PUBLIC ISLAMIC BANK LOANIFINANCING APPLICATION ACKNOWLEDGEMENT FORM 8 PUBLIC BANK BORANG PENGESAHAN PENERIMAAN PERMOHONAN PINJAMAN/PEMBIAYAAN ‘Tarn Pamohonan Dera) / Dat Application Received ||| | as ‘SayarKam telah mengomukakan dokumen-cokumen berkut bagi prmahonan saya/kami. Saya/Kam akan mengemtXakan dokunen-dokumen tambahan yang cperukan sepert yang ctandakan (dalam rvangan “Akan dikemukakan" dalam tampon _habokorja supaye parmohoransaya/kami bolo lproseskan. Me have submited the folowing documents for myfourlaninancing application. (We shal fuish the folowing acctional documents requied as inccated (in the "To be fumished column within ___ working days er rocessng of my/our application ‘DOKUMEN-DOKUMEN TAMBAHAN DIPERLUKAN / ~ = Frarkhkemkakan| Akan ckemukakan’ ADDITIONAL DOCUMENTS REQUIRED Date fumished | Tbe fumished ¥) Individs India ‘Salinan KP/MyKad/ Photocopy oF NRICINy Kad “Borang Jbagi2 tahun yang tra / Form Jfor he atest 2yeare ‘Sip ga bagi 3 bulan yang lepas/SuratPujukan Majkan / Salary sips for the past 3 montis/EmployersRfernce Lat Resi Depost TetapPelaburan Ari Mucharabsh/Buku Simpanar/Simpanar- Wadia / Fed Depost/Mucharabah General investment Account ReceotSavings/Wadiah Savings Account Passbook Bukan individu / Non individual ‘orang Pencaftren Peiagaan orang A/B/D)/ Business Regivaton Form Farm ATBID) Momevandum &Tataurusan Persatuan / Memorandum & Articles of Association Borang 24 & 49/ Form 248 48 “Jngkaan Aion Tunai/Peryata Untung Fug! untuk? tahun akan datang / Projected Cashifow/ Profi & Loss ‘Statomonts for to next 2 years Fancangan Periagaar/Perasaran / Business] Marketing Pan DDokumen-dokumen Lain / Other Documents PenyataAkaun Serasa/Akaun Semase- Wadiah bagi 6 buen yang pas / Curent Account Wadih Caren Account1 ‘Statements othe past 6 months re Penyata Praman/Pembayaen PerurhavPryanan/Pembiayean TapSewa-Bel/Kad Kd] HoushgiFxed LoanfFinancing ire Pachase\Grect Gard Statements Perrin Jul Be/Rest Temparan / Sls 8 Purchase Agrement/Bockng Reco Peranjian Peryewaan/ Tenancy Agreement Laporan Penisian /Vaiston Report ‘Salnan Hak Miik/Phofocopy of Til | “andstangan Pelanggan/ Senate of Customer (Apabile Sebahagian Dokunen Dra / When Partial Documents Received) Ta oate | ‘Sepert yang diminta,sayarkami mengemukakan semua dokumen yang diperukan untuk permohonan pnjamar/pembiayaan sayakami./As requested, live have fused a the requred documents fr my /aurloanitinaneng application. “andetangan Pelanggan Signature of Customer (paola semua dokumen cterima / When fll documents receveo) “Tandatangan/ Signature Nama Pegawai/ Name of Ofcar "No, Untuk Dinubungi/ Contact No6) We hereby declare = 8) that Lam/we are not directors), office(s) or employee(s) of your Bank or its subsidiaries. ) that none of the directors, officers or employees of your Bank or its subsidiaries is my/our guarantor. ©) that none of the directors, partners, managers, agents or guarantors of our fimm/corporation isa director, officer or employee of your Bank or its subsidiaries, nor do any of the directors, officers or employees of your Bank have any interest whatsoever irectly or indirectly inthe shares of our corporation. Dengan ini, saya/kami mengakui :- 4) bahawa sayarhami bukan pengarah, pegawai aiau kakitangan Bank atau subsidiarinya. 5) bahawa tiada seorang pun daripada pengarah, pegawai atau kakitangan Bank atau subsidiarinya adalah penjamin savavkami. ©) bahawa tiada seorang pun daripada pengarak, rakan niaga, pengurus, ¢jen atau penjamin firma(perbadanan kami adalah pengarah, pegawai atau kakitangan Bank atau subsidiarinya, alaupun mana-mana pengarah, pegawai atau kakitangan Bank ‘mempunyai apa jua kepentingan secara langsung atau tidak langsung dalam saham-saham perbadanan kami. 7) We agree and covenant, jointly and severally, to fully settle all credit or banking facilities extended to me/us to my/our firm oF corporation prior tothe happening