1/10

u CIMB Islamic Bank Berhad (671380-H) u CIMB Bank Berhad (13491-P) u This is a security document for cross-selling application
Property Financing Application Form
MY PERSONAL DETAILS (MAIN APPLICANT) CURRENT EMPLOYMENT DETAILS

u Mr u Miss u Madam u Dr u Others Employment Type :

u Employed (Fixed) u Employed (Non-Fixed)
Full Name As In NRIC : u Own Business (Professional) u Own Business (Non Professional)
u Unemployed (Without Income) u Unemployed (With Income)
Employment Status : u Permanent u Contract u Temporary
Occupation :
New I/C No. : Old I/C No. :
- - Designation/Job Title :
Employers Name :
Other Identification (complete if you do not have an NRIC) :
u Passport u Army/Police
Specify Number :
Passport Expiry Date (DD/MM/YYYY) : Employers Address :
/ /

Sex : u Male u Female

Date Of Birth (DD/MM/YYYY) : / /

Nationality : u Malaysian u Others Postcode :

u If US1, Tax ID
For Non-Malaysians, What Is Your Residence Status?
u Non-Malaysian Resident u Non-Malaysian Non-Resident
u Permanent Resident u Malaysia My 2nd Home
Employers Tel No. : Employers Fax No. :
- -
Length Of Service (MM/YY) : Total Working Experience (MM/YY) :
/ /

Bumiputra : u Yes u No Main Monthly Income : Other Monthly Income :

R M R M
Marital Status :
u Single u Married u Widowed u Divorced u Separated Industry :
Business Type :
Number And Age(s) Of Dependent Children :
u CIMB Group u MNC - Non FI u Government Agency
Age(s) u Bursa Listed u Financial Institution u Public Ltd Company - Not Listed
Highest Education Level :
u Private Limited Companies u Sole Proprietorship/Partnership
u Not Applicable u Primary u Secondary u College/University u None/Unemployed u Others
u Professional Qualification u Bachelor u Masters u Doctorate Number Of Employees In The Company :
u Small Entity (<15 employees) u Medium (15 to 50 employees)
MY HOME ADDRESS u Big Entity (>50 Employees)
Permanent Home Address : PREVIOUS EMPLOYMENT DETAILS
(Complete if you have worked for your current employer for <2 years)
Previous Employers Name :

Postcode :
Previous Occupation :

Mailing Address (complete if different from above) : Length Of Service (MM/YY) : /

MY SPOUSE DETAILS
(Complete only if your spouse is not a joint applicant/guarantor)
Full Name As In NRIC / Passport :

Postcode :

Home Tel No. : Mobile Tel No. :

New I/C No. : Old I/C No. :
- -
- -
E-mail (Compulsory) : Other Identification (complete if you do not have an NRIC) :
u Passport u Army/Police
Current Residence Status : Specify Number :
u Employers Quarters u Family Home u Own Mortgaged Passport Expiry Date (DD/MM/YYYY) : / /
u Own Not Mortgaged u Rented u Relatives
Home Tel No. : Mobile Tel No. :
Years There : - -

1 
A U.S. Resident (including a current work permit); or a U.S. Citizen or a Citizen of a US Territory2; or hold a U.S. Permanent Resident Card (Green Card)
2 
American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, the Commonwealth of Puerto Rico, or the U.S. Virgin Islands.
Version 6.0/April16
 2/10

MY PERSONAL DETAILS (JOINT APPLICANT/GUARANTOR) CURRENT EMPLOYMENT DETAILS

u Mr u Miss u Madam u Dr u Others Employment Type :

u Employed (Fixed) u Employed (Non-Fixed)
Full Name As In NRIC : u Own Business (Professional) u Own Business (Non Professional)
u Unemployed (Without Income) u Unemployed (With Income)
Employment Status : u Permanent u Contract u Temporary
Occupation :
New I/C No. : Old I/C No. :
- - Designation/Job Title :
Employers Name :
Other Identification (complete if you do not have an NRIC) :
u Passport u Army/Police
Specify Number :
Passport Expiry Date (DD/MM/YYYY) : Employers Address :
/ /

Sex : u Male u Female

Date Of Birth (DD/MM/YYYY) : / /

Nationality : u Malaysian u Others Postcode :

u If US1, Tax ID
For Non-Malaysians, What Is Your Residence Status?
u Non-Malaysian Resident u Non-Malaysian Non-Resident
u Permanent Resident u Malaysia My 2nd Home
Employers Tel No. : Employers Fax No. :
- -
Length Of Service (MM/YY) : Total Working Experience (MM/YY) :
/ /

Bumiputra : u Yes u No Main Monthly Income : Other Monthly Income :

R M R M
Marital Status :
u Single u Married u Widowed u Divorced u Separated Industry :
Business Type :
Number And Age(s) Of Dependent Children :
u CIMB Group u MNC - Non FI u Government Agency
Age(s) u Bursa Listed u Financial Institution u Public Ltd Company - Not Listed
Highest Education Level :
u Private Limited Companies u Sole Proprietorship/Partnership
u Not Applicable u Primary u Secondary u College/University u None/Unemployed u Others
u Professional Qualification u Bachelor u Masters u Doctorate Number Of Employees In The Company :
u Small Entity (<15 employees) u Medium (15 to 50 employees)
RELATIONSHIP WITH MAIN APPLICANT u Big Entity (>50 Employees)
u Spouse u Child u Relative u Business Partner u Parent
u Sibling u Others PREVIOUS EMPLOYMENT DETAILS
(Complete if you have worked for your current employer for <2 years)
MY HOME ADDRESS Previous Employers Name :
Permanent Home Address :

