here - Bank Muamalat Malaysia

APPLICATION FORM FOR
CONSUMER FINANCING
IMPORTANT: Please read our Personal Data Protection Notice ("Notice") before completing this form. By giving us your personal data and signing this form, you are
indicating to us that you consent and agree to the terms of our Notice and to terms of this form. Our Notice is available on our website at www.muamalat.com.my and from
any of our outlets.
PENTING : Sila baca Notis Perlindungan Data Peribadi kami ("Notis") sebelum melengkapkan borang ini. Dengan mengemukakan data peribadi anda dan
menandatangani borang ini, anda memaklumkan kepada kami bahawa anda memberi kebenaran dan persetujuan terhadap terma-terma Notis kami dan termaterma di dalam borang ini. Notis kami boleh diperolehi dari laman web kami di www.muamalat.com.my dan mana-mana cawangan kami.
The Manager
Bank Muamalat Malaysia Berhad
BRANCH :
DATE :
I/We wish to apply for the following financing facility and furnish below particulars for your consideration :TYPE OF APPLICATION:
Single Application
Joint Application
TYPE OF FACILITY:
House Financing
House Re-Financing
Shophouse/ShopLot Financing
Shophouse/ ShopLot Re-Financing
Land Financing
Aitab Vehicle Financing
Aitab Non-Vehicle Financing
Personal Financing
Educational Financing
Mcash
Bank Guarantee
Others:
CAMPAIGN/ PACKAGE:
AMOUNT REQUESTED: RM
TENURE :
years
A. PERSONAL DETAILS (MAIN APPLICANT)
FULL NAME:
TITLE:
IDENTIFICATION TYPE:
(as per identification card)
New Identity Card
IDENTIFICATION NO:
Old Identity Card
i.
New Identity Card
ii.
Old Identity Card/ Army IC/ Police IC/
Passport
-
Army IC
Police IC
-
CURRENT ADDRESS:
DATE OF BIRTH:
ADDRESS
CITIZENSHIP:
POSTCODE
TOWN
STATE
COUNTRY
RESIDENTIAL STATUS:
Owned
STAY DURATION:
TEL NO. (H)
Employer's Quarters
Relatives
Rented
TEL NO. (H/P)
-
years
Permanent Resident
BUMIPUTRA STATUS:
Yes
No
GENDER:
Female
Male
RACE :
Malay
Chinese
Indian
RELIGION :
Islam
Christian
Hindu
EMAIL
MARITAL STATUS:
Others:………..
Others:………..
HIGHEST EDUCATION :
HOMETOWN ADDRESS:
AGE:
-
Citizen
Buddha
FAX NO.
-
-
Non-Citizen
years
-
Passport
Primary
Secondary
Master
Doctorate
Single
NO. OF DEPENDENTS:
Married
Tertiary
Professional
Widowed
< 12 years old
ADDRESS
Divorced
12 - 18 years old
> 18 years old
MOTHER'S MAIDEN NAME:
POSTCODE
TOWN
STATE
COUNTRY
RELATED TO BMMB STAFF:
If yes, please specify:
TEL NO.
-
FAX NO.
-
PREFERRED MAILING ADDRESS:
Current
Yes
No
Staff Name/ ID No.:
Relationship:
Hometown
Dept./ Branch:
B. EMPLOYMENT DETAILS
CURRENT EMPLOYMENT
EMPLOYER'S NAME:
NATURE OF BUSINESS:
OCCUPATION:
TYPE OF EMPLOYMENT COMPANY:
POSITION:
Government Agency
Conglomerate/MNC
Listed Company at Bursa Malaysia
Clerical/ Gen. Admin
Managerial
Professional
Self-employed
Financial Institution
Public Ltd. (Bhd)
Private Ltd. (Sdn Bhd)
Officer/Executive
Director
Uniform body
Others
Partnership
Sole-Proprietorship
Others: ………………………………
DATE JOINED:
EMPLOYER'S ADDRESS:
-
-
YEARS OF SERVICE:
years
ADDRESS
POSTCODE
TOWN
STATE
TEL NO. (O)
COUNTRY
-
FAX NO.