of any event that will cause any director, officer oF employee af your Bank or its subsidiaries to become related to me or us as aforesaid arising from marriage or a change in parnership/directorship or constitution of our firm or corporation. Saya/Kami bersetwu secara bersesama dan berasingan untuk menvelesaikan sepenuhnya semua kemudahan kredit dan perbankan yang diberi kepada saya/tami, firma atau perbadanan sayarkami sebelum berlakunya apa-apa perkara yang akan menyebabkan engarah, pegawai dan kakitangan Bank atau subsidiarinya untuk mempunyai hubungan kekeluargaan dengan saya atau kami ‘melatui perkawinan atau perubahan dalam perkongsiawkepengarahan atau perlembagaan firma atau perbadanan kami 8) 1/We undertake jointly and severally 10 indemnify your Bank and any director, officer or employee of your Bank against any Josses/iabilties whatsoever arising from any action/proceedings/claims against your Bank or any director, officer or employee of your Bank in connection with any nén-compliance any provisions of the Financial Services Act 2013/Islamic Financial Service Act 2013, the Bank Negara Malaysia (BNM) Guidelines on Credit Transaction and Exposures with Connected Parties or any other Guidelines or standards issued by BNM from time to time: Sava‘Kami mengaku janji secara bersesama dan berasingan untuk menangeung rugi Bank dan mana-mana pengarah, pegawal atau Kakitangan Bank daripada apa jua kerugianibiliti berikuan daripada apa-apa tindakan’prosiding/tuntutan terhadap Bank atau ‘mana-mana pengarah, pegawai atau kakitangan Bank berkaitan dengan keildakpanhan pada apa-apa perunukan dalam Alta Perkhidmatan Kewangan 2013/Akta Perthidmatan Kewangan Islam 2013, Garis Panduan Bank Negara Malaysia (BNM) mengenai Uns Niaga Kredit dan Pendedahan dengan Pihak-pihak Berkaitan atau apa-apa Garis Pandvan atau standard yang dikeluarkan ‘oleh BNM dari semasa ke semasa. 9) This Application Form and all loan related information and other supporting documents (by way of hard copy and electronically stored) belongs to you and are for your retention. Borang Permohonan ini dan semua maklumar berkaitan dengan pinjaman dan dokumen sokongan yang lain (dalam salinan keras ddan disimpan secara elekironik) adalah milik Bank dan untuk disimpan oleh Bank Signatures of Applicant(s) / Tandatangan Pemohon TWe have read and understood your above tems and conditions fr applications for accommodation. UWe hereby undenake and agree 1 be Bound by your terms and conditions as mentioned therein ‘Saparkanitelah membaca dan menohami terma dan syara di alas Baxi permohonan prjaman int. Dengan ini, seya'hami mengaku jan dan bersetyu tntuk mematuht terme dan ssarat ua seperti se se but di dalam Name /Nama Name / Nama Name Nama Date Tarik: PLEASE DATE THE APPLICATION FORM TO ASSIST US IN PROVIDING A BETTER AND QUICKER SERVICE TO YOU. cRTOOLO0SPUBLIC BANK KART Date Dear Sir/MadanvSirs Application for Credit Facilities Please be informed that the information relating to your application for the credit faclityies) applied by you may be forwarded to any bureau or agencies established or approved by Bank ‘Negara Malaysia (BNM) including Borrowers Loan Information System, Biro Maklumat Cek (BMC), Central Credit Referral Information System (CRIS) and other such bodies, bureaux or corporations as the case may be for the purpose of collecting information from financial institutions regarding credit facilites to be granted or accounts maintained with such financial institutions, You are further informed that the Bank shall not in any event be liable for any claim, loss, damage or lability howsoever arising whether in contract, tort, negligence, strict liability or any other basis (including director indirect, special, incidential, consequential or punitive damages or loss of profits or savings) arising from any inaceuracy or loss, deletion oF modification of data or for any other