Previous Occupation :
Length Of Service (MM/YY) : /
Postcode :

Mailing Address (complete if different from above) : MY SPOUSE DETAILS

(Complete only if your spouse is not an Applicant)
Full Name As In NRIC / Passport :

Postcode :

Home Tel No. : Mobile Tel No. : New I/C No. : Old I/C No. :
- - - -

E-mail (Compulsory) : Other Identification (complete if you do not have an NRIC) :

u Passport u Army/Police
Specify Number :
Current Residence Status :
u Employers Quarters u Family Home u Own Mortgaged Passport Expiry Date (DD/MM/YYYY) : / /
u Own Not Mortgaged u Rented u Relatives
Home Tel No. : Mobile Tel No. :
Years There : - -

1 
A U.S. Resident (including a current work permit); or a U.S. Citizen or a Citizen of a US Territory2; or hold a U.S. Permanent Resident Card (Green Card)
2 
American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, the Commonwealth of Puerto Rico, or the U.S. Virgin Islands.
 3/10

Applicant Name :

u CIMB Islamic Bank Berhad (671380-H) u CIMB Bank Berhad (13491-P)

NRIC No. :

Property Financing Application Details

FACILITY DETAILS OWNERS DETAILS (IF THE PROPERTY IS OWNED BY

Purpose of Facility : A 3RD PARTY OTHER THAN THE APPLICANTS)
u Purchase u Refinance u Top-Up u Cash out Owners Name :
Owner occupied : u Yes u No
Product Name :
Relationship With Main Applicant :
First time property purchase : u Yes u No
Reason for enhancement/cash out :
u Renovation u Other Personal Use/Education New I/C No. : Old I/C No. :
- -
FACILITY AMOUNT
Housing/Term Loan / Home/Term Financing : Term (YY) : Other Identification (complete if owner does not have an NRIC) :
R M u Passport u Army/Police
Other (GMTA/GMTT, legal and valuation fees) : Specify Number :
R M Passport Expiry Date (DD/MM/YYYY) : / /

PROPERTY VALUE
UNDER CONSTRUCTION PROPERTY
Purchase Price : Indicative Market Value :
Project Name :
R M R M
Margin Of Finance (%) : %
Phase :
INSURANCE (PLEASE SELECT OPTION)
Developers Name :
u I wish to apply for the below insurance :
For Conventional financing: Allianz General Insurance Malaysia Berhad
u HomeSafe Plan 1* u HomeSafe Plan 2* u Houseowner*
REFINANCING PROPERTY
For Islamic financing: Sun Life Malaysia Takaful Berhad
Current Financier (if applicable) :
u Takaful Houseowner*
u I wish to apply the below GMTA*/GMTT* insurance polices underwritten
by Sun Life Malaysia : Amount Of Loan/Financing Outstanding (if applicable) :
Insured/Covered Insured/Covered Term Insured/ R M
Applicant(s) Amount (RM) Covered (Years)
SECONDARY MARKET PROPERTY
Vendor Name :

*Kindly refer to the relevant Product Disclosure Sheet for detailed description
of these policies. Vendors New I/C No. : Vendors Old I/C No. :
u I wish to apply from another Insurance company/Takaful Operator for the - -
following product :
u Fire/Houseowner u GMTA/GMTT Vendors Other Identification (complete if vendor does not have an NRIC) :
u Passport u Army/Police
PROPERTY DETAILS
Specify Number :
Property Type : u Residential u Commercial u Land
Passport Expiry Date (DD/MM/YYYY) : / /
Property Description :
Land Area : Built Up Area : EMERGENCY CONTACT DETAILS
(FOR MAIN APPLICANT ONLY)
Construction Status (if applicable) : Full Name As In NRIC :
u Completed u Under Construction Specify % Completed
Source Of Property :
Relationship With Main Applicant :
u Developer u Vendor u Auctioned u Refinancing u Others
Title Type : u Individual u Strata u Master
Home Tel No. : Mobile Tel No. :
Title Status : u Freehold u Leasehold
- -
Specify Expiry Date Of Lease : / /
Property Address : AS FINANCING EXTENDS BEYOND MY/OUR AGE RETIREMENT
AGE, I/WE PROPOSE TO SETTLE/REDUCE THE FINANCING VIA
THE FOLLOWING:
Postcode :
u Withdrawal from EPF
Title Number : Lot Number : u Pension provisions or contracted annuity payments
u Proceeds from Insurance/Takaful policy cash value
Sub-District : District : u Proceeds from investments i.e. Unit Trusts/Shares
u Refinancing to be undertaken by children
State : u Other manner, please specify
 4/10

Applicant Name : (i)

(ii)
Amanah Saham Bumiputera Financing NRIC No. : (i)
Application Details (ii)
Enquiries : +603 6204 7788

