Date Applied :

LOAN/FINANCING APPLICATION FORM

Please tick () where applicable. Complete all sections in block letters with a BLACK-inked pen. All fields are mandatory to be
filled up to process your application, except those indicated with “*". Please ensure each box represents one alphabet.

MY/OUR PERSONAL DETAILS

1. MAIN APPLICANT
Nationality : Ethnicity :
TITLE * Mr Miss Madam Others
: : Malaysian Bumiputera
Full Name as per NRIC :
Others : Non - Bumiputera

Race :
Malay Indian

Chinese Others :

NRIC/Passport : Old IC No / Other ID :

Home / Permanent Address : Date of Birth : Age :

Marital Status :

Single Married Others :

No Of Dependent : Gender :

Female Male

Hand phone No :
Owned Family Mortgage Rented RM : -
/month
City :
Home Telephone No :

State :
Statement Delivery Address :

Home Office Correspondence Email

Postcode : Highest Education Level :

Email :

Correspondence Address :

City : Postcode :

State :

Loan/Financing Application Form v1.18–Oct 2021 Page 1 of 22

 2. MAIN APPLICANT – Current Employment
3. Employment Type:
Employer ( 111 )
Government Employee ( 112 )
Employment Category:
Employment Type:
AmBank Employee
Infant/ Child/ Minor
Self Employed (with salaried
employee(s))
Private Employee ( 113 ) Self – Employee ( 115 ) Unemployed ( 112 )
Reporting Entity (RE) Employee ( 114 ) Unpaid Family Worker ( 116 ) Outside Labour Force ( 200 )
Retiree/ Pensioner Student Unemployed ( 112 )
Self Employed (with no
Salaried Employee-Contract Salaried Employee-Permanent
salaried employee(s))
Housewife/ Househusband/
Unpaid Family Worker
Homemaker

Company Name :

Nature of Business : Job Function :

Occupation :

Office Address :

City : Postcode :

State : Office Tel No :

-

Gross
: Monthly Income : RM Other Income : RM Years Of Service :

Years : Months :

Occupational Code : Job Sector :

: :
FOR OFFICE USE ONLY
Preferred Company Code :

3. MAIN APPLICANT – Previous Employment ( If current employment is less than 2 years )

Company Name :

Nature of Business : Designation :

Office Address :

City : Years Of Service :

Years : Months :

Loan/Financing Application Form v1.18–Oct 2021 Page 2 of 22

 State : Postcode :

:
Occupational Code : Job Sector :
FOR OFFICE USE ONLY
Preferred Company Code :

4. MAIN APPLICANT – Emergency Contact ( Spouse )

Full Name as per NRIC :

Home / Permanent Address :

City :

State : Postcode :

Handphone
: No : House telephone No :
-

-
5. MAIN APPLICANT – Emergency Contact ( Next-Of-Kin (residing separately) )

Relationship :

Full Name as per NRIC :

-

Home / Permanent Address :

City : Postcode :

State :

Handphone
: No : House telephone No :
-

Loan/Financing Application Form v1.18–Oct 2021 Page 3 of 22

 MY/OUR PERSONAL DETAILS JOINT APPLICANT GUARANTOR

RELATIONSHIP WITH MAIN APPLICANT Spouse Others. Please specify :

1. JOINT APPLICANT/GUARANTOR
Nationality : Ethnicity :
TITLE * Mr Miss Madam Others
: : Malaysian Bumiputera
Full Name as per NRIC :
Others : Non - Bumiputera

Race :
Malay Indian

Chinese Others :

NRIC/Passport : Old IC No / Other ID:

Home / Permanent Address : Date of Birth : Age :

Marital Status :

Single Married Others :

No Of Dependent : Gender :

Female Male
Handphone No :
Owned Family Mortgage Rented RM : -
/month
City :
Home Telephone No :

State :
Statement Delivery Address :

Home Office Correspondence Email

Postcode : Highest Education Level :

Email :

Correspondence Address :

City : Postcode :

State :

