EXCIMBISLAMIC ERICIMBBANK — REMITTANCE APPLICATION FORM 90099334 Cimento INN eB Den) Alleformaton i rected nies oterwise spettecs Branch: ioryira._YorL COMPUTER VALIDATION (for dabit account only [APPLICATION FOR [-] Telegraphic Tanster (TT) __[] RENTAS Transfer Ti interbank RO (8G) Banker's Onecue 5) Fereign Demand Drat UN ain oom 2 EXCONTRAGT = ilyou tg i " . ae: IC /Pasgport No. /Compary Registration No./ Other. ia iddress LUG PME, Oa LO Ne ARO Spel bh, fia ast wourans CA Ni. Lo EMMCRAGTSN TER 1 Prasat Ns gy egal Ne Tome, ERDOM Ri (C1 Non-Resident, please state county of ori | wrarararan MENS ct RM Account No. for charges to Ue ey acoount Co (SHA) for Shared [House Creaue No. | Payable to Ot BanicBerhad CID ilamsc Bank Berhad |] (OUR) for Reiter Cash for Non-CIMB Account Hold Ory). ny wth ofa approve) & x Recent Heide ; BR/AP/0031 (04/18) - BOF ‘Goods [1] Services & investment income _[ Please spect for at _ Fact Mack cee Bea Relationship betwoen Applicant and Beneficiary [| Related, please specy Dh Wet Rated Foreign Worker Remittances [| Non-Resident whe werksin Malaysia less thant yeer [| Non-Resident who werks in Malaya for 1 year & mor + VWe hereby declare that Ye have ec and understood the tr and cnaitons ea forth onthe revert ofthis fom and agraeto comply with and bo boul bythe provisions of tho ald terme andl condone. + Ve declare and confirm that al the information herein is true and correct and in compliance withthe Foreign Exchange Administration Rules made pursuant to the Financial Services Act 2019/lslamic Financlel Services Act 2013 and the Contra Bank of Malaysia Act 2008. Io shall be fully responsible for ‘Transter {J Capita Investment Transaction” ea thy incr, rts or neon omaton gated ie om, Priacy Notice Ackronledoroyeek (>> sD ewe horaby actowurtane tea Ob has alePtead the Privacy Notice issued by CIME Group [which i avaliable at all IMB website at ‘tm cmbaniom my +g erhas cherie Bor ade aval me/s) an cont mou aperontt th ea Date won) ZENE V2} le sn 258 [Dm approved by Oca sn approved by Ofter2 patted LS