TERM LOAN REQUESTED

Facility Requested to Purchase : u ASB units u ASB2 units

GASA Premium Amount (total free cover limit is RM450k and below) : R M
Loan Tenure Requested : Interest Rate : Current BR :
Y E A R S

GROUP AMANAH SAHAM ASSURANCE (GASA) (OPTIONAL)

(Please tick () to confirm your application for GASA and your acknowledgement and agreement to the declarations hereunder which includes your
irrevocable authorization to the termination of GASA insurance coverage in the circumstances stated therein. Please read the Important Notice to
Applicant for GASA before confirming your application for GASA.)
u Main Applicant (Name) (I/C No.)
u Joint Applicant (Name) (I/C No.)
u Yes, I/We wish to apply for Group Amanah Saham Assurance (GASA) which is a life insurance plan offered, underwritten and issued by Sun Life
Malaysia Assurance Berhad (Sun Life Malaysia), licensed under the Financial Service Act 2013 and regulated by Bank Negara Malaysia. The
benefits of GASA applied for shall not take effect unless and until this application is approved by Sun Life Malaysia and the premium is received in
full by Sun Life Malaysia during my/our lifetime.
I/We am/are satisfied with the explanation given to me/us on the GASA and acknowledge and confirm that I/we have read and fully understood
and agree to be bound by the terms and conditions of the Master Contract for GASA and the information, benefits and exclusions under GASA
which are summarized but not exhaustive in the GASA Product Disclosure Sheet/Sales Illustration. I/We hereby consent to the Bank disclosing the
information contained in this application form to Sun Life Malaysia which will then consider my/our application to enroll me/us as their GASA life
assured. If approved, then a Certificate of Insurance will be issued by Sun Life Malaysia and shall be sent by Sun Life Malaysia to me/us upon my/
our enrollment as a GASA life assured.
I/We acknowledge and agree that in the event the Facility is recalled, cancelled, withdrawn and/or suspended by the Bank in accordance with the terms
and conditions governing the Facility (the Termination of Facility), I/we hereby irrevocably authorize the Bank:
1) to notify Sun Life Malaysia of the Termination of Facility wherein my/our Certificate of Insurance will end and my/our GASA insurance coverage will
terminate with immediate effect;
2) to claim and receive the applicable cash value of the Certificate of Insurance from Sun Life Malaysia towards payment of the outstanding amount
payable by me/us to the Bank under the Facility;
3) to pay to me/us the balance of any cash value after the set-off of such outstanding amounts due to the Bank (if any); and
4) to convey to Sun Life Malaysia my/our authorization herein and to give any notice required on my/our behalf.
Important notice to applicant of GASA :
a)  Please note that you are to disclose in this application form fully and accurately/correctly all the statements or information given by you; otherwise the
Certificate of Insurance issued hereunder may be avoided, your claim denied or reduced, the terms of the certificate changed or varied or the certificate
terminated. Please note that you must inform Sun Life Malaysia of any change to statement or information given by you in this application form if the
change occurred after you have submitted the application but before the insurance coverage is provided.
b)  The GASA Product Disclosure Sheet is provided to you to summarize the benefits which are guaranteed and those which are not guaranteed and your
duties as a life assured under the Certificate of Insurance issued hereunder.
c) Proof of age is required prior to the payment of any benefit under the Certificate of Insurance.
d) You may apply for GASA in this application form in the event that your cumulative aggregate GASA sum assured (inclusive of premium which is financed
by the Bank) which is in force and taken up in the past three (3) years and the amount of GASA sum assured (inclusive of premium which is to be financed by the
Bank) under your current application, does not exceed Ringgit Malaysia Four Hundred and Fifty Thousand (RM450,000) (the Amount). In the event the Amount
is exceeded, please note that you will have to execute and complete a Sun Life Malaysias separate insurance proposal form to apply for GASA.
e)  In the event there is any shortfall between premium paid and actual premium required by Sun Life Malaysia, Sun Life Malaysia reserves the right to shorten
the Policy Term based on the actual premium paid and this will be reflected in the Certificate of Insurance issued by Sun Life Malaysia and sent to you
upon your enrollment as a GASA life assured.
f)  Please refer to the GASA Group Master Policy for the exact terms, conditions and exclusions. A copy of the Master Policy can be viewed and downloaded
from Sun Life Malaysias official website at sunlifemalaysia.com
g)  Sun Life Malaysia being the licensed insurer and underwriter of GASA shall undertake the full insurance obligations under the GASA. The Bank merely acts as a
Distributor and is not responsible in any way for the GASA. The GASA is not a Bank product and therefore not an obligation of nor guaranteed by the Bank.
h)  The coverage under GASA shall not take effect until Sun Life Malaysia has processed and approved your application
i)  Sun Life Malaysia reserves the right to reject your application and the Bank is entitled to give full refund to you without any interest in the event the
application is rejected by Sun Life Malaysia and you shall not have any claim whatsoever against the Bank.
j)  You are obliged to accept the refund from the Bank and not to insist on the GASA cover in the event that Sun Life Malaysia has rejected your application.
By signing below I/we hereby
(a) Confirm that I/we (i) wish to apply for Amanah Saham Bumiputera (ASB) Financing with the Bank; and (ii) have read, understood and agree to be bound
by the ASB Financing Terms and Conditions and any amendments to the same which the Bank may subsequently introduce from time to time upon
giving adequate prior notice to me/us;
(b) Authorise the Bank to debit my/our Current Account** or Savings Account** (**Delete whichever not applicable)
No. : (the Account) with the Bank for the payment of the monthly instalment and/or interest and/or the
outstanding amount due to the Bank under the ASB Financing. I/We undertake to ensure that sufficient funds are kept in the Account to meet this payment.*
Where the Account is a Current Account, I/we hereby understand and agree that it shall be my/our responsibility to ensure there is sufficient funds at all
times in the Account to honour cheques deposited for payment. I/We further acknowledge and agree that the Bank will not be held liable for defamation
and/or for breach of contract and/or for any losses, damages, expenses, costs or charges whatsoever which may be claimed against the Bank arising
from remarks placed on the returned cheque(s) by the Bank and/or upon the grounds that cheque(s) issued under the Account was returned due to
insufficient funds in the Account as a result of the Bank debiting the Account pursuant to my/our above authorisation.
* To complete (b) by filling in the Account number if you wish to authorise the Bank to debit the Account with the Bank for the payment of the monthly
instalment and/or interest and/or the outstanding amount due to the Bank under the ASB Financing.
(c) Authorise the Bank to check my/our ASB account or inquiry on balance and available units to be purchased.