Loan/Financing Application Form v1.18–Oct 2021

Page 4 of 22
 2. JOINT APPLICANT/ GUARANTOR – Current Employment
Employment Type:
Employer ( 111 ) Private Employee ( 113 ) Self – Employee ( 115 ) Unemployed ( 112 )
Government Employee ( 112 ) Reporting Entity (RE) Employee ( 114 ) Unpaid Family Worker ( 116 ) Outside Labour Force ( 200 )
Employment Category:
Employment Type:
AmBank Employee Retiree/ Pensioner Student Unemployed ( 112 )
Self Employed (with no
Infant/ Child/ Minor Salaried Employee-Contract Salaried Employee-Permanent
salaried employee(s))
Self Employed (with salaried Housewife/ Househusband/
Unpaid Family Worker
employee(s)) Homemaker

Company Name :

Nature of Business : Job Function :

Occupation :

Office Address :

City : Postcode :

State : Office Tel No :

-

Gross Monthly Income : RM Other Income : RM Years Of Service :

:
Years : Months :

Occupational Code : Job Sector :

: :
FOR OFFICE USE ONLY
Preferred Company Code :

3. JOINT APPLICANT/ GUARANTOR – Previous Employment ( If current employment is less than 2 years )
5. 6. Company Name :

Nature of Business : Designation :

Office Address :

City : Years Of Service :

Years : Months :

Loan/Financing Application Form v1.18–Oct 2021 Page 5 of 22

 State : Postcode :

:
Occupational Code : Job Sector :
FOR OFFICE USE ONLY
Preferred Company Code :

4. JOINT APPLICANT / GUARANTOR – Emergency Contact ( Spouse )

Full Name as per NRIC :

Home / Permanent Address :

City :

State : Postcode :

Handphone
: No : House telephone No :
-

-
5. JOINT APPLICANT / GUARANTOR – Emergency Contact ( Next-Of-Kin (residing separately) )

Relationship :

Full Name as per NRIC :

-

Home / Permanent Address :

City : Postcode :

State :

Handphone
: No : House telephone No :
-

Loan/Financing Application Form v1.18–Oct 2021 Page 6 of 22

 MY/OUR APPLICATION

HOUSE/PROPERTY LOAN/FINANCING

AmBank (M) Berhad AmBank Islamic Berhad

Main Facility : Main Facility :

Home Loan HomeLink Home Loan PR1MA Home Financing - i Property Financing - i
Property Loan PropertyLink Term Loan Term Financing - i

BNM Affordable Home Scheme for First Time House Buyers : BNM Affordable Home Scheme for First Time House Buyers :

Home Loan – Scheme 2 ( FTHB ) Property Financing-i – Scheme 2 ( FTHB )

Additional/Sub-Facility : Additional/Sub-Facility :

Overdraft Others : Cash Line Facility-i Others :

Special Scheme/Tagging Special Scheme/Tagging

My First Home Scheme My First Home Scheme
EPF Ring Financing. EPF RF Amount
: MRTA MRTT MLTA Financing Cash
Purpose of Financing :
Main Applicant :
Refinancing Sub-Sale Purchase From Developer
Sum Insured/
Top-Up Financing Others :
Covered : RM :

Loan/Financing Period : Years Tenure :

%

SPA Price : RM Joint Applicant / Guarantor :

Sum Insured/
Market Value : RM Covered : RM :
RM
Loan/Financing Tenure : %
RM
Amount
HOUSEHOLD GUARD ( complete properties only )
MRTA/MRTT/M
RM
LTA Amount : I/We agree to take not to take Household Guard with AmGeneral
Insurance (arranged by and applicable for AmBank (M) Berhad only
Other Financing RM
Amount Plan 1 (Sum Covered : RM30,000) Plan 2 (Sum Covered : RM40,000)

Total Financing Plan 3 (Sum Covered : RM50,000) Plan 4 (Sum Covered : RM60,000)
Amount : RM
Plan 5 (Sum Covered : RM70,000)

PARTICULARS OF PROPERTY TITLE

Purpose of Property Acquisition : Property type :

Investment Owner Occupied Refinancing

Land Status :
Leasehold. Expiry :
Freehold

Leasehold Period : Others :

1st Party 3rd Party : Justification :

Registered Owner/Purchaser :

Name :

NRIC/Passport No :

Loan/Financing Application Form v1.18–Oct 2021 Page 7 of 22

 Name :

NRIC/Passport No :

