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PUBLIC

PUBLIC

PUBLIC

PUBLIC

FINE

FINE

FINE

FINE

PUBLIC PUBLIC PUBLIC PUBLIC FINE FINE FINE FINE GOLD GOLD GOLD GOLD SOUND AND SOLID INVESTMENT

GOLD

GOLD

GOLD

GOLD

SOUND

AND

SOLID

INVESTMENT

INTERNATIONAL

INTERNATIONAL

INTERNATIONAL

INTERNATIONAL

SDN

SDN

SDN

SDN

CUSTOMER

CUSTOMER

CUSTOMER

CUSTOMER

顾客登记表

REGISTRATION

REGISTRATION

REGISTRATION

REGISTRATION

FORM

FORM

FORM

FORM

.

.

.

.

BHD

BHD

BHD

BHD

.

.

.

.

(818840-U)

(818840-U)

(818840-U)

(818840-U)

PERSONAL

PERSONAL

PERSONAL

PERSONAL

INFORMATION

INFORMATION个人资料

INFORMATION

INFORMATION

 

会员名称

N

N

N

N

ame

ame ame ame

of

of

of

of

Member

Member

Member

Member

(English)

(English)Mr.

(English)

(English)

Mr./

Mr.

/

/

Mr.

/Mrs.

Mrs./

Mrs.

/

/

Mrs.

/Miss

Miss

Miss

Miss

(

(

(

(

英文

)先生

)

)

)

/

/

/

/

太太

/

/

/

/

小姐

 

介绍人名称

Name

Name

Name

Name

of

of

of

of

Introducer

Introducer

Introducer

Introducer

Nurul

Nurul

Nurul

Nurul

Huda

Huda

Huda

Huda

Ismail

Ismail

Ismail

Ismail

No.

No.

Introducer

Introducer

Introducer

Introducer

No.

No.

s

s

s

s

Registration

Registration

Registration

Registration

介绍人之会员号码

PG000338

PG000338

PG000338

PG000338

C

C

C

C

hinese

hinese

hinese

hinese

Name中文名称

Name

Name

Name

 

Date

Date

Date

Date

of

of

of

of

Birth

Birth出生日期

Birth

Birth

I.C.

I.C.

I.C.

I.C.

)

)

)

)

/Passport

/Passport

/Passport

/Passport

No.身份证号码

No.

No.

No.

(

(

(

(

或护照号码及签证国

 

Nationality

Nationality国籍

Nationality

Nationality

O

O

O

O

ccupation

ccupation

ccupation

ccupation

(Or

(Or

(Or

(Or

Type

Type

Type

Type

of

of

of

of

Business)职业

Business)

Business)

Business)

(

(

(

(

或业务性质

)

)

)

)

 

Year(s)

Year(s)

Year(s)

Year(s)

Employed

Employed任职年期

Employed

Employed

 

雇主名称

Name

Name

Name

Name

of

of

of

of

若自雇

Employer

Employer

Employer

Employer

(If

(If

(If

(If

self-employed,

self-employed,

self-employed,

self-employed,

(

(

(

(

,

,

,

,

请填业务名称

)

)

)

)

name

name name name

of

of

of

of

business)

business)

business)

business)

 

Business

Business

Business

Business

Address

Address公司地址

Address

Address

Residential

Residential

Residential

Residential

Address住宅地址

Address

Address

Address

 

Residential

Residential

Residential

Residential

Phone

Phone

Phone

Phone

住宅电

Business

Business

Business

Business

Phone

Phone

Phone

Phone

公司电话

 

Mobile

Mobile

Mobile

Mobile

Phone

Phone

Phone

Phone

手提电话

 

Facsimile

Facsimile

Facsimile

Facsimile

No.

No.

No.

No.