Main Applicants Signature : Joint Applicants Signature : SLMA Authorised Representatives Signature :
Full Name : Full Name : Full Name :
Staff ID :
New I/C No. : New I/C No. : Date :
Date : Date : Branch Name :
Branch Code :
 5/10

Credit Card-i & Credit Card Application Form (For Main Applicant)

MINIMUM INCOME PER ANNUM

Gold/Platinum Visa SIGNATURE World MasterCard Visa INFINITE Enrich World Elite

RM24,000 RM100,000 RM100,000 RM150,000 RM250,000

1 I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE CHOOSE A MAXIMUM OF 2 CARD PRODUCTS ONLY) :
A. CIMB BANK CREDIT CARD
u CIMB PETRONAS Platinum MasterCard u CIMB Platinum MasterCard u CIMB Visa SIGNATURE
u CIMB Cash Rebate Platinum MasterCard u CIMB Visa Platinum (Basic) u CIMB Visa INFINITE
u CIMB World MasterCard

u CIMB TESCO Platinum MasterCard

By applying for the CIMB TESCO Platinum Credit Card, I agree that CIMB Bank may share my information contained in this application form with
TESCO STORES (MALAYSIA) SDN BHD (Company No. 521419-K) (Tesco Stores), its successor or any of its related companies to enable me to
enjoy the rewards, services and benefits including accumulation of Tesco Clubcard points offered under the CIMB TESCO Platinum Credit Card.
To start enjoying and earning Tesco Clubcard points, kindly insert your existing TESCO Clubcard No. here:

If you do not have your Clubcard number with you, please call our Clubcard Helpline at 1 300 13 1313 for immediate assistance.
If you are not an existing TESCO Clubcard member, Tesco Stores may contact you on the application of a TESCO Clubcard in order for you to enjoy
Tesco Clubcard rewards and benefits.

u CIMB Enrich World MasterCard u CIMB Enrich World Elite MasterCard

My Enrich Card No. :

u I do not have an Enrich Card and wish to be enrolled as a new Enrich member under the Enrich Frequent Flyer Programme. I hereby consent to
CIMB Bank sharing the information contained in this application form with Malaysian Airline System Berhad (10601-W) (Administrator Appointed), its
successor or any of its related companies which upon receipt of my information herein will then consider my application for the same.

B. CIMB ISLAMIC CREDIT CARD-i

u CIMB Islamic PETRONAS Gold MasterCard u CIMB Islamic Platinum MasterCard

Important Note:
(1) Additional credit card-i/credit card will share a combined credit limit. Principal Credit Card-i/Credit Card Applicants Signature :
(2) Please sign within the signature box. Date :

2 MY PERSONAL DETAILS

Name To Appear On Card (Not More Than 19 Letters) : Mothers Maiden Name :

3 MY BILLING DELIVERY INSTRUCTIONS

E-mail :
Customers with e-mail address will be enrolled for e-Statement
automatically.

u Paper Statement : u CIMB CLICKS Internet Banking :

No, I prefer paper statement to be sent to my mailing address No, I prefer to receive my statement via CIMB Clicks Internet Banking

4 CIMB TOUCH N GO ZING AUTOMATIC RELOAD AMOUNT

CIMB Touch n Go Zing Card (Touch n Go card linked to CIMB Bank/CIMB Islamic Credit Card)
u I would like to have the CIMB Touch n Go Zing Card with the following automatic reload amount
Principal Card u RM100 u RM200 u RM300
Note : If the auto reload amount is not specified, CIMB Bank/CIMB Islamic Bank will automatically set the default reload amount to RM100.