Name :

NRIC/Passport No :

Name :

NRIC/Passport No :

Address of Property ( applicable for both Primary and Secondary Market ) :

City : Postcode :

State :

FOR PRIMARY MARKET ONLY

Project Type : Project’s Name :

Tie-Up Direct

Developer’s Name :

Completion Stage :

Expected Completion Date : Completed with CCC/CF : Yes No

FOR Developer Code : Development Code :

BANK’S
USE Project Code : Postcode :

FOR COMPLETED PROPERTIES DIRECT PURCHASED FROM DEVELOPER ONLY

Developer’s Name :

Project’s Name :

FOR SECONDARY MARKET ONLY

Vendor’s name :

Vendor’s NRIC/Passport No: Relationship with Vendor :

Loan/Financing Application Form v1.18–Oct 2021 Page 8 of 22

 FOR REFINANCING ONLY

Redemption Balance : RM Cash-Out Amount : RM Monthly Installment RM :

Purpose of cash out :

TITLE PARTICULARS

Master Individual / Strata

Waiver of Private Caveat Obtained

Date : By :

Waiver of Private Caveat Required ( state reason ) :

Title No :

Lot/PT No :

Mukim/Pekan/Town :

District :

Encumbered.Chargee : Unencumbered

Built-Up Area : Sq Feet Land Area : Sq Feet

Sq Meter Sq Meter

PROPERTY VALUATION

Verbal Valuation Report

1. Date :

Valuer’s Name :

Valuer’s Branch : Valuer’s Code :

Contact Person :

Market Value : RM

2. Date :

Valuer’s Name :

Valuer’s Branch &

Valuer’s Code :
Code :

Contact Person :

Market Value : RM

Additional Special Tagging : Agent ID :

FOR
BANK’S 1. 3.
USE . ..
2. 4.
..

Loan/Financing Application Form v1.18–Oct 2021 Page 9 of 22

B1. CREDIT CARD

MDS Branch Code : Program Code :

FOR
BANK’s Introducer / Agent ID :
Bundle MQMK3 Bundle
USE
Gift Code :
Cross-Sell RDS : Cross-Sell

MAIN APPLICANT
AmBank (M) Berhad AmBank Islamic Berhad

SIGNATURE Priority Banking Visa Infinite Card1 SIGNATURE Priority Banking Visa Infinite Card-i1

Visa Infinite Card Visa Platinum Visa Infinite Card-i

Visa Signature Visa Signature-i

BonusLink Visa Signature Visa Platinum-i

BonusLink Visa Platinum CARz Visa Platinum-i

Cash Rebate Visa Platinum

UnionPay Platinum Card

1 Applicablefor AmBank SIGNATURE Priority Banking Customers only.

Credit Card Service Tax ( yearly) – Principal/Supplementary RM25 per Card

Credit Card Applicant’s Name :

Name to appear on Card ( maximum 19 alphabets ) :

Mother’s name ( for Security Purpose ) :

Card Delivery Address : Home Correspondence Office

Statement Delivery :
Please send my statement(s) for the Credit Card(s) selected above and all my other Credit Cards that I have with the Bank to my email. I
agree to be bound by the Bank’s terms and conditions for Email Statement Delivery in respect of all my Credit Card statements requested to
be sent to me via email.

I do not wish to receive my statement via email. Please send the printed copy of my statement to my address at my:
Home Correspondence Office

Note: An annual fee of RM12.00 is chargeable should the cardholder choose to receive printed copies of his/her statement(s).

SUPPLEMENTARY CARD REQUEST

Relationship with Main Applicant : Spouse Others. Please Specify :

TITLE * Mr Miss Madam Others

: :
Full Name as per NRIC :

NRIC/Passport No : Old IC / Other ID :

Loan/Financing Application Form v1.18 –Oct 2021

Page 10 of 22
Date of Birth (DD/MM/YY): / / Nationality : Malaysian Others :

Age: Ethnicity: Bumiputera Non - Bumiputera Gender : Male Female

:
Race: Malay Chinese Marital Status : Single Married :
:
Indian Others : Others :
: :
Address for Card Delivery :

Postcode :

Handphone No : Email :

Name to appear on Card ( maximum 19 alphabets ) :

Mother’s name ( for security purposes ) :

Nomination of Credit Limit :

Yes, I would like to nominate a credit limit for this supplementary Card application. Credit Limit : RM :

No, I do not wish to nominate. This Supplementary Card applicant will share my Current credit limit.

