Assessment and Consent Form - Retail Financing

Customer Full Name NRIC No. / ID No. Date of Birth Contact No.
(dd/mm/yyyy) (mobile)

CMD / DSU / Ver. 1.2

Introducer Name NRIC No. Staff ID No. Branch

PART A : APPLICAN BAC!"R#$ND INF#

i) Name of %m&lo'er iii) %m&lo'ment Status iv) %ducation (ualification v) )arital Status vi) S&ouse-Name of %m&lo'er (if any) Permanent Professional Single Contract Degree arried Temporary Diploma Self Employed ii) Position _____________________________ Others:____________________

Others : _________________________ vii) S&ouse Position (if any) __________________________________

Others : ___________________________

PART ! : FACILI * APPLICA I#N D% AILS

i) )BSB Facilit' '&e A&&lication
(Please select)

Primar'

+oint A&&lication

"uarantor

ortgage

"ame:__________________________ "ame:____________________________ Personal #inancing$ i Others :______________________________

ii) )BSB Product A&&lication iii) )BSB Product Profit Rate A&&lication (Please select) iv) Financing Amount

_____________________________________________________________________ (i.e. MBSB S !er Ultimate" Va#an$a" %&ec'( etcs) #i%ed Rate )aria*le Rate &nt ' Profit Rate : &nt ' Profit Rate : __________________( (i.e. ).**" +.2, etcs)

BLR pl+s ' min+s : _________________(

(!lease select)
(i.e. 1,",,,.,, etcs)

(i.e. 2.-" +.- etcs)

R
R

v) Financing

enure :

mth

(i.e. 2+" 12, etcs)

PART C , APPLICAN INC#)% / C#))I )%N D% AILS

i) "ross Income iii) #ther Income (if any) '&e of Income a) *) c) d) e) Income R R R R R per month per month per month per month per month ASS%SS%D B*, DA %, enure month month month month month Financial Institution Name DSR S A $S R%)AR!S _____________ per month ii) Net Income R __________________________ per month

DSR SP%CIALIS $NI $S%

, ,

PASS / FAIL

iv) Financing Commitment (.it/ 0inancial (nstit tions / Coo!erati1es / Credit com!anies etcs) (if any) '&e of Financing a) *) c) d) e) R R R R R Financing Amount

v) Financing Settlement (.it/ 0inancial (nstit tions / Coo!erati1es / Credit com!anies etcs) (if any) '&e of Financing a) *) c) d) e) R R R R R Deduction Amount per mth per mth per mth per mth per mth #utstanding Balance R _________________ R _________________ R _________________ R _________________ R _________________ Financial Institution Name

PART D : CCRIS INF#R)A I#N

i) A&&lication Ref No. / CIF No. iii) Priorit' Sector v) Location of Financing $tilisation vii) Pro&ert' '&e
((ntrod cer to fill' ! for Mort#a#e facility)

ii) Pur&ose of Financing iv) Financing Conce&t vi) Purchase Price (for mort#a#e) R

PART E : D%CLARA I#N

(/2e /ereby ac3no.led#e t/at MBSB reser1es t/e absol te ri#/t to a!!ro1e or re4ect my/o r a!!lication as MBSB deems fit" .it/o t assi#nin# any reason. Co!ies of doc ments s bmitted are ret rnable !on recei!t of my/o r .ritten re5 est. MBSB is irre1ocably a t/orised to disclose all information or !artic lars #i1en by me/ s /erein or arisin# from or ! rs ant to my/o r a!!lication (.it/in and o tside of Malaysia) at it deems fit at any time and for s c/ ! r!oses as MBSB deems necessary. 6ot.it/standin# t/e #enerality of t/e fore#oin#" (/.e confirm t/at MBSB is irre1ocably a t/orised to 1erify and/or ma3e any c/ec3s and/or obtain any information and/or confirmations" .it/ or from any credit reference a#encies and/or from any financial instit tions" on me/ s and/or any ot/er !erson" indi1id al and/or entity as MBSB may deem fit" for any ! r!ose ./ic/ MBSB deems fit. (/2e confirm t/at t/e information #i1en is tr e" correct and com!lete and declare t/at (/.e /a1e not been ad4 d#ed a ban3r !t.

(7!!licant Si#nat re) "ame : Date :

((ntrod cer Si#nat re) "ame : Date :

N# % , ./ Please attach co&' of a&&licant NRIC / ID card and latest month &a'sli& 0co&' of &a'sli& is com&ulsor' for Personal Financing-i a&&lication/ 1/ his form is used for &reliminar' assessment of customer2s a&&lication 3ith )BSB. Full documentation are re4uired to 5e su5mitted 3ithin . month from the a5o6e assessment date &rior to final decision 5' )BSB, 7/ For 8oint a&&lication- each a&&licant is to com&lete and sign the assessment and consent form se&aratel'. 9/ Please scan this form 3ith co&' of a&&licant NRIC / ID card / latest month &a'sli& and email to dsrs&ecialist:m5s5.com.m' 0DSR S&ecialist $nit/