u

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

PROPERTY FINANCING APPLICATION FORM
PERSONAL DETAILS (JOINT APPLICANT/GUARANTOR)

Are you an existing customer u Yes u No Date of Birth D D / M M / Y Y Y Y

Salutation Marital Status

u Mr u Mrs u Miss u Madam u Single u Married u Widowed u Divorced
u Others, please specify
With Dependent Children
Full Name as per NRIC / Passport u No u Yes, please specify how many

Highest education level

NRIC / Passport no. u Not applicable u Primary u Secondary

u Diploma u Professional Qualification
u Bachelor u Masters u Doctorate
*For Passport holders please indicate your passport expiry date
D D / M M / Y Y Y Y Residential Address

u Other Identification no.

u MyTentera u MyPolis u Old I/C u Birth Certificate
Postcode City
Identification no.
State Country
Nationality
Mailing Address (If different from Residential Address)
u MALAYSIAN (Please 3 one)
u Bumiputra u Non-Bumiputra
u Non-MALAYSIAN, please specify country, visa type and Postcode City
expiry date of visa
State Country
Country
Home phone no.
Visa type

Visa expiry date D D / M M / Y Y Y Y Mobile no.

E-mail Address (required)

Residency Status (Please 3 one)
u Resident u Permanent Residency
Residence Type (Please 3 one)
u Malaysia My 2nd Home
u Non-Resident, please specify Country of Residence u Employer’s Quarters u Family Home / Relatives
u Own (Mortgaged) u Own (Not Mortgaged)
u Rented
Race
u Malay u Chinese u Indian Relationship with main applicant

u Others, please specify u Spouse u Child u Relative

u Business Partner u Sibling u Parent
Gender u Male u Female u Others

EMPLOYMENT DETAILS (JOINT APPLICANT/GUARANTOR)

Employer Name Office Address

Office phone no.

Postcode City
Gross Monthly Income Other Monthly Income State Country
RM RM

V2018.0063.1.0 [Page 3]
 EMPLOYMENT DETAILS (JOINT APPLICANT/GUARANTOR)... CONTINUE
Occupation (please select code from list in appendix) Type of company (Please 3 one)
Code u CIMB Group u MNC (Non FI)
u Government Agency u KLSE listed
Employment Type (please select code from list in appendix)
u Financial Institution u Private Limited Company
Code
u Public Ltd Company u Sole Proprietorship/
Employment Status - Not Listed Partnership

u Permanent u Contract u Temporary u None/Unemployed

u Others
Employment Sectors (please select code from list in appendix)
Code Size of current employment company (Please 3 one)

Length of Service Total Working Experience u <15 employees u 15-50 employees

Y Y / M M Y Y / M M u >50 employees

FACILITY DETAILS
Purpose of facility Product name
u Purchase u Refinance u Top-up u Cash-out

Owner occupied u Yes u No First time property purchase u Yes u No

Reason for enhancement/cash out
u Renovation u Personal use/education

FACILITY AMOUNT
Housing/Term Loan/Home/Term Financing Other (GMRTA/GMRTT, Legal and Valuation fees)
RM RM

Margin of finance % Term Y Y

PROPERTY VALUE
Purchase price Indicative market value
RM RM

INSURANCE/TAKAFUL (PLEASE SELECT OPTION)

u I wish to apply for Insurance/Takaful*

For Conventional financing : Berjaya Sompo Insurance Berhad
u Home Safe Plus Plan 1* u Home Safe Plus Plan 2* u Houseowner*
For Islamic financing: Syarikat Takaful Malaysia Berhad
u Takaful myHouseowners*
u I wish to apply for GMRTA/GMRTT insurance/takaful policies underwritten by SunLife Malaysia/Sun Life Malaysia Takaful Berhad
Insured/Covered applicant Insured/Covered amount (RM) Term insured/covered (years)

u I wish to apply from another insurance company/takaful operator for the following product
u Fire/Houseowner u GMRTA/GMRTT
* Kindly refer to the relevant Product Disclosure Sheet for detailed description of these policies.