Note: In either of the above instances, the total combined credit limit cannot exceed the Principal Cardholder’s current approved credit limit. If no nomination
is made, the Supplementary Card will share the Principal’s credit limit.

REMINDER : The Supplementary Cardholder is hereby reminded to read and understand the terms and condition of this application before
signing below.

Signature of Supplementary Cardholder

Date :

Loan/Financing Application Form v1.18–Oct 2021

Page 11 of 22
B2. CREDIT CARD

MDS Branch Code : Program Code :

FOR
BANK’s Introducer / Agent ID :
Bundle MQMK3 Bundle
USE
Gift Code :
Cross-Sell RDS : Cross-Sell

JOINT APPLICANT / GUARANTOR

AmBank (M) Berhad AmBank Islamic Berhad

SIGNATURE Priority Banking Visa Infinite Card1 SIGNATURE Priority Banking Visa Infinite Card-i1

Visa Infinite Card Visa Platinum Visa Infinite Card-i

Visa Signature Visa Signature-i

BonusLink Visa Signature Visa Platinum-i

BonusLink Visa Platinum CARz Visa Platinum-i

Cash Rebate Visa Platinum

UnionPay Platinum Card

1 Applicablefor AmBank SIGNATURE Priority Banking Customers only.

Credit Card Service Tax ( yearly) – Principal/Supplementary RM25 per Card

Credit Card Applicant’s Name :

Name to appear on Card ( maximum 19 alphabets ) :

Mother’s name ( for Security Purpose ) :

Card Delivery Address : Home Correspondence Office

Statement Delivery :
Please send my statement(s) for the Credit Card(s) selected above and all my other Credit Cards that I have with the Bank to my email. I
agree to be bound by the Bank’s terms and conditions for Email Statement Delivery in respect of all my Credit Card statements requested to
be sent to me via email.

I do not wish to receive my statement via email. Please send the printed copy of my statement to my address at my:
Home Correspondence Office

Note: An annual fee of RM12.00 is chargeable should the cardholder choose to receive printed copies of his/her statement(s).

SUPPLEMENTARY CARD REQUEST

Relationship with Main Applicant : Spouse Others. Please Specify :

TITLE * Mr Miss Madam Others

: :
Full Name as per NRIC :

NRIC/Passport No : Old IC / Other ID :

Loan/Financing Application Form v1.18 –Oct 2021

Page 12 of 24
Date of Birth (DD/MM/YY): / / Nationality : Malaysian Others :

Age: Ethnicity: Bumiputera Non - Bumiputera Gender : Male Female

:
Race: Malay Chinese Marital Status : Single Married :
:
Indian Others : Others :
: :
Address for Card Delivery :

Postcode :

Handphone No : Email :

Name to appear on Card ( maximum 19 alphabets ) :

Mother’s name ( for security purposes ) :

Nomination of Credit Limit :

Yes, I would like to nominate a credit limit for this supplementary Card application. Credit Limit : RM :

No, I do not wish to nominate. This Supplementary Card applicant will share my Current credit limit.

Note: In either of the above instances, the total combined credit limit cannot exceed the Principal Cardholder’s current approved credit limit. If no nomination
is made, the Supplementary Card will share the Principal’s credit limit.

REMINDER : The Supplementary Cardholder is hereby reminded to read and understand the terms and condition of this application before
signing below.