-
EMAIL :
EMPLOYMENT STATUS:
Permanent
Contract
CONFIRMATION OF
EMPLOYMENT:
Confirmed
Under probation
RETIREMENT AGE:
years
RETIREMENT DATE:
(only if applicable)
Self-employed
N/A
PREVIOUS EMPLOYMENT (if any)
*To be filled if the applicant has less than 1 year of working experience with the present employer.
EMPLOYER'S NAME:
NATURE OF BUSINESS:
OCCUPATION:
EMPLOYER'S ADDRESS:
POSITION:
ADDRESS
POSTCODE
Managerial
Professional
Self-employed
Officer/Executive
Director
Uniform body
Others
TOWN
STATE
TEL NO. (O)
Clerical/ Gen. Admin
COUNTRY
-
FAX NO.
YEARS OF SERVICE:
CFF July 2014 v1.0
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C. SPOUSE DETAILS
FULL NAME:
TITLE:
IDENTIFICATION NO:
(as per identification card)
i.
New Identity Card
-
ii.
Old Identity Card/ Army IC/ Police IC/
Passport
-
OCCUPATION:
EMPLOYER'S NAME:
HOMETOWN ADDRESS:
EMPLOYER'S ADDRESS:
ADDRESS
ADDRESS
POSTCODE
TOWN
COUNTRY
TEL NO. (H)
COUNTRY
STATE
-
TEL NO. (H/P)
TOWN
POSTCODE
STATE
TEL NO. (O)
-
-
MONTHLY INCOME:
RETIREMENT AGE:
years RETIREMENT DATE:
(only if applicable)
D. REFERENCE (Parents or close relatives who are not staying with the applicant)
FULL NAME:
1. TITLE:
(as per identification card)
RELATIONSHIP TO APPLICANT:
TEL NO. (H)
-
HOMETOWN ADDRESS:
TEL NO. (O)
TEL NO. (H/P)
-
RELATIONSHIP TO APPLICANT:
TEL NO. (H)
-
HOMETOWN ADDRESS:
TEL NO. (O)
TEL NO. (H/P)
-
POSTCODE
-
TOWN
STATE
COUNTRY
FULL NAME:
2. TITLE:
POSTCODE
(as per identification card)
-
TOWN
STATE
COUNTRY
E. MONTHLY INCOME AND EXPENDITURE
MONTHLY INCOME:
BASIC SALARY/ INCOME
MONTHLY EXPENDITURE:
-
EPF
RM
-
SOCSO
RM
OTHER EXPENDITURE/ FINANCIAL COMMITMENT:
2)
RM
-
1) HOUSE
RM
3)
RM
-
2) VEHICLE
RM
-
3) CREDIT CARD
RM
-
4) PERSONAL / OD
RM
5) OTHERS:……………………………………RM
6) OTHERS:……………………………………RM
-
FIXED ALLOWANCE:
1)
RM
OTHER INCOME:
1)
2)
3)
TOTAL GROSS INCOME
F.
RM
RM
RM
-
RM
-
RM
TOTAL FINANCIAL COMMITMENT
RM
-
-
EXISTING BANKING RELATIONSHIP WITH OTHER FINANCIAL INSTITUTIONS
FINANCING FACILTY :
TYPE OF FACILITY
BANK'S NAME & BRANCH
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
G. EXISTING BANKING RELATIONSHIP WITH BMMB (FOR BANK'S USE)
FINANCING FACILTY :
TYPE OF FACILITY
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
CFF July 2014 v1.0
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JOINT APPLICATION
A. PERSONAL DETAILS (CO-APPLICANT)
TITLE:
(as per identification card)
FULL NAME:
IDENTIFICATION TYPE:
New Identity Card
IDENTIFICATION NO:
Old Identity Card
i.