Customers NRIC / Passport No. : (Compulsory)

 6/10

Credit Card-i & Credit Card Application Form (For Joint Applicant)

MINIMUM INCOME PER ANNUM

Gold/Platinum Visa SIGNATURE World MasterCard Visa INFINITE Enrich World Elite

RM24,000 RM100,000 RM100,000 RM150,000 RM250,000

1 I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE CHOOSE A MAXIMUM OF 2 CARD PRODUCTS ONLY) :
A. CIMB BANK CREDIT CARD
u CIMB PETRONAS Platinum MasterCard u CIMB Platinum MasterCard u CIMB Visa SIGNATURE
u CIMB Cash Rebate Platinum MasterCard u CIMB Visa Platinum (Basic) u CIMB Visa INFINITE
u CIMB World MasterCard

u CIMB TESCO Platinum MasterCard

By applying for the CIMB TESCO Platinum Credit Card, I agree that CIMB Bank may share my information contained in this application form with
TESCO STORES (MALAYSIA) SDN BHD (Company No. 521419-K) (Tesco Stores), its successor or any of its related companies to enable me to
enjoy the rewards, services and benefits including accumulation of Tesco Clubcard points offered under the CIMB TESCO Platinum Credit Card.
To start enjoying and earning Tesco Clubcard points, kindly insert your existing TESCO Clubcard No. here:

If you do not have your Clubcard number with you, please call our Clubcard Helpline at 1 300 13 1313 for immediate assistance.
If you are not an existing TESCO Clubcard member, Tesco Stores may contact you on the application of a TESCO Clubcard in order for you to enjoy
Tesco Clubcard rewards and benefits.

u CIMB Enrich World MasterCard u CIMB Enrich World Elite MasterCard

My Enrich Card No. :

u I do not have an Enrich Card and wish to be enrolled as a new Enrich member under the Enrich Frequent Flyer Programme. I hereby consent to
CIMB Bank sharing the information contained in this application form with Malaysian Airline System Berhad (10601-W) (Administrator Appointed), its
successor or any of its related companies which upon receipt of my information herein will then consider my application for the same.

B. CIMB ISLAMIC CREDIT CARD-i

u CIMB Islamic PETRONAS Gold MasterCard u CIMB Islamic Platinum MasterCard

Important Note:
(1) Additional credit card-i/credit card will share a combined credit limit. Principal Credit Card-i/Credit Card Applicants Signature :
(2) Please sign within the signature box. Date :

2 MY PERSONAL DETAILS

Name To Appear On Card (Not More Than 19 Letters) : Mothers Maiden Name :

3 MY BILLING DELIVERY INSTRUCTIONS

E-mail :
Customers with e-mail address will be enrolled for e-Statement
automatically.

uP
 aper Statement : uC
 IMB CLICKS Internet Banking :
No, I prefer paper statement to be sent to my mailing address No, I prefer to receive my statement via CIMB Clicks Internet Banking

4 CIMB TOUCH N GO ZING AUTOMATIC RELOAD AMOUNT

CIMB Touch n Go Zing Card (Touch n Go card linked to CIMB Bank/CIMB Islamic Credit Card)
u I would like to have the CIMB Touch n Go Zing Card with the following automatic reload amount
Principal Card u RM100 u RM200 u RM300
Note : If the auto reload amount is not specified, CIMB Bank/CIMB Islamic Bank will automatically set the default reload amount to RM100.

Customers NRIC / Passport No. : (Compulsory)

 7/10

Cash Plus Personal Loan Application Details

LOAN REQUEST AUTHORIZATION

, 0 0 I declare that I have received, read and understood the Terms and
Amount : R M Conditions (Terms) of the Cash Plus Personal Loan (Facility) and hereby
submit my application to request the Bank to grant me the Facility upon
Tenure (years): u 5 years u 4 years u 3 years u 2 years the Terms.
Disbursement Details and Monthly Repayment
Note:
* Payment mode : Monthly  lease credit the Facility amount into my *CIMB Bank Berhad /
P
*CIMB Islamic Bank Berhad *savings account / *current account (*delete
* Interest rate : Fixed Interest Rate or any rate offered by Bank. whichever is not applicable) as follows:-

If no account number is provided by me, I hereby instruct the Bank to credit
the Facility amount at its sole discretion into any of my savings or current
account with CIMB Bank Berhad or CIMB Islamic Bank Berhad. The account
above or the account selected by the Bank (if no account number is provided
by me) is hereinafter referred to as the Account.
Main Applicants Signature : I hereby authorize CIMB Bank Berhad or CIMB Islamic Bank Berhad, as the
Date : case may be, to debit or cause to be debited the monthly instalments on or
before each monthly instalment due date and other charges related to the
Facility from the Account without further prior notice to me.

DOCUMENTS ENCLOSED

Which of the following documents are you providing with this form?