Signature of Supplementary Cardholder

Date :

Loan/Financing Application Form v1.18 –Oct 2021

Page 13 of 22
 C. AmMoneyLine/AmMoneyLine Facility-i (PERSONAL LOAN/FINANCING)

FOR OFFICE USE ONLY Ch/Br Code : Agent Type/ID :

FINANCING DETAILS

Facility Applied :

AmMoneyLine ( AmBank (M ) Bhd ) AmMoneyLine Facility-i ( AmBank Islamic Bhd )

Applicant’s Name :

Purpose of Account :

House Renovation Holiday Settlement of Another Loan / Financing Account

Education Medical Fee Others :

Loan/Financing Amount :

RM2,000 RM10,000 RM20,000

RM50,000 RM100,000 Others :

Tenure ( Months )

12 24 36 48 60

Reducing Term Takaful (RTT) - coverage towards the financing amount in the event of death or permanent disablement. (This is only applicable
for AmMoneyLine Facility-i. )
I would like to apply for : RTT

Single Contribution : RM Tenure :

The final approval on my application, facility amount, tenure and prescribed rate are subject to AmBank’s/AmBank Islamic’s credit
evaluation. The Bank reserves the right to approve an amount or tenure different from applied by an applicant.

I confirm my acceptance of this facility if the approved amount is within the range of RM

to RM

DISBURSEMENT INSTRUCTION

Debt Consolidation Financing1

Bank’s Name :

Type Of Account :

Credit Card Personal Financing

Account Number :

Amount : RM

Bank’s Name :

Type Of
Account :
Credit Card Personal Financing

Account Number :

Amount : RM

Loan/Financing Application Form v1.18 Oct 2021

Page 14 of 22
 Bank’s Name :

Type Of Account :

Credit Card Personal Financing

Account Number :

Amount : RM

Bank’s Name :

Type Of Account :

Credit Card Personal Financing

Account Number :

Amount : RM

Bank’s Name :

Type Of Account :

Credit Card Personal Financing

Account Number :

Amount : RM

Bank’s Name :

Type Of Account :

Credit Card Personal Financing

Account Number :

Amount : RM

Cash-Out

I am aware that an AmBank/AmBank Islamic Savings/Current Account-i is required to facilitate the disbursement of funds under this financing.

Please credit the net loan/financing into my existing account below (after fees and charges deduction).

Please sign me up and credit the net loan/ financing amount (after deduction of fees and charges) into the account below.

Type of Account

AmBank Savings / Current Account AmBank Islamic Savings / Current Account-i

Account Number :

Amount : RM

IMPORTANT NOTES
1Please produce a copy of the latest credit card(s) and financing account statement(s) to facilitate debt consolidation application. Disbursement is not allowed
to existing AmBank/AmBank Islamic financing account. Disbursement can only be made to an active personal account. Dormant and joint accounts are not
allowed. A copy of latest account statement/savings account passbook is required as documentary evidence for the loan/financing to be disbursed to the
applicant.

Loan/Financing Application Form v1.18 Oct 2021

Page 15 of 22
 D. TERM LOAN / FINANCING-1 SECURED BY ASB/ASD 2 CERTIFICATE

Applicant Name :

NRIC No :

FINANCING DETAILS

Facility Applied : Security Type :

Term Loan ( Ambank ) Term Financing-i ( AmBank Islamic ) ASB ASB 2

ASB/ASB2 Membership No :
Loan/ Financing Amount : RM
Base Rate: %
Loan/ Financing Tenure : Years
Margin: % per anmun
DTA premium
DTA
RTT Contribution : RM RTT Option : Financing Cash

DTA/ RTT Tenure : Years

DOCUMENT ENCLOSED

All Application(s) : Salaried Applicant(s)

Copy of applicant’s NRIC/Passport Latest three (3) months’ salary slip

Latest three (3) months’ bank statements Letter from Employer ( if any )

Latest EA Form/Form B with proof of tax payment/EPF Self Employed Applicant(s)

Sale and Purchase Agreement or booking receipt or copy of title deed Audited Account

Business registration A & D or Return of Allotment of Shares (formerly

Valuation Report ( if available )
known as Form 24) and Notification of Change in the Register of
Latest loan/financing statement (if refinancing) Directors, Managers and Secretaries Form (formerly known as 49

Copy of ASNB Unit Trust Investment Holding statement (mini statement)