New Identity Card
-
ii.
Old Identity Card/ Army IC/ Police IC/
Passport
Army IC
Police IC
RELATIONSHIP TO
MAIN APPLICANT:
CURRENT ADDRESS:
DATE OF BIRTH:
ADDRESS
CITIZENSHIP:
POSTCODE
TOWN
STATE
COUNTRY
RESIDENTIAL STATUS:
Owned
STAY DURATION:
TEL NO. (H)
Employer's Quarters
Relatives
Rented
-
-
-
Permanent Resident
No
Yes
Male
Female
RACE :
Malay
Chinese
Indian
RELIGION :
Islam
Christian
Hindu
EMAIL
MARITAL STATUS:
Others:………..
Others:………..
HIGHEST EDUCATION :
HOMETOWN ADDRESS:
years
AGE:
Non-Citizen
BUMIPUTRA STATUS:
Buddha
FAX NO.
TEL NO. (H/P)
Citizen
GENDER:
years
-
Passport
-
Primary
Secondary
Tertiary
Master
Doctorate
Professional
Single
NO. OF DEPENDENTS:
Married
Widowed
< 12 years old
ADDRESS
Divorced
12 - 18 years old
> 18 years old
MOTHER'S MAIDEN NAME:
POSTCODE
TOWN
STATE
COUNTRY
RELATED TO BMMB STAFF:
If yes, please specify:
TEL NO.
-
FAX NO.
-
PREFERRED MAILING ADDRESS:
Current
Yes
No
Staff Name/ ID No.:
Relationship:
Hometown
Dept./ Branch:
B. EMPLOYMENT DETAILS
CURRENT EMPLOYMENT
EMPLOYER'S NAME:
NATURE OF BUSINESS:
OCCUPATION:
TYPE OF EMPLOYMENT COMPANY:
POSITION:
Government Agency
Conglomerate/MNC
Listed Company at Bursa Malaysia
Clerical/ Gen. Admin
Managerial
Professional
Self-employed
Financial Institution
Public Ltd. (Bhd)
Private Ltd. (Sdn Bhd)
Officer/Executive
Director
Uniform body
Others
Partnership
Sole-Proprietorship
Others: ………………………………
DATE JOINED:
EMPLOYER'S ADDRESS:
-
-
YEARS OF SERVICE:
years
ADDRESS
POSTCODE
TOWN
STATE
TEL NO. (O)
COUNTRY
-
FAX NO.
-
EMPLOYMENT STATUS:
Permanent
Contract
CONFIRMATION OF
EMPLOYMENT:
Confirmed
Under probation
RETIREMENT AGE:
Self-employed
N/A
years
EMAIL :
PREVIOUS EMPLOYMENT (if any)
*To be filled if the applicant has less than 1 year of working experience with the present employer.
EMPLOYER'S NAME:
NATURE OF BUSINESS:
OCCUPATION:
EMPLOYER'S ADDRESS:
POSITION:
ADDRESS
POSTCODE
Managerial
Professional
Self-employed
Officer/Executive
Director
Uniform body
Others
TOWN
STATE
TEL NO. (O)
Clerical/ Gen. Admin
COUNTRY
-
FAX NO.
YEARS OF SERVICE:
-
C. SPOUSE DETAILS
FULL NAME:
TITLE:
IDENTIFICATION NO:
(as per identification card)
i.
New Identity Card
-
ii.