ALL APPLICANTS SALARIED APPLICANTS

u Copy of applicants NRIC/Passport u Latest 3 months salary slip
u Latest 3 months bank statements u Letter from employer
u Latest EA Form/Form B with proof of tax payment/EPF Statement
u Sale and purchase agreement OR booking receipt OR copy of title deed
u Valuation report (if available) SELF EMPLOYED APPLICANTS

u Latest loan/financing statement (if refinancing) u Profit and loss statement

u Copy of ASB passbook/ASNB Unit Trust System (UTS) balance inquiry statement u Business registration A & D OR Forms 24 & 49
u Duly completed US IRS form, when applicable as requested by the bank
Note: To use the latest form, download from US IRS website (http://www.irs.gov/Businesses/Corporations/FATCA-Current-Alerts-and-Other-News) >> Forms
and Publications (PDF) section for the form and instructions. W-8 forms (http://apps.irs.gov/app/picklist/list/formsPublications.html;jsessionid=HWB
dbXB4i5kwMZvndb6Fog__?value=w-8&criteria=formNumber&submitSearch=Find), W-9 form (http://apps.irs.gov/app/picklist/list/formsPublications.
html;jsessionid=55K-+0VI1PmJE5z-FUjoNw__?value=w-9&criteria=formNumber&submitSearch=Find)

DECLARATION/DISCLOSURE BY APPLICANT**

In addition to my application for Property Financing, I hereby acknowledge that I am applying for the following products in this application form :

Products Main Applicants Initial Joint Applicants Initial

CIMB Bank Amanah Saham Bumiputera Financing

** T
 his declaration shall apply to all CIMB Bank Berhad and/or CIMB Islamic Bank Berhad, as the case may be, (the Bank) product(s) which you
apply for as stated in this application form and above table. The Bank refers to CIMB Bank Berhad and/or CIMB Islamic Bank Berhad, as the
case may be, being the licensed financial institution offerring the loan/financing product(s) referred to in this application form.

FOR ALL PRODUCTS:

(i) I/We declare that I/we have/do not have outstanding debt payment obligation from banks and non-banks (e.g. cooperative building societies, credit
companies and merchants that provide credit sales)
Particulars of the main applicants outstanding debt payment obligation are as follows (no declaration from the main applicant denotes that this
declaration is not applicable) :

No. Name of Entity Amount of Outstanding Debt (RM) Monthly Instalment Amount (RM)

2
 8/10

Applicant Name :

NRIC No. :

CONTINUATION OF DECLARATION/DISCLOSURE BY APPLICANT**

Particulars of the joint applicants (if applicable) outstanding debt payment obligation are as follows (no declaration from the joint applicant denotes that
this declaration is not applicable) :

No. Name of Entity Amount of Outstanding Debt (RM) Monthly Instalment Amount (RM)

(ii) I/We declare that the information furnished in this form are completely true and accurate and I/we have not withheld any information which may
prejudice my/our financing/loan application or have a bearing on your financing decision.
(iii) I/We hereby authorize you or your representative to obtain information relating to this information from any source.
(iv) Application(s) remains the Bank property regardless of whether the facility is approved and the Bank reserves the right to reject the application(s) at its
sole discretion without any reasons whatsoever.
(v) I/We have not committed any act of bankruptcy and/or been adjudged a bankrupt.
(vi) I/We shall comply with the Bank requirements in respect of my/our loan/financing application and understand that the Banks offer of the loan/financing
shall be subject to the Bank performing any necessary verification.
(vii) I/We confirm that the Bank is authorised to verify and/or make any checks and/or obtain any information and/or confirmation at any time and from time
to time now and/or in the future, with or from any credit reference/reporting agencies, including but not limited to CCRIS, FIS and/or any other agencies
and/or from any financial institution and to provide to such aforesaid party(s) with the required information requested to enable the Bank to ascertain my/
our status and/or any other person, individual and/or entity related to and/or associated with me/us as may be required by the Bank for the purpose of the
consideration of this application and thereafter if this application is approved for the purposes of the grant and/or continued maintenance of the facility/
account; and/or recovery of debts owing under the facility/account; and/or any purpose related to or in connection with the facility/account applied for;
and/or for any other purpose that is required or permitted by any law, regulations, guidelines and/or relevant regulatory authorities.
(viii) In connection with the Bank Negara Guidelines on Credit Transactions and Exposures with Connected Parties, I/we hereby declare that (no declaration
from the applicant(s) denotes that this declaration is not applicable) :
u I am a staff of the CIMB Group1
u To the best of my knowledge, I have close relative(s)2 employed under the CIMB Group or particulars of my close relatives in CIMB Group and
whether they have asked as my guarantor

Name I/C / Passport No. Relationship Acted As Guarantor (Indicate Yes or No)

u Yes u No

u Yes u No

CIMB Group means CIMB Bank Berhad or CIMB Islamic Bank Berhad or CIMB Investment Bank Berhad or other subsidiaries or companies controlled by
1

the aforesaid respective banking institutions.

Close relative(s) include parents/spouse of staff including the spouses dependents/children/spouse of the children/brother and sister/spouse of brother/
2