DECLARATION/DISCLOSURE BY APPLICANT/CO-APPLICANT/GUARANTOR FOR ALL PRODUCTS

1. I/We declare that I/We:

 have provided my/our information to the Bank in good faith and the same is true and correct, and I/we have not withheld any information which
might prejudice my/our application.
 hereby undertake and confirm that the transactions to be effected using the account(s) and monies or funds to be used for payment of the
account(s) are neither obtained from any unlawful sources nor related to any unlawful activities as defined under provisions of Anti-Money
Laundering, Anti –Terrorism Financing and Proceeds of Unlawful Activities Act 2001 and Strategic Trade Act 2010.
 hereby provide my/our consent to the Bank to conduct any verification of my/our credit standing/credit worthiness with BNM’s Central Credit
Reference Information System (CCRIS) and any credit reporting agency in Malaysia registered under Credit Reporting Agencies Act 2010 or
from any other source that the Bank considers appropriate.
 hereby provide my/our consent to the Bank to share any of my/our information relevant to this financing application with a third party such as
credit reporting agencies in Malaysia registered under the Credit Reporting Agencies Act 2010, Fraud Bureau and/or other information-sharing
database for the purpose of detecting and/or investigating and/or preventing fraud and I/we shall not hold the Bank and/or such third parties
liable for any loss or damage arising from such sharing of my/our information and/or the processing thereof save and except where such losses
or damages were directly attributable to the Bank’s gross negligence, wilful default or fraud.
 hereby confirm that I/we have obtained the consent of the third party/parties referred to in this application form for me/us to disclose his/her/their
information to the Bank and for the Bank to use and/or process and/or share his/her/their information for the purposes stated herein.
 hereby provide consent to the Bank to conduct credit checks with any credit reporting agency in Malaysia and for the Bank to receive the credit
report containing my credit information from the credit reporting agency.
 enclose the relevant documents for the Bank’s consideration of my/our Application. I/We am/are aware and agree that all supporting documents
will not be returned to me/us.
 am/are not a close relative of the directors/controlling shareholders/executive officers/credit officers of the Bank or its related companies and
that none of them or their close relatives have stood as guarantors for any credit/financing facilities provided to me/us by the Bank. If otherwise,
I/we hereby wish to inform the Bank as follows:
No. Name of Staff I/C No. Relationship
1.
2.
3.

Loan/Financing Application Form v1.18 Oct 2021

Page 16 of 22
 2. I/We declare that I/we  have/ do not have outstanding payment obligation on debt from non-banks entities.
Financing Outstanding
No. Non-Bank Entities Facility Type Installment
Amount Balance
1 RM RM RM
2 RM RM RM
3 RM RM RM

3. I/We declare that I/we:

 do not have any bankruptcy or legal proceedings taken against me/us relating to any financial matters.
 have a bankruptcy or legal proceeding taken against me/us relating to certain financial matters.
Please provide details:
_____________________________________________________________________________________________________________
3A. I/We hereby acknowledge that all the related companies and associate companies of the Bank and its holding company (“AmBank Group”) have
zero tolerance towards all forms of bribery and corruption. I/We further undertake to the Bank that I/We shall not directly or indirectly offer, promise,
request from and/or authorize any form of improper payments, financial benefits, rewards or any valuable consideration (“Gratifications”) to or
from any of the Bank’s directors, officers, employees, representatives, agents or other persons associated with or controlled by or acting on behalf
of any of them (the “Bank’s Agents”) from any of my/our family members or any parties acting for or representing me/us in exchange for business
favors, information, favorable treatment, improper benefits or advantage or inducement to do or not to do something.

I/We shall undertake to immediately notify the Bank of any attempt by any parties to solicit or to give any Gratifications or solicit or give any
advantage (financial or otherwise) to or from the Bank and the Bank’s Agents. In furtherance to the above, I/We agree and undertake that:-

a) I/We has/have read, understood and shall fully comply with the Bank’s Anti-Bribery and Corrupt Practices Policy (“ABCP Policy”) and shall
promptly notify the Bank of any breach and/or suspected breach of the ABCP Policy. The ABCP Policy is available at
https://www.ambankgroup.com/eng/Pages/AntiBriberyCorruptPracticesPolicy.aspx;

b) Pursuant to the ABCP Policy, I/We shall fully execute the Bank’s anti-bribery and corruption declaration and return the duly executed copy
to the Bank for its record;

c) I/We shall strictly comply with current laws and regulations in Malaysia relating to anti-bribery or anti-corruption including but not limited to
the Malaysian Anti-Corruption Commission Act 2009 including all its amendments acts (“MACCA”); and

d) Notwithstanding anything stated herein, if