Great Wl DIRECT CREDIT FACILITY FORM “Eastern il 1 Ths Diet Grad! facity is only avaiable for accounts maintained in harks parte/patig in the Imerhank GIRO payment system (18) in Malaysia 2 This Dect Cred! facty is naa owed for ry join! bank accnunts unas Ine Paley Owner Payer is tne primaty account rode 43, We vesaive fe rig lo feease payment by cheque "the even of (a) eulcentincorect information having beng provided 1 ths. Dect Credit Fac form, f) payment being made to joint Payaes (e.g, inl alministatore a” a.m executors, anda! (6) falure of Wansle’ to ne bone cary ‘bank for any eas wratsoe Payee “eles to any persenicompary who's the person enttied io ine Palcy monies, €9. poievowne. ile aaaured, nominee, assgnee, iustee, Puble TusteeiAmanan Raya, executo executis, administateadmin strain. ofr group employee benef poicies, emplayer. In aiaion toa Payee" who # 2 minor, payments shal anly be made io accounts maintained by the parent or ity gual Pei] af if ie Name of Policy Owner Payee" NRIC No. / Company Registration No, *asma sin Poy ra Bonk Accout ‘Group Scheme Number * only apical or Gra fsa Policy No, Cerificate No. Contract No f7 3 PllTrttftto.itl 7 Berefciry Bank Bank Account Ne ‘Account Tingle Accant Toi Rosaomt ae {Oni mw Pay Onrer/ ayes shri scr ce) Email Address (mandatory) Modi@ (mandatory) + oxanpie 012-58 670 (Malaysia) POLIGY OWNER PAYEE AUTHORIZATION We hereby: 1. Instuet the Company to payinte my Jour Acccunt al the future amount payable i me/us a'sng from vansactions effected tough the above poicy (es) unt tis struction expressly revoked 'n writing of eplaced, 2, Contin tal lam the Account nolde’ and have fl power and aulnoriy To operate the Account fn espec ofa partnership oF a body corporate, ‘we further confirm that he person sigring Ins form's the author ged Signaler forthe. Accours, and have fll power and autnoriy 0 operate he ‘Recount ‘8, Canfirm thatthe information provided by me /us i his form ia tse and correct and undertake to immediately inform the Company of ay range inthe same and vill not hold tne Company Table inthe event that any payment transaction into my / our Account is dlayed or cannot be etfected dus to incorrect or ineampete information beng provided s ths form, andor for anyother reason bayond the reasonable contro af the Compa 4, Understand tat the Company has the right to reject this sanding instucton in he avert that ti found tobe payable toa third party accourt. Iwo algo understand nat ine. Campany may in te absolute dsoreion terminate nis Dect Cradt sendee at anytime and wihout assigning any reason(s) therefor '5, Agree to mmedatalyretund 0 the Company in ull any monies paid into the Account whichis paid in avvor ar which lam / we are atnewise not, fanttled to rece ve. 6, Dacia that im relation to payments made by he Company ito the above Account, 1/ We ‘a seknowiedge and agree tia! payments made by tha Company info the above-mentioned Account shal be a vad dicnarge of the Companys Tabiity under tne poey(es), and iat the Company sha not Be lade Tor any damages, oases, clams, costs andor expenses wrich may indut ‘ising iam such payments agree to Heep the Company indemafed of any damages, asses, claims, cost anda’ expenses incured by the Gompary in defendina any ‘Gaim arsing trom andi’ connection win Mis inatuct on 7, Decava that | amet an uidiscnarged bankrupt [in respect ofa partnership er a body corporate]. We declare that no order has been made, petiion fled or eseluion passed lor cur winding up, dissolution or iquidation er forthe apporniment ofa iquidater, receiver, custedian or rustee fora! or ay part of cur property or asses 0” fo an admin stration order aga net us 8, Agree that Ihe persona dala provided inns farm may be recorded, ised, dscosed, processed and stored by the Company fo" Ihe purpases ‘atating to the payment ot kinds. 'n accordance witn my /qur nsitutions neve.n, and for Ine purposes of compliance wi any legal oF feQualary ‘equrements Sonanre Payee Name: ‘Signature af Wines Name: bate oonawrn, NAIC Ne, For Office Use: ee Lerche Addvess: Branch Code! eject Reason: (CSD-FDGFF-V02-082016 (ENG) rere Gre Eso 30s Arg 900 fe rr 662399757 Website: groves ‘ ttecom Ernalt wecaranySgreiensl. cmIll_ DISCHARGE VOUCHER FOR WITHDRAWAL/SURRENDER FOR INVESTMENT-LINKED PLANS BAUCER PELEPASAN UNTUK PENGELUARAN/PENYERAHAN ara UNTUR PELAN SERKAIT-PELASURAN (PSF33 Poicy Ne, [New NRG No, (O18 NRIGIBInn Cantfeate/Passpon No. “"Piease tick the appropriate box Sis ianavan gin ayy |; he Polcy Quner of ne above mentoned Poicy would ike ake ine folowing scion wilh regard to miyiavastment- Inked policy, on The Understand'ng