传真号码

Email

Email

Email

Email

Address

Address电邮地址

Address

Address

Communication

Communication

Communication

Communication

Method

Method

Method

Method

(for

(for

(for

(for

Notices)

Notices)通讯方式

Notices)

Notices)

(for (for Notices) Notices) 通讯方式 Notices) Notices) Post Post Post Post to to to to Residential

Post

Post

Post

Post

to

to to

to

Residential

Residential

Residential

Residential

Address

Address邮寄至住宅地址

Address

Address

(

(

(

(

用作发送通知

)

)

)

)

Address Address ( ( ( ( 用作发送通知 ) ) ) ) Post Post Post Post to

Post

Post

Post

Post

to

to to

to

Business

Business

Business

Business

Address

Address邮寄至公司地址

Address

Address

Payment

Payment

Payment

Payment

Method

Method

Method

Method

(for

(for

(for

(for

fund

fund

fund

fund

withdrawal)付款方式(

(

withdrawal)

withdrawal)

withdrawal)

(

(

用作资金提取

)

)

)

)

Cheque Cheque Cheque Cheque 支票 Deposit Deposit Deposit Deposit in in in in Bank Bank
Cheque Cheque Cheque Cheque 支票 Deposit Deposit Deposit Deposit in in in in Bank Bank
Cheque Cheque Cheque Cheque 支票 Deposit Deposit Deposit Deposit in in in in Bank Bank

Cheque

Cheque

Cheque

Cheque

支票

Deposit

Deposit

Deposit

Deposit

in

in

in

in

Bank

Bank

Bank

Bank

(please

(please

(please

(please

T

T

T

T

elegraphic

elegraphic

elegraphic

elegraphic

Transfer

Transfer

Transfer

Transfer

complete

complete

complete

complete

the

the

the

the

bank

bank

bank

bank

details

details

details

details

in

in

in

in

(Charges

(Charges

(Charges

(Charges

shall

shall

shall

shall

be

be

be

be

borne

borne

borne

borne

by

by

by

by

the

the

the

the

the

the

the

the

next

next next

next

section)

section)

section)

section)

存入银行

(

(

(

(

请填写下一个部分之银行资料

account

account account

account

holder)

holder)

holder)

holder)

电汇

(

(

(

(

费用由户口持有人支付

)

)

)

)

)

)

)

)

Bank

Bank

Bank

Bank

Details

Details

Details

Details

银行资料

Name

Name

Name

Name

of

of

of

of

Bank

Bank

Bank

Bank

Account

Account

Account

Account

Holder

Holder

Holder

Holder

银行户口持有人名称

 

N

N

N

N

ame

ame ame ame

of

of

of

of

Bank

Bank

Bank

Bank

银行名称

Account

Account

Account

Account

No.

No.

No.

No.

帐户号码

 

A

A

A

A

ccount

ccount ccount

ccount

Type

Type

Type

Type

户口类别

ccount ccount ccount ccount Type Type Type Type 户口类别 S S S S aving aving aving

S

S

S

S

aving

aving

aving

aving

Account

Account

Account

Account

储蓄户口

C C C C

C

C

C

C

urrent

urrent urrent

urrent

Account

Account

Account

Account

往来户口

 

Applicant

Applicant

Applicant

Applicant

Declaration

Declaration

Declaration

Declaration

I

hereby

declare

that

the

information

International

International

International

International

Sdn

Sdn

Sdn

Sdn

Bhdhas

Bhd

Bhd

Bhd

the

right

application

has

being

approved,

I

hereby

given

to

above

is

undertake

reject

my

true,

accurate

and

in

assigning

complete.

application

and

agree

to

without

be

bound

all

any

I

by

reason

understand

that

thereof.

the

Public

Public

Public

Public

In

the

s

respects

company

Fine

Fine

Fine

Fine

Gold

Gold

Gold

Gold

regulation.

event

of

my

Date

(dd/mm/yy)Name

of

ApplicantSignature

of

Applicant

Only Only Only Only Use Use Use Use Office Office Office Office For For For
Only
Only
Only
Only
Use
Use
Use
Use
Office
Office
Office
Office
For
For
For
For
: : : : No.) No.) No.) No.) Registration Registration Registration Registration (Customer (Customer (Customer
: :
:
:
No.)
No.)
No.)
No.)
Registration
Registration
Registration
Registration
(Customer
(Customer
(Customer
(Customer
by
by
by
by
Sponsored
Sponsored
Sponsored
Sponsored
: :
:
:
No.
No.
No.
No.
Registration
Registration
Registration
Registration
Customer
Customer
Customer
Customer
: :
:
:
approval
approval
approval
approval
of
of
of
of
Date
Date
Date
Date
: :
:
:
Remarks
Remarks
Remarks
Remarks
: :
:
:
Date
Date
Date
Date
: :
:
:
by
by
by
by
Checked
Checked
Checked
Checked