[Page 4]
 PROPERTY DETAILS
Property type
Title type u Individual u Strata u Master
u Residential u Commercial u Land
Title status u Freehold u Leasehold
Property description
Specify expiry date of lease D D / M M / Y Y Y Y

Land Area Built up area Property Address

Postcode
Construction status (if applicable)
u Completed u Under construction Title number Lot number

% of completion
Sub-district District
Source of property
u Developer u Vendor u Auctioned u Refinancing State
u Others

OWNER’S DETAILS (FOR THIRD PARTY ONLY)

Owner’s Name 1 Owner’s Name 2

NRIC / Passport no. NRIC / Passport no.

*For Passport holders please indicate your passport expiry date *For Passport holders please indicate your passport expiry date
D D / M M / Y Y Y Y D D / M M / Y Y Y Y

Relationship with main applicant Relationship with main applicant

FOR COMPANIES WHO ACT AS REGISTERED OWNER, KINDLY FILL IN THE INFORMATION BELOW
Company Name Company Registered Number

Industry Sector (please select code from list in appendix)

Code

UNDER CONSTRUCTION PROPERTY

Project name Developer’s name

Phase

REFINANCING PROPERTY
Current Financier (if applicable) Bank Account Number with current financier (if applicable)
u Master Account Number
Outstanding Amount Financial Institution Code
RM u Sub Account Number

[Page 5]
 SECONDARY MARKET PROPERTY
Vendor name u Other Identification no.
u Passport u Army/Police
u Others, please specify
Vendor’s NRIC
Specify number

*For Passport holders please indicate your passport expiry date

D D / M M / Y Y Y Y

AS FINANCING EXTENDS BEYOND MY/OUR RETIREMENT AGE, I/WE PROPOSE TO SETTLE/REDUCE THE
FINANCING VIA THE FOLLOWING:

u Withdrawal from EPF u Proceeds from investment

u Pension provisions or contracted annuity payments u Refinancing to be undertaken by children
u Proceeds from Insurance/Takaful policy cash value u Other manner, please specify

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

ALL APPLICANTS
u Copy of applicant’s NRIC/Passport u Latest EA Form/Form B with proof of tax payment/EPF Statement
u Latest 3 months’ bank statements u Sale and purchase agreement OR booking receipt OR copy of title deed
u Valuation report (if available) u Latest loan/financing statement (if refinancing)
SALARIED APPLICANTS SELF EMPLOYED APPLICANTS
u Latest 3 months’ salary slip u Profit and loss statement
u Employment letter 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;jse
ssionid=HWBdbXB4i5kwMZvndb6Fog__?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)

[Page 6]

u CIMB Bank Berhad (13491-P)
CREDIT CARD/CREDIT CARD-i APPLICATION FORM
(MAIN APPLICANT)
Branch Code
Employee No.
u CIMB Islamic Bank Berhad (671380-H)
Please tick (3) where applicable
u New Card u Additional Card

REQUIREMENTS

Age Principal Card : 21 years old Supplementary Card : 18 years old

Minimum Enrich World Elite Visa INFINITE Enrich World Mastercard World Mastercard Visa SIGNATURE Platinum
Income
Per Annum RM250,000 RM120,000 RM100,000 RM90,000 RM60,000 RM24,000

I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE CHOOSE A MAXIMUM OF 3 CARD PRODUCTS ONLY)

A. CIMB BANK CREDIT CARD

u CIMB Enrich World Elite u CIMB Enrich World Mastercard u CIMB Enrich Platinum
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 Malaysia Airlines Berhad (1116944-X), its successor or any of
its related companies which upon receipt of my information herein will then consider my application for the same.

u CIMB Visa INFINITE u CIMB Platinum Mastercard u CIMB Cash Rebate Platinum
u CIMB WORLD Mastercard u CIMB Visa Platinum u CIMB PETRONAS Platinum
u CIMB Visa SIGNATURE
u CIMB Tesco Platinum
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.