thatthe effacve price wl be aa at tne data Grea! Eastern Life Assurance (Malaysia) Berhad racsivestns fly completed application and equrements maniac oer rosa ba Salty Davai BBO Harps te HAN Cid © Benno inn osoosed Sonam ye mea (A. PARTIAL WITHDRAWAL ASiii.7, GAGAN SEGANAGIAN TI would ike to eect partal windianal as folows i/n hye mania sampaoe ‘The selection below is only appiicable to paliy wih folowing accounts: 1 Insurance Premium Account (IPA) A: 803 A [Bl Top-Up Premium Account (TUPA) 1 Akaun Dana Pendiikan (ILES) FUND TYPE. SHG BANA FUND TYPE ‘Withdrawal Amount in weno 8 Auta Peg sai late aM Units FM Uns ES att ime a Tor tin Bancea Fund) Dict sires Tire Lon rowh Fund) Oreo Bana esu ir) Dre lon Fed come Fund L) roe Lor Pogessie Fund TIF? on Emences Eau Find | Di Foe bana Seat Fre bana Gerniana it) TF09 Lon Saiogs Fund 0) D1 £22 Lion Smal Mid Gap th) ote ‘avanead Seago Ford [Saag Rat Dene See ae ome wea IaH RTE Wasa Sond Ts Pease incate amount n AM value Number of Unis" or nfeate“Al it ye request isin AIM value, the numberof units fa be cancelled wl be amount requastedieffective price 1 request 's in Number of Units, the amount to be psd wl be the number of urits requested times eflecive pce 12 request is fr"All Uns", the umber of units avalabie wil besa Ie dle th's appieaton and requirements are received by the Company Lunderstane tat: [a)” The Company ‘eserves te right o eject my application snoud the amount be less than the limits sat by te company. [b) The Base Sum Assured and Living Assurance Benelli Sum Assured (i appeabe) may’may not be adjisied upon wtndrawal rom the Unit Funds (depending on the poley canditons) and mat he poly wil be endorsed accorcingy. {o) The cutoff imo for Foreign Fund (F)'s 11-O0am and Local Fund (L) 83:00pm. Forms suomited to ow Office ator the cut ime sal be ne Pampane i) B. FULL SURRENDER NAN ROL SERENA TH would ike to surrender my poy afl We 9¥e Great Easter Life Assurance (Malaysia) Berhad full and complete dacnage of is abilities Poley and of any fur clams, which could be made against iby vite of by melus ar by anyone whomsoever ‘SSFonce Mrmr Sate St eer esate Pagetoi2 1762259327 I Sie uiene ayegacastnne om ce wegen oS0.PS35.v10-092020PLEASE NOTE: {a} The actual amount payable shal be issued only ater the unit pce is avaiable {b) Signatures) of tne Policy Owner andi: persans giving consent on this form should be sintlar tothe signature in ur racords and must be witnessed by atid pary wih no benefeal interest (c) The Gompany requites a photocopy of the deat Card/Passpot ofthe Policy Ouner/Absolute Assignee (where applicable) (4) tis mandatory to submit Direct Credit Faciity Form. SiL4 Abbie PEAHATIAN |} Pengtimanaren Boreas Kemutishen Reece Pacis ctoh suntan ena / / Day See Month Bisse Year “Slonaure of Paley Oper eam Teste) TprureotWiness INRIC No. 83? Te Ne, “STATEMENT OF WITNESS. KEWYATAAN SA0S¢ Tareby witness and catty thatthe signata(s) inthis form wasiwere made before me and tha to my ovm personal krowadge itis te signature(s) the Poly Ownerite ASsurediAss greeNoninee Trust Boley Ne, 2 Paiey ner 963 consent as trust, f appicabie CONSENT FOR APPLICATION FOR PART WITHDRAWAL'SURRENDER KESENABAN UNTUK PERMOMONAN PENCE UABAN SERABABENTER AMAR le, ne ruses) NonneesyParen af te Nong\syCondional ASS gee, hereby ierocaiy and uncondionaly ive my consent he Poicy Owner to de ie pata wihdrawa surrender requested Ine turner agiae that we shal hold be Company harmess in respect of any and all consequences and ings which may arise as ares a is comotance win ine Poicy Onna nstuctons 0 ayo ih stove dead and cs ‘Signature of Trustee / Nominee / Parent of Nominee! Signature of Winess* Gandtional Assignee rao Sue si ee Pecan (Pesan aint Siatorent cl Winws) Name i INRIC No. KP Date “ne: ‘Signature of “Trustee / Nomi Conditonal Assignee igre! Pansa9 Sere 6 Br oa Name figmee Name Semon; NRIC No. *:. XP RIC No, 80% Date Tose: Tel No, * Please delete wrichever nat applicable = 1p san Fes boners _Naie: Ie policy is eandtionaly assigned, consent s equred from the conditional assignee OR if you are a Non-Muslim and your eurent rominee(s) sire your spouse, cid or parent ("you have ne spouse ar ch vng athe time of nominator, thea your poly s deemed tobe a ‘rust policy. Therefore, consents requited from the rusiee(s) ofthe policy If here's no tustee appoinie, (a) tne nominee wo 's competent 12 Contset, GF (b) unere te nominee's incompetent o contact, he parent eine ncompetent nominee (ine! han Ihe Poley Owner), where there 'S no surviving paren, the pubic ston shal be the Vustoe ofthe policy src fe ory sear Sta pmgaNe 6 hk page 2ut? 0osiaseszi ll