 0.20 We hereby authorised the Bank to make periodically monthly payment based on subscription type for ibiz Muamalat subscription fee by debiting our account below: Dengan ini kami membernarkan pihak Bank untuk membuat bayaran berjadual, berdasarkan jenis langganan bagi yuran langganan ibiz Muamalat, dengan mendebit akaun kami seperti di bawah: G Pengakuan Declaration 1) I/We hereby apply for the service for ibiz Muamalat provided by Bank Muamalat Malaysia Berhad 2) I/We shall deemed to have read, understood and accepted the Terms and Conditions governed the use of ibiz Muamalat before submitting this application, and agree irrevocable and unconditionally to be bound by such terms and conditions. 3) I/We hereby confirm that I/we are authorised to act for and on behalf of the Company/Association/Club/Society/Partnership to apply for ibiz Muamalat services provided by the Bank. 4) I/We hereby confirm that all information provided is true and accurate to the best of my/our knowledge at the date of application. 5) I/We hereby agree and undertake to indemnify you and at all times keep you fully indemnified from and against all claims and demands, actions and proceedings, losses and expenses including legal costs as between solicitor and own client and all other liabilities of whatsoever nature or description which may be made or taken or incurred or suffered by you in connection with or in any manner arising out of the said authorisation given by me/us. 6) I/We further agree that my/our liabilities shall be a continuing liability and shall remain in full force and effect until my/our liabilities if any is fully discharge to your satisfaction. 7) I/We further irrevocably agree to indemnify you in full against all liabilities and all actions, suits, proceedings, demands, damages, costs and any expenses whatsoever or howsoever arising and/or incurred and/or sustained by you arising out of or in connection with any instructions given or purported to be given by the authorised person(s) Authorised Signatory and Company Stamp (Chop) : Designation: IC Number: Authorised Signatory and Company Stamp (Chop) : Designation: IC Number:
For Bank Use / Untuk Kegunaan Bank Received and Verified by (Branch) Setup Done By (HQ) Approved by (HQ) CIF Number (For Bank Use Only) Nombor CIF (Untuk Kegunaan Bank) Maklumat Token USB IVEST bagi kegunaan applikasi i-biz Muamalat * 1) USB IVEST Tokens are issued by Digicert Sdn Bhd (www.digicert.com.my) Token USB IVEST dikeluarkan oleh Digicert Sdn Bhd (www.digicert.com.my) 2) New applicant is required to complete the IVEST Application Form.A photocopy of ID Card and Referal Letter from organization are required for each new applicant. Pemohon perlu melengkapkan borang permohonan IVEST. Setiap permohonan baru perlu disertakan dengan salinan Kad Pengenalan/Lesen Memandu dan Surat Rujukan dari Organisasi 3) The Summary cost of USB IVEST Token cost is as per below: Kos bagi token USB IVEST adalah seperti berikut: Spesifikasi Produk Product Specifications Complete ivest Client CA Kit Individual Cert for 2 years validity (2048) Smartcard Preprinted Reader Rockey 2000 PIN Mailer ivest Client CA New / Renewal Package Individual Cert for years validity (2048) Smartcard Preprinted Pin Mailer Kuantiti Quantity Harga (RM) * Price (RM) * 1 RM200.00 1 RM220.00 Handling Fee 1 10.00 * Above mentioned prices are subject to change by Digicert Sdn Bhd without prior notice. Harga di atas adalah tertakluk kepada perubahan dibuat oleh Digicert Sdn Bhd. 4) Sila rujuk borang permohonan IVEST untuk maklumat lengkap permohonan. Kindly refer on the IVEST application form for more detail *Hanya untuk Pengesah bagi mode P,BPP,FTT dan FM *Only for Authorizer for P,BPP, FTT and FM Mode