sister and any other dependents and persons who may influence/be influenced by the staff.
(ix) I/We hereby confirm the information provided and declaration below are true, accurate and complete.
Subject to the applicable local laws, I/we hereby consent for the Bank, the Group Companies and/or any of their licensed financial institution affiliates
(including branches) (collectively as CIMB) to share my information with domestic or overseas governmental, supervisory or regulatory authorities
where necessary to establish my tax liability in any relevant jurisdiction.
Where required by domestic or overseas governmental, supervisory or regulatory authorities, I/we also understand and agree that CIMB may be
required to obtain additional documents and/or forms, which I/we will sign, if I/we am/are subject to the relevant jurisdictions requirements.
Where required by domestic or overseas governmental, supervisory or regulatory authorities, I/we understand and agree that CIMB may withhold,
and pay out, from any of my/our account(s) such amounts as may be required according to applicable laws, regulations, directives, guidelines and/or
agreements with and/or from domestic or overseas governmental, supervisory or regulatory authorities.
(x) Subject to the provisions below which (i) prohibit disclosure of information to Group Companies if objected to by me/us; and (ii) require my/our express
consent for disclosure of information to third parties for the stated purposes, I/we hereby agree and authorise the Bank to disclose to any of its agents,
service providers, auditors, legal counsel, professional advisors, security providers and guarantors in or outside Malaysia and to companies within
the group of the Bank as well as companies within the group of CIMB Group Holdings Berhad, the Banks ultimate holding company (the Group
Companies) whether such Group Companies are residing, situated, carrying on business, incorporated or constituted within or outside Malaysia any
information relating to me/us, my/our affairs and/or any accounts maintained by me/us with the Bank for facilitating the business, operations, facilities
and services of or granted or provided by the Bank and/or the Group Companies to their customers.
 Disclosure to Group Companies shall be for facilitating the operations, businesses, cross-selling and other purposes of the Bank and/or the Group
Companies provided always that disclosure for cross selling purposes shall not be effected if such disclosure is objected by me/us by contacting
the Bank at the following telephone number or address (which may be changed by the Bank from time to time by notice to me/us): 19th Floor, Menara
Bumiputra Commerce, 11 Jalan Raja Laut, 50350 Kuala Lumpur, Tel No.: +603 6204 7788.
Further, where the Bank intends to share my/our information (excluding information relating to my/our affairs or account) with third parties for strategic
alliances, marketing and promotional purposes,
u I/We hereby give my/our consent to the above disclosure to third parties.
u I/We do not consent to the giving of the above disclosure to third parties.
 9/10

CONTINUATION OF DECLARATION/DISCLOSURE BY APPLICANT**

(xi) I/We also 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), a database maintained by BNM.

(xii) CIMB Touch n Go Zing Card

I agree to abide by the terms and conditions of the CIMB Touch n Go Zing Card (the Card) and any other terms and conditions imposed by Touch n Go
Sdn. Bhd. (hereinafter referred to as TNGSB) and/or the Bank from time to time upon giving twenty one (21) calendar days prior notice in respect of the
use of the Touch n Go features of the Card. I am aware the Card has an automatic reload amount of RM100, RM200 or RM300 and that the automatic
reload fee of the RM1.59 is payable. I confirm and irrevocably authorize the Bank to debit my Credit Card account, linked to the Card for each reload and
automatic reload fee (where chargeable) whenever the account balance drops to RM50 and below. In the event that I cancel my Card and my Card has an
account balance at the point of cancellation, such balance will be refunded, upon request, to my Credit Card account after deducting the processing fee
of RM5.30 from the account balance of the Card. In the event that my Card doest not have any account balance when I cancel my Card, no processing
fee will be charged. A RM10.00 fee is also chargeable for new Card replacements. By signing and/or using the Card I agree to be bound by the terms and
conditions imposed on the Card and other variations or amendments thereof. I understand that the Card remains the property of TNGSB and must be
returned to TNGSB upon request.

(xiii) For Cash Plus Personal Loan

The right to reject the application at its sole discretion without stating any reasons. The Bank is hereby expressly authorized to discuss with my
previous, current and future employers regarding this application and/or my payment record. I hereby declare that I am not a bankrupt and there
is no on-going legal action against me presently. I have read and understood the Terms and Conditions (Terms) of the Cash Plus Personal Loan
(Facility) which are attached to this Application Form and make the offer for the Facility contained in this Application Form on these Terms. This
Application Form, the Disbursement Notice and the Terms shall govern the Facility. The Bank may offer me the Facility at the amount, interest rate
and/or tenure approved by the Bank which may be different to the amount, interest rate and/or tenure applied for by me. I may accept the Banks
offer expressly or by conduct by utilizing the Facility offered by the Bank which has been credited to the Account, whichever happens earlier.
I agree that any agreement, confirmation, declaration, consent or undertaking given by me verbally or by any telecommunication or electronic
method shall be legal and binding on me.

(xiv) For Credit Card

I/We hereby request the Bank to issue, upon approval of this application, the credit card(s) which I/we have indicated. I/We acknowledge that the use
of the credit card(s) issued to me/us shall be subject to the Banks Cardholder Terms and Conditions (Cardmember Agreement) which will be sent
to me/us with the credit card(s) upon the approval of this application, and I/we further agree to be bound by the terms and conditions set forth in the
Cardmember Agreement upon issuance or use of the credit card(s). I, the Principal Applicant further agree to accept joint and several liability for all
amounts incurred arising from the use of the Principal and/or Supplementary credit card(s) issued pursuant to this application or at any time thereafter
at my and/or the Supplementary Applicants request. I/We further understand that the Bank shall not hold the Supplementary Applicant jointly and
severally liable for the debts or amounts incurred by the Principal Applicant or other Supplementary Applicant(s). I/We understand that the credit card(s)
when issued shall at all times remain the property of the Bank and must be duly returned upon request by the Bank. I/We further agree to accept liability
for all amount incurred arising from the use of my/our credit card(s) issued pursuant to this application or at any time thereafter at my/our request.