B. CIMB ISLAMIC CREDIT CARD-i

u CIMB PETRONAS Gold-i u CIMB Platinum-i

By signing here, I acknowledge and confirm making the declaration/
disclosure appearing under the caption of ‘For All Products’, ‘Declarations
for Financing Products’ and ‘Product Specific Declarations For Credit
Card/Credit Card-i’.
Important Note: Principal Credit Card-i/Credit Card Applicant’s Signature :
(1) Additional credit card-i/credit card will share a combined credit limit.
(2) Please sign within the signature box.
Date : D D / M M / Y Y Y Y

MY PERSONAL DETAILS
Credit Card statement will be sent to your e-mail provided in the application form. For existing cardmembers, your other statements will also be sent tot his e-mail address.
Name to appear on card (Not more than 19 letters) Mother’s Maiden Name

MY EMERGENCY CONTACT
Name Relationship to principal cardmember / applicant

Contact no.

CIMB Touch ‘n Go Zing AUTOMATIC RELOAD AMOUNT

CIMB Touch ‘n Go Zing Card (Touch ‘n Go card linked to CIMB Bank / CIMB Islamic Bank Credit Card)
u I would like to apply for 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, the Bank will automatically set the default reload amount to RM100.

Customer’s NRIC / Passport No. : [Page 7]


u CIMB Bank Berhad (13491-P)
CREDIT CARD/CREDIT CARD-i APPLICATION FORM
(JOINT APPLICANT)
Branch Code
Employee No.
u CIMB Islamic Bank Berhad (671380-H)
Please tick (3) where applicable
u New Card u Additional Card

REQUIREMENTS

Age Principal Card : 21 years old Supplementary Card : 18 years old

Minimum Enrich World Elite Visa INFINITE Enrich World Mastercard World Mastercard Visa SIGNATURE Platinum
Income
Per Annum RM250,000 RM120,000 RM100,000 RM90,000 RM60,000 RM24,000

I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE CHOOSE A MAXIMUM OF 3 CARD PRODUCTS ONLY)

A. CIMB BANK CREDIT CARD

u CIMB Enrich World Elite u CIMB Enrich World Mastercard u CIMB Enrich Platinum
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 Malaysia Airlines Berhad (1116944-X), its successor or any of
its related companies which upon receipt of my information herein will then consider my application for the same.

u CIMB Visa INFINITE u CIMB Platinum Mastercard u CIMB Cash Rebate Platinum
u CIMB WORLD Mastercard u CIMB Visa Platinum u CIMB PETRONAS Platinum
u CIMB Visa SIGNATURE
u CIMB Tesco Platinum
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.

B. CIMB ISLAMIC CREDIT CARD-i

u CIMB PETRONAS Gold-i u CIMB Platinum-i

By signing here, I acknowledge and confirm making the declaration/
disclosure appearing under the caption of ‘For All Products’, ‘Declarations
for Financing Products’ and ‘Product Specific Declarations For Credit
Card/Credit Card-i’.
Important Note: Principal Credit Card-i/Credit Card Applicant’s Signature :
(1) Additional credit card-i/credit card will share a combined credit limit.
(2) Please sign within the signature box.
Date : D D / M M / Y Y Y Y

MY PERSONAL DETAILS
Credit Card statement will be sent to your e-mail provided in the application form. For existing cardmembers, your other statements will also be sent tot his e-mail address.
Name to appear on card (Not more than 19 letters) Mother’s Maiden Name

MY EMERGENCY CONTACT
Name Relationship to principal cardmember / applicant

Contact no.