Old Identity Card/ Army IC/ Police IC/
Passport
-
OCCUPATION:
EMPLOYER'S NAME:
HOMETOWN ADDRESS:
EMPLOYER'S ADDRESS:
ADDRESS
ADDRESS
POSTCODE
TOWN
STATE
TEL NO. (H)
TEL NO. (H/P)
POSTCODE
COUNTRY
-
TOWN
STATE
TEL NO. (O)
MONTHLY INCOME:
COUNTRY
CFF July 2014 v1.0
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D. REFERENCE (Parents or close relatives who are not staying with the applicant)
1. TITLE:
(as per identification card)
FULL NAME:
RELATIONSHIP TO APPLICANT:
TEL NO. (H)
-
HOMETOWN ADDRESS:
TEL NO. (O)
-
TEL NO. (H/P)
POSTCODE
-
TOWN
STATE
COUNTRY
FULL NAME:
2. TITLE:
(as per identification card)
RELATIONSHIP TO APPLICANT:
TEL NO. (H)
-
HOMETOWN ADDRESS:
TEL NO. (O)
-
TEL NO. (H/P)
POSTCODE
-
TOWN
STATE
COUNTRY
E. MONTHLY INCOME AND EXPENDITURE
MONTHLY INCOME:
BASIC SALARY/ INCOME
MONTHLY EXPENDITURE:
RM
-
FIXED ALLOWANCE:
EPF
RM
-
SOCSO
RM
-
1)
RM
-
2)
RM
-
OTHER EXPENDITURE/ FINANCIAL COMMITMENT:
1) HOUSE
RM
-
3)
RM
-
2) VEHICLE
RM
-
3) CREDIT CARD
RM
-
OTHER INCOME:
1)
RM
-
4) PERSONAL / OD
RM
-
2)
RM
-
5) OTHERS:…………………………………… RM
-
3)
RM
-
6) OTHERS:…………………………………… RM
-
RM
-
TOTAL GROSS INCOME
F.
TOTAL FINANCIAL COMMITMENT
RM
-
EXISTING BANKING RELATIONSHIP WITH OTHER FINANCIAL INSTITUTIONS
FINANCING FACILTY :
TYPE OF FACILITY
BANK'S NAME & BRANCH
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
G. EXISTING BANKING RELATIONSHIP WITH BMMB (FOR BANK'S USE)
DEPOSIT:
ACCOUNT NO.
ACCOUNT NO.
SAVINGS ACCOUNT
1.
2.
CURRENT ACCOUNT
1.
2.
GENERAL INVESTMENT ACCOUNT
1.
2.
FINANCING FACILTY :
TYPE OF FACILITY
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
CFF July 2014 v1.0
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APPLICATION FORM FOR
CONSUMER FINANCING
IMPORTANT: Please read our Personal Data Protection Notice ("Notice") before completing this form. By giving us your personal data and signing this form, you are indicating to
us that you consent and agree to the terms of our Notice and to terms of this form. Our Notice is available on our website at www.muamalat.com.my and from any of our outlets.
PENTING : Sila baca Notis Perlindungan Data Peribadi kami ("Notis") sebelum melengkapkan borang ini. Dengan mengemukakan data peribadi anda dan menandatangani
borang ini, anda memaklumkan kepada kami bahawa anda memberi kebenaran dan persetujuan terhadap terma-terma Notis kami dan terma-terma di dalam borang ini. Notis
kami boleh diperolehi dari laman web kami di www.muamalat.com.my dan mana-mana cawangan kami.