(xv) For Goods & Services Tax (GST) (Effective 1 April 2015)
I am aware that the published fees/charges are inclusive of Goods and Services Tax (GST), where applicable and I hereby further agree that I shall be liable
for all GST payable in connection with or arising out of the products applied for under this application form or any account or any services in connection
therewith and you shall be authorised to debit my account for the same.

(xvi) For E-mail Statement Delivery

I/We agree to be bound by CIMB Bank/CIMB Islamic Bank Terms & Conditions for E-Mail Statement Delivery available at CIMB Bank/CIMB Islamic
Bank website - www.cimbbank.com.my/www.cimbislamic.com.my in respect of all my/our credit card statements requested to be sent to me/us by
e-mail.

(xvii) To View/Receive Statements By CIMB CLICKS Internet Banking

Where I/we have a CIMB Clicks Internet Banking account (CLICKS) and have requested to view all my/our CIMB Bank/CIMB Islamic Bank credit card
Statement(s) via CLICKS. I/We agree to be subject to the Terms and Conditions for Credit Card e-statement accessed via CIMB Clicks published on
CIMB Banks/CIMB Islamic Banks website. I/We agree that I/we will not receive hardcopy Statements nor will I/we receive Statement(s) via E-mail.

(xviii) For HomeSafe/Houseowner (Underwritten by Allianz General Insurance Malaysia Berhad), Takaful Houseowner
(Underwritten by Sun Life Malaysia Takaful) and GMTA/GMTT (Underwritten by Sun Life Malaysia) (referred to singly or
collectively as the case may be as the Insurance Company)
I/We declare that the information furnished in this form is completely true and accurate. I/We hereby consent to CIMB Bank sharing the information
contained in this application form with the Insurance Company selected by me which upon receipt of my/our information herein will then consider my
application for the same.

I hereby confirm having read, understood and retained a copy of Product Disclosure Sheet that explains the benefits and my duties to my application
for the Product(s) that I/we applied for. For Property Financing, the Product Disclosure Sheet will be given together with the Letter Offer.

I am aware the full terms and conditions of the product(s) that I applied for is/are also available in:

Cash Plus Personal Loan : www.cimbbank.com.my 03 6204 7788

CIMB Islamic Credit Card : www.cimbislamic.com.my 03 6204 7788
CIMB Credit Card : www.cimbbank.com.my 03 6204 7788
HomeSafe/Houseowner/Fire : www.cimbbank.com.my 03 6204 7788
 10/10

PRIVACY NOTICE ACKNOWLEDGEMENT

I hereby acknowledge that I have accessed and/or read the Privacy Notice issued by CIMB Group (which is available at all CIMB branches as well as at the
CIMB website at www.cimbbank.com.my or www.cimbislamic.com.my or has otherwise been made available to me) and confirm my agreement to the same.

VOLUNTARY DECLARATION/DISCLOSURE BY APPLICANT

(i) I/We declare that I/we have/do not have contingent liabilities with any other party(ies). Where I/we have contingent liabilities, particulars of my
contingent liabilities are as follows :

No. Name of Entity Maximum Amount of Contingent Liabilities (RM) (where ascertainable)

Main Applicants Signature : Joint Applicants Signature :

Date : Date :

DECLARATION/DISCLOSURE BY GUARANTOR
I/We hereby irrevocably confirm, consent and authorise the Bank
i. to be provided information as may be required by the Bank for processing pursuant to the Personal Data Protection Act 2010 including for use
in accordance and in connection with the applicants application or request for accounts, products, banking facilities and/or services (collectively
Facilities);
ii. to carry out the necessary reference checks at any time and from time to time now and/or in the future including but not limited to credit reference/
reporting checks with credit reference/reporting agencies, including but not limited to CCRIS, FIS and/or any other agencies and/or from any financial
institution and to provide to such aforesaid party(s) with the required information requested to enable the Bank to ascertain my/our status as may be
required by the Bank for the purposes of considering the Facilities and thereafter (if applicable) for the grant and/or continued maintenance of the
Facilities; and/or recovery of debts owing under the Facilities; and/or any purpose related to or in connection with the Facilities applied for by the
applicant; and/or for any other purposes that is required or permitted by law, regulations, guidelines and/or relevant regulatory authorities;
at the Banks sole discretion, without further reference to me/us. I/We undertake to update the Bank in writing should there be any change to my/our personal
and financial, credit information.

Guarantors Signature : Guarantors Signature :

Date : Date :

BANK USE ONLY

For Property / ASB Financing

Salesperson Name : Salesperson I/D : Sales Team/Branch Code :
Referrer Name : Referrer I/D :
Fire Insurance : u HomeSafe u Houseowner
GMTA/GMTT : u Yes - Self finance u Yes - Bank financed u No Free Moving Costs : u Yes u No

For Credit Card / Credit Card-i For Cash Plus Personal Loan
Branch Code : Branch Code :
Employee I/D : Employee I/D :

Applicant Name : Verified by : SD Doc No.

Name of Manager* :
NRIC No. : * Confirmed the required forms are duly completed and signed