INCOME DECLARATION FORM

To be filled up by Mother/ Father/ Guardian who are Self-Employed/ Unemployed/

No Payslip

APPLICANT’S DETAILS
Applicant’s Name:

NRIC No.:

FATHER’S DETAILS / GUARDIAN 1 MOTHER’S DETAILS / GUARDIAN 2

Name: Name:

NRIC No.: NRIC No.:

Mobile No.: Mobile No.:

Occupation: Occupation:

Job Description: Job Description:

Work Address: Work Address:

Currency: Currency:

Annual Income: _______________________ / year Annual Income: _______________________ / year

I hereby declare that all information furnished is true. I understand that MAYBANK reserves the rights to
terminate my application/scholarship without notice or compensation at any time should MAYBANK
discover that any of the said particulars was false, untrue or incorrect.

Father / Guardian 1 Signature Mother / Guardian 2 Signature

VALIDATION
I hereby declare that all information furnished above is true.

_________________________________________________
` (Signature and Official Stamp)

Name : ........................................................................ *Validation can only be made by:

Commissioner of Oaths
NRIC No. : ........................................................................

Designation : ........................................................................

Date : ........................................................................