reason whatsoever relating to any information forwarded by the bank as aforesaid to any bureau established by BNM including BMC and CRIS or such other bodies, bureaux or corporations as the case may be or in relation to any access or use oF the inability to access of use by any body, bureau or corporation established by BNM or reliance on the information contained therein, whether caused by any technical, hardware or software failure of any kind, the interruption, error. omission, delay, viruses or otherwise howsoever. ‘Thank you, Yours truly for PUBLIC BANK BERHAD Name Designation UWe (NRICIBR NoMROC | NGet rns ue ie ey of accept and consent to the above information being disclosed to any body, bureau or corporation established by BNM, & Authorised Signatories Gawangan valan’ Beeereh ; AQ70/ - ASTO/A, Jalan Baserah, 25900 Kuantan, Pahang Telephone: 09-567 6461, 568 8088 Facsimile: 09-566 9272, 5€0 6968. Widsile: www publebank com myCREDIT BUREAU MALAYSIA Notification from Credit Bureau Malaysia Sdn. Bhd. Please be informed that your Credit Information will be collected and used for: - () processing application made to the Bank/Companies; and/or (i) reviewing of credit facility by the Bank; and/or (ii) in any other Purposes permitted by any written law in Malaysia. Your consent for disclosure of your credit information was made by you during your application for the above Purposes. Credit Information may include personal identification, business registry, repayment history and credit facilties. Credit Information will be kept confidential and will be disclosed only with your consent to Financial Institutions, Corporations, Government Agencies, Businesses and other credit grantors, Credit Information is derived from Central Credit Reference Information System (‘CRIS’), Dishonoured Cheques from Bank Negara ("DCHEQS'), Non-bank Credit Information, Companies Commission of Malaysia ((CCM'") and other legal sources. (‘Data Sources’). {In the event you discover any error or inaccuracy, you must notify the Data Sources and at the same time notify CBM in writing, Access to your credit information can be restricted by purchasing CBM's Credit Lock. However with Credit Lock, there is possibilty that this may cause issues or disruptions to your facility application or review. You may also access your credit information by purchasing CBM’ Self Enquiry Report. Kindly refer to the Summary of Rights available on CRA Act Registrar's website; www.ppapk.treasury.gov.my or ‘www. creditbureau.com my Further Details:- CREDIT BUREAU MALAYSIA SDN BHD Level 5, Bangunan CGC, Kelana Business Centre, No 97, Jalan SS 7/2, 47301 Petaling Jaya, Selangor Darul Ehsan. Hotline: 03-7808 8080 Email: info@creditbureau.com my Pemberitahuan daripada Credit Bureau Malaysia Sdn. Bhd. ‘Adalah dimaklumkan bahawa maklumat kredit anda akan dikumpulkan dan digunakan untuk :- () emprosesan permohonan yang dibuat kepada pinak Bank/ Syarikat; dan/atau (i) semakan fasilt kredt oleh pinak Bank; dan/atau (li) apa ~ apa tujuan yang dibenarkan oleh undang-undang bertlis di Malaysia. Kebenaran pendedatian maklumat kredit telah dilakukan oleh anda semasa permohonan anda bagi tuluan di ates. Maklumat kredit merangkumi maklumat pengenalan dir, pendaftaran perniagaan, sejarah pembayaran semula dan juga fasilti kredit. Makiumat kredit anda adalah dirahsiakan dan hanya akan didedahkan kepada Institusi Kewangan, Perbadanan, Agensi Kerajaan, Pemiagaan dan pemberi kredit lain bergantung kepada persetujuan anda. Makiumat Kredit diperolehi daripada Central Credit Reference Information System (“CCRIS"), Dishonoured Cheques from Bank Negara (‘DCHEQS"), data bukan bank, Suruhanjaya Syarikat Malaysia ("SSM") dan sumber-sumber lain yang sah. ("Sumber Data’ Sekiranya anda mendapati terdapat sebarang kesilapan atau ketidaktepatan maklumat, anda periu memaklumkan kepada Sumber Data dan dalam masa yang sama