The Manager
Bank Muamalat Malaysia Berhad
BRANCH
DATE
:
:
I/We wish to apply for the following financing facility and furnish below particulars for your consideration :TYPE OF APPLICATION:
Single Application
TYPE OF FACILITY:
House Financing
Joint Application
House Re-Financing
Shophouse/ShopLot Financing
Shophouse/ ShopLot Re-Financing
Land Financing
Aitab Vehicle Financing
Aitab Non-Vehicle Financing
Personal Financing
Educational Financing
Mcash
Bank Guarantee
Others:
CAMPAIGN/ PACKAGE:
AMOUNT REQUESTED:
RM
TENURE :
years
A. COMPANY/ PARTNERSHIP/ SOLE PROPRIETORSHIP
COMPANY'S NAME:
(as per registration certificate)
REGISTRATION NO:
TYPE OF COMPANY:
Government Agency
Conglomerate/MNC
Listed Company at Bursa Malaysia
Financial Institution
Public Ltd. (Bhd)
Private Ltd. (Sdn Bhd)
Partnership
Sole-Proprietorship
Others: ………………………………
AUTHORISED CAPITAL:
RM
PAID-UP CAPITAL:
RM
DATE OF INCORPORATION:
-
BUMIPUTRA STATUS:
Yes
No
YEARS IN BUSINESS OPERATION:
RELATED TO BMMB STAFF:
Yes
No
NATURE OF BUSINESS:
If yes, please specify:
years
Staff Name/ ID No.:
Relationship:
PREFERRED MAILING ADDRESS:
Dept./ Branch:
Business
Registered
BUSINESS ADDRESS:
REGISTERED ADDRESS:
ADDRESS
ADDRESS
POSTCODE
TOWN
POSTCODE
STATE
TEL NO.
NO (O)
-
FAX NO.
-
TOWN
STATE
COUNTRY
EMAIL
COUNTRY
TEL NO.
NO (O)
-
FAX NO.
-
B. DIRECTORS/ PARTNERS INFORMATION
NAME
SHAREHOLDINGS
RM
NRIC NO.
%
1.
2.
3.
4.
C. MONTHLY INCOME AND EXPENDITURE
MONTHLY BUSINESS TURNOVER:
RM
-
YEAR:
RM
-
YEAR:
RM
-
PROFIT FOR THE PREVIOUS YEARS:
MONTHLY BUSINESS EXPENDITURE:
RM
-
COMPANY'S NETWORTH:
RM
-
D. EXISTING BANKING RELATIONSHIP WITH OTHER FINANCIAL INSTITUTIONS
FINANCING FACILTY :
TYPE OF FACILITY
BANK'S NAME & BRANCH
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
E. EXISTING BANKING RELATIONSHIP WITH BMMB (FOR BANK'S USE)
DEPOSIT:
SAVINGS ACCOUNT
CURRENT ACCOUNT
GENERAL INVESTMENT ACCOUNT
FINANCING FACILTY :
TYPE OF FACILITY
ACCOUNT NO.
ACCOUNT NO.
1.
1.
2.
2.
1.
2.
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
CFF July 2014 v1.0
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SECURITY
OTHERS
(for personal financing/ other financing, if applicable)
FOR BANK'S USE
Clean
Security Deposit
GIA
Stock/Shares
Unit Trust
FINANCING TERMS
Others:…………
FINANCING REQUIRED:
Account No./ Referrence No./
Certificate No./ Receipt No.:
Name/ Remark
(if applicable)
Security Value (RM):
1.
(
%)
2.
(
%)
3.
(
%)
4.
(
RM
TENURE:
PERSONAL FINANCING TYPE:
PROFIT RATE:
Micro
Cash
Others:…………
If Micro, source of repayment from:………………
FREQUENCY OF PAYMENT:
TYPE OF REPAYMENT:
Salary deduction at source
%)
%
PPI/ SI from BMMB
Monthly
Yearly
PPI/ SI from other Bank
Quarterly
Bullet payment
Post-dated cheque
Half-yearly
Others:………….
Payment over counter/CDM
PROPERTY (for house financing/ other financing, if applicable)
PURCHASE TYPE:
Purchase From Developer
Own Construction
FOR BANK'S USE
Purchase From Vendor
Re-financing
DEVELOPER'S STATUS :
Premier
Auction
DEVELOPER'S NAME (if any) :
BRIDGING FINANCING BY BMMB ?