CIMB Touch ‘n Go Zing AUTOMATIC RELOAD AMOUNT

CIMB Touch ‘n Go Zing Card (Touch ‘n Go card linked to CIMB Bank / CIMB Islamic Bank Credit Card)
u I would like to apply for 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, the Bank will automatically set the default reload amount to RM100.

Customer’s NRIC / Passport No. : [Page 8]

 DECLARATION/DISCLOSURE BY APPLICANT/GUARANTOR
These declaration shall apply to all CIMB Bank Berhad and/or CIMB Islamic Bank Berhad (“the Bank”), as the case may be, being the licensed
financial institution granting the Property Financing referred to in the application form(s).
I/We hereby consent and authorize the bank to disclose my/our loan/financing application status and any other relevant loan/financing details to Property
Developer and/or Real Estate Agent or any of their authorised agents. I/We agree to be bound by the Bank’s Terms and Conditions for E-Mail Statement
Delivery available at the Bank’s website - www.cimbbank.com.my/www.cimbislamic.com.my in respect of all my/our statements requested to be sent to me/
us by e-mail. Where I/we have a CIMB Clicks Internet banking (“CLICKS”) and have requested to view all my/our CIMB Bank/CIMB Islamic facility/account
statement via CLICKS. I/We agree to be subject to the Terms and Conditions for e-statement accessed via CIMB Clicks published on CIMB Bank/CIMB
Islamic Bank website. I/We agree that I/we will not receive hardcopy Statements nor will I/we receive Statement(s) via E-mail.
For Home Safe Plus/Houseowner (Underwritten by Berjaya Sompo Insurance Berhad), Takaful myHouseowners (Underwritten by Syarikat Takaful
Malaysia Berhad) and GMRTA/GMRTT (Underwritten by Sun Life Malaysia/Sun Life Malaysia Takaful Berhad) (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 the Bank sharing the information contained in
this application form with the Insurance Company selected by me/us which upon receipt of my/our information herein will then consider my/our application
for the same.
For Withdrawal From Employee Provident Fund (“EPF”)
I/We hereby irrevocably consent to the Bank disclosing any information pertaining to my/our facility and all matters relating thereto to the EPF, whenever
requested by EPF, to facilitate my/our application for withdrawal of monies from the EPF.
For Property Financing under the Special PR1MA End Financing (“SPEF”) Scheme with or without Employee Provident Fund withdrawal
I/We hereby irrevocably consent to the Bank disclosing any information pertaining to my/our facility and all matters relating thereto to PR1MA Corporation
Malaysia and/or the Government of Malaysia and/or any other bodies, authorities and/or agencies in relation to the PR1MA programme.
For Property Financing under Corporate Employer Scheme (“CES”)
I/We hereby irrevocably consent to the Bank disclosing any information pertaining to my/our facility and all matters relating thereto to my/our employer in
relation to the CES from time to time during my/our facility tenure.
Main Applicant’s Signature Joint Applicant’s Signature

Date D D / M M / Y Y Y Y Date D D / M M / Y Y Y Y

Declaration/Disclosure by Guarantor and Registered Owner

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 applicant’s 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 Bank’s 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.
By signing below, I/we acknowledge and confirm making the declaration/disclosure appearing under the caption of ‘For All Products’ and ‘Declarations for
Financing Products for Property Financing’.
Guarantor’s/Registered Owner’s Signature Guarantor’s/Registered Owner’s Signature

Date D D / M M / Y Y Y Y Date D D / M M / Y Y Y Y

BANK USE ONLY

For Property Financing
Salesperson Name Fire Insurance/Takaful
u Home Safe Plus u Houseowner
Salesperson I/D GMRTA/GMRTT
Sales Team/Branch Code u Yes - Self finance u Yes - Bank financed u No
Referrer Name
Free Moving Costs u Yes u No

Referrer I/D

Applicant Name Verified by SD Doc No.

NRIC No. Name of Manager*

*Confirmed the required forms are duly completed

and signed