memaklumkan kepada CBM secara bertulis. Akses kepada maklumat kredit anda boleh dihadkan dengan pembelian Credit Lock CBM Walaubagaimanapun dengan Credit Lock jini terdapat kebarangkalian gangguan/isu kepada permohonan/semakan fasilti anda, ‘Anda juga boleh mengakses maklumat kredit anda dengan membeli Self Enquiry Report CBM daripada kami. Sila rujuk Ringkasan Hak yang boleh didapati di laman web Pendaftar Akta Agensi Pelaporan Kredit 2010; www. ppapk treasury. gov.my atau www.creditbureau.com my.PUBLIC BANK BERHAD (6463-H) PUBLIC ISLAMIC BANK BERHAD (14328-V) A379I1, A-379/2, A-37913 & A-379/4 Jalan Beserah 25300 Kuantan Pahang Darul Makmur Malaysia LETTER OF CONSENT FOR DISCLOSURE (FOR INDIVIDUALS) 1 |Lunderstand that in order for you to consider the request for credit or banking facilities or other accommodation (‘the Facilities’ which shall include any other facilities considered or applied for by me hereinafter) prior to the date ofthis Letter and the Letter of Offer, if any, being issued or to grant or continue to make avaliable the Facilites pursuant to the terms of the Letter(s) of Offer, my personal or credit information, whether relating directly or indirectly to me ("My Personal Data’) may be collected, recorded, stored by you andior disclosed to, shared with or received from, relevant third parties, business partners, bodies, bureaux, corporation, credit reporting agencies or my employer. You will not be able to provide or continue to provide the Facies unless you ‘can cisclose, share with or receive My Personal Data from the said relevant third parties. | hereby consent and authorise that My Personal Data_may be forwarded or made known by you to the Customer/Borrower/Hirer/Securty Party of the Facilites or to Public Bank Berhad (‘PBB')/Publc Islamic Bank Berhad ("PIBB")'s subsidiaries and Public Investment Bank Berhad ("PIVB‘) fo the purposes of and to give effect tothe terms of the Facies, | hereby consent and authorise that My Personal Data may be forwarded to any bureau or agencies established ‘approved by Bank Negara Malaysia (BNM) or registered and licensed under the Credit Reporting Agencies Act 2010 including (but nt limited to) the Central Credit Bureau, the Borrower Loans Information System, Dishonoured Cheque Information System (DCheqs), Central Credit Reference Information System (CCRIS),CTOS Data Systems Sdn Bhd, FIS Data Reference Sdn Bhd, Credit Bureau Malaysia Sdn Bhd, Dun & Bradstreet (D&B) Malaysia Sdn Bhd, RAM Credit Information Sdn Bhd, Basis Corporation Sdn Bhd and other such bodies, bureaux, corporations or credit reporting agencies, as the case may be, for the purpose of ‘conducting credit checks and collecting information regarding facilities granted or accounts maintained with financial institutions. | hereby consent and authorise that My Personal Data may be forwarded or made known by you to Ife and general insuranceltakaful companies such as (but not limited to) Lonpac Insurance Berhad, AIA Group Lid ‘Takaful las Sdn Bhd, ETIQA Takaful Berhad, Syarkat Takaful Malaysia Sdn Bhd, AIA PUBLIC Takaful Berhad and other panel insurers/takaful | hereby consent and authorise you to obtain and verily any information about me, including My Personal Data from the Customer/Borrower/HireriSecurty Party for the application andlor review of the Facies, from PBB, PIBB, PIVB andior such other relevant third parties, business partners, bodies, bureaux, corporations credit reporting agencies as stated above or my employer at any time and from time to ime, | understand and agree that the consent and authority provided by me herein extends to (but not limited to) the disclosure by you andlor any ofthe parties named above, of My Personal Data prior to the date ofthis Letter. | further agree that you shall notin any event be liable for any claim, loss, damage or lability howsoever arising winether in contract, tor, negligence, strict labilty or any basis (including direct or indiect, special, incident Consequential or punitive damages or loss of profits or savings) arising from any inaccuracy or loss, deletion or ‘modification of data or for any other reason whatsoever relating to any information forwarded by you as aforesaid to any bureau established by BNM including the Central Credit Bureau, DChegs and CCRIS or such other relevant third parties, business partners, bodies, bureaux, corporations, credit reporting agencies or my lemployer, asthe case may be, or in relation to any access or use, or the inability fo access or use by any body, bureau oF corporation established by 8NM or creait reporting agencies or reliance on the information contained therein, whether caused by any technical, hardware or software fallure of any kind, the interruption, error, ‘mission, delay, viruses or otherwise howsoever. FulNames FatName NRIC/Passport. No. NRIC/Passport. No. Date Date Enhanced Letter of Consent dated 15/10/2014To: Public Bank Berhad i) Sharing of customer information with related and associate companies within the Public Bank Group (PBB Group), parties approved by Bank Negara Malaysia (BNM) and/or third parties to enable the Bank andlor the related and associate companies within the PBB Group to perform its andlor their functions, We understand and acknowledge that pursuant to the Banking and Financial Institutions Act (1989) (’BAFIA’), the Bank is legally permitted to disclose my/our information relating to my/our affairs, banking accounts or conduct thereof (including my/our credit standing) to third parties as approved by NM to faciltate and/or enable the Bank andior the related and associate companies within the PBB Group to perform its andlor their functions and lwe hereby irrevocably consent to and authorize the Bank to disclose the said information to any guarantor(s)/securty parties, the Bank's lawyers, debt collection agents, third parties andlor related and associate companies within the PBB Group at any time and without notice or lability as the Bank may in its absolute discretion deem necessary or ‘expedient to enable the Bank and/or the related and associate companies within the PBB Group to Perform its andlor their functions. In doing so, live agree that the Bank shall be absolved from any responsibilities or liabilities whatsoever. ii) Sharing of customer information for cross selling, marketing and promotional purposes with strategic aliances/3rd parties and to related/associate companies within the PBB Group. Please tick any ofthe following Die hereby irevocably consent to and authorize the Bank to disclose any of my/our information (excluding information relating to my/our affairs or account) to any related andior associate company within the PBB Group, the Bank's existing or future business partners or strategic alliances andor any other 3rd party as the Bank may in its absolute discretion deem necessary or expedient for the purpose of cross-selling or the marketing and promotion of products and services. We hereby confirm that no further permission or consent from me/us is/are necessary or required in relation thereto and this shall constitute the consent required ursuant to Section 99(1)(a) of the BAFIA and any other contractual consent for such disclosures of information. In doing so, lwwe agree that the Bank shall be absolved from any responsibilities or liablties whatsoever. oR Unless further permission or consent in writing from me/us is/are obtained, the Bank shall not disclose any of my/our information to any related and/or associate company within the PBB Group and/or the Bank's existing or future business or strategic alliances and/or any other 3rd party for the purpose of cross-selling or the marketing and promotion of products and services. Name Name NRIC No. NRIC No, Date Date Name Name NRIC No. NRIC No, Date Date