VENDOR'S NAME (if any) :
LAND USE :
CHARGEE BANK (if any) :
PROPERTY TYPE :
PROPERTY SUB TYPE :
BUILDING TYPE :
Tier 3
N/A
No
Argicultural
Commercial
Residential
Mixed
Mining
Native Land
Commercial
TITLE TRANSFER
Malay Reserve
Bumi Lot
Industrial
Vacant Land
RESTRICTION :
State Consent
Not Applicable
Industrial
Semi-Detached
Terrace/ Link
Bungalow
LOCATION STATUS :
High Growth
Medium Growth
Townhouse
Cluster
Apartment
LAND STATUS :
Freehold
Leasehold
Condominium
Shophouse
Shop / Office Lot
Commercial Complex
Factory
Vacant Land
BUILT UP AREA:
Leasehold Expiry Date: …………
Single Storey
1 1/2 Storey
Double Storey
LAND AREA:
Remaining Period: ………..years
2 1/2 Storey
Triple Storey
Others:…………..
SPA/ PRO-FORMA INVOICE/ AUCTION PRICE:
USE OF PROPERTY:
DATE SPA/ PRO-FORMA INVOICE/ AUCTION:
Under Construction (Stage of Completion ………..%)
VALUATION REPORT:
Owner Occupied
For Company Use
VALUER'S NAME:
(for director/worker etc.)
VALUATION DATE:
Investment
Individual Title
Master Title
TITLE NO./ UNIT NO. :
STATE :
Indicative Valuation
VALUATION PRICE:
RM
FINANCING TERMS
FINANCING REQUIRED: RM
LOT NO. / PLOT NO. :
RM
Full Valuation
Strata Title
TOWN / DISTRICT :
Low Growth
Leasehold Period: ………...years
Completed (If Completed, CF available? YES / NO )
TITLE PARTICULARS :
MUKIM :
Yes
Tier 2
Non Panel
Residential
CONSTRUCTION STATUS :
TITLE STAGE :
Tier 1
Contractor (Non-HDA)
MOF:
SUB-PRODUCT TYPE
DURATION
TENURE:
PROFIT RATE
TYPE OF REPAYMENT:
PROPERTY ADDRESS:
1.
ADDRESS
RM
Salary deduction at source
PPI/ SI from BMMB
PPI/ SI from other Bank
POSTCODE
TOWN
STATE
COUNTRY
VEHICLE/ MACHINERY
PURCHASE TYPE:
2.
Post-dated cheque
RM
Payment over counter/CDM
(for vehicle financing/ other financing, if applicable)
Purchase From Vendor
Purchase From Dealer
Auction
FOR BANK'S USE
PRO-FORMA INVOICE/
AUCTION PRICE:
DEALER STATUS :
Panel
Non-Panel
DEALER'S NAME (if any) :
Direct walk-in
SALESMAN'S NAME:
CONTACT NO:
VALUATION:
VALUER
VENDOR'S NAME (if any) :
RM
DATE PRO-FORMA
INVOICE/ AUCTION:
RM
DATE
1. BMMB VALUATION GUIDE
2.
3.
CHARGEE BANK (if any) :
VEHICLE/ MACHINERY TYPE:
New
Unregistered Recond
Used
Registered Recond
FINANCING TERMS
CASH PRICE
RM
MAKE:
FINANCING REQUIRED
RM
MODEL:
PROFIT RATE (FLAT)
ENGINE/ SERIAL NO.:
C.C.
YEAR MADE:
REGISTRATION NO.:
COLOUR
REGISTRATION DATE:
%
Personal
Commercial
TYPE OF REPAYMENT:
RM
Salary deduction at source
TOTAL PAYABLE
RM
PPI/ SI from BMMB
MONTHLY RENTAL:
RM
PPI/ SI from other Bank
SELLING PRICE:
USE OF VEHICLE/MACHINERY:
%
YEARS
PROFIT AMOUNT
FINAL INSTALLMENT/
HP AGREEMENT (Ref. No.):
MOF
% DURATION
EFFECTIVE YIELD (IRR)
CHASIS NO.:
DEPOSIT RM
Post-dated cheque
RM
DEALER'S HANDLING FEE RM
Payment over counter/CDM
EWP RM
CFF July 2014 v1.0
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APPLICANT'S DECLARATION
1. I/We hereby declare that the information given in this financing form and other documents are true and I/We do not conceal any information that may affect my/our
application.
2. I/We have read the Bank’s Personal Data Protection Notice (“Notice”) before completing this form. By furnishing my/our personal data and signing this form, I/we
hereby give our consent and agree to the terms of the Notice and to the terms of this form.
3. I/We have not committed any act of bankruptcy as defined under Section 3 of the Bankcruptcy Act 1967.
4. I/We hereby authorize the Bank to contact my/our employer or any party to obtain any information required by the Bank.
5. I/We hereby give my/our consent for BMMB to proceed with the credit checking with any credit referrence agencies. Pursuant to that, I/We hereby authorize the
Bankto give, furnish, divulge or otherwise disclose, to the said credit referrence agencies of any information, statements or facts with respect to the matters
relating to my/our facility(ies) or account(s) with the Bank.
6. The Bank has the right to decline or reject my/our application should the Bank in its absolute discretion decides that my credit appraisal quality does not meet the
Bank's requirement. The Bank also has the right to withdraw any of the financing facilities being approved if the information given by me/us is/are false.
Name:
Name:
Authorised Company Chop & Signature
Date:
Date:
Date:
FOR BANK'S USE ONLY
Interviewed by:
Remark (if any):
Name & Staff
Designation
Date:
CFF July 2014 v1.0
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GUARANTOR
A.
PERSONAL DETAILS
TITLE:
FULL NAME:
IDENTIFICATION TYPE:
(as per identification card)
New Identity Card
IDENTIFICATION NO:
Old Identity Card
i.
New Identity Card
-
ii.
Old Identity Card/ Army IC/ Police IC/
Passport
Army IC
Police IC
RELATIONSHIP TO
MAIN APPLICANT:
CURRENT ADDRESS:
DATE OF BIRTH:
ADDRESS
CITIZENSHIP:
POSTCODE
TOWN
STATE
COUNTRY
Owned
RESIDENTIAL STATUS:
Employer's Quarters
Relatives
Rented
-
FAX NO.
-
-
Permanent Resident
No
Yes
Male
Female
RACE :
Malay
Chinese
Indian
RELIGION :
Islam
Christian
Hindu
Others:………
Others:………..
HIGHEST EDUCATION :
EMAIL
MARITAL STATUS:
HOMETOWN ADDRESS:
years
AGE:
Non-Citizen
BUMIPUTRA STATUS:
Buddha
-
TEL NO. (H/P)
Citizen
GENDER:
years
STAY DURATION:
TEL NO. (H)
Passport
-
NO. OF DEPENDENTS:
Primary
Secondary
Tertiary
Master
Doctorate
Professional
Single
Married
Widowed/Divorced
< 12 years old
ADDRESS
12 - 18 years old
> 18 years old
MOTHER'S MAIDEN NAME:
POSTCODE
TOWN
STATE
COUNTRY
RELATED TO BMMB STAFF:
If yes, please specify:
TEL NO.
-
FAX NO.
-
PREFERRED MAILING ADDRESS:
Current
Yes
No
Staff Name/ ID No.:
Relationship:
Hometown
Dept./ Branch:
B. EMPLOYMENT DETAILS
CURRENT EMPLOYMENT
EMPLOYER'S NAME:
NATURE OF BUSINESS:
OCCUPATION:
TYPE OF EMPLOYMENT COMPANY:
POSITION:
Government & Its Agency
International Co.
Financial Institution
Clerical/ Gen. Admin
Managerial
Professional
Self-employed
Public Ltd. (Bhd)
Private Ltd. (Sdn Bhd)
Partnership
Officer/ Executive
Director
Uniform body
Others:……..
Sole-Proprietorship
Self-employed
Others: ………………………………
DATE JOINED:
EMPLOYER'S ADDRESS:
-
-
YEARS OF SERVICE:
years
ADDRESS
POSTCODE
TOWN
STATE
TEL NO. (O)
COUNTRY
-
FAX NO.
-
EMPLOYMENT STATUS:
Permanent
Contract
CONFIRMATION OF
EMPLOYMENT:
Confirmed
Under probation
RETIREMENT AGE:
Self-employed
N/A
years
EMAIL :
PREVIOUS EMPLOYMENT (if any)
*To be filled if the applicant has less than 1 year of working experience with the present employer.
EMPLOYER'S NAME:
NATURE OF BUSINESS:
OCCUPATION:
EMPLOYER'S ADDRESS:
POSITION:
ADDRESS
POSTCODE
Managerial
Professional
Self-employed
Officer/ Executive
Director
Uniform body
Others:……..
TOWN
STATE
TEL NO. (O)
Clerical/ Gen. Admin
COUNTRY
-
FAX NO.
YEARS OF SERVICE:
-
C. MONTHLY INCOME AND EXPENDITURE
MONTHLY INCOME:
BASIC SALARY/ INCOME
MONTHLY EXPENDITURE:
RM
-
FIXED ALLOWANCE:
EPF
RM
-
SOCSO
RM
-
1)
RM
-
2)
RM
-
1) HOUSE
RM
-
3)
RM
-
2) VEHICLE
RM
-
3) CREDIT CARD
RM
-
OTHER INCOME:
OTHER EXPENDITURE/ FINANCIAL COMMITMENT:
1)
RM
-
4) PERSONAL / OD
RM
-
2)
RM
-
5) OTHERS:…………………………………… RM
-
3)
RM
-
6) OTHERS:…………………………………… RM
-
RM
-
TOTAL GROSS INCOME
TOTAL FINANCIAL COMMITMENT
RM
CFF July
y 2014 v1.0
8
D. EXISTING BANKING RELATIONSHIP WITH OTHER FINANCIAL INSTITUTIONS
FINANCING FACILTY :
TYPE OF FACILITY
BANK'S NAME
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
E. EXISTING BANKING RELATIONSHIP WITH BMMB (FOR BANK'S USE)
DEPOSIT:
ACCOUNT NO.
ACCOUNT NO.
SAVINGS ACCOUNT
1.
2.
CURRENT ACCOUNT
1.
2.
GENERAL INVESTMENT ACCOUNT
1.
2.
FINANCING FACILTY :
TYPE OF FACILITY
APPROVED LIMIT (RM)
O/S BALANCE (RM)
MONTHLY INSTALMENT (RM)
F. GUARANTOR'S DECLARATION
1. I hereby declare that I will be a GUARANTOR to ___________________________________________ for the financing amount of RM__________________ and you are
at liberty to check with my employer or my bank representative for any information on my financial position and creditworthines.
2. I have read the Bank’s Personal Data Protection Notice (“Notice”) before completing this form. By furnishing my personal data and signing this form, I hereby give my
consent and agree to the terms of the Notice and to the terms of this form.
3. The information given in financing application form (guarantor) and other documents are true and I do not conceal any information which may affect the applicant's
4. I have not committed any act of bankruptcy as defined under Section 3 of the Bankcruptcy Act 1967.
5. I hereby authorize the Bank to contact my employer or any party to obtain any information required by the Bank.
6. I hereby give my consent for BMMB to proceed with the credit checking with any credit reference agencies.
agencies Pursuant to that,
that I hereby authorize the Bank to give
give, furnish,
furnish
divulge or otherwise disclose, to the said credit reference agencies of any information, statements or facts with respect to the matters relating to my facility(ies) or account(s)
Signature of Guarantor
Date:
CFF July 2014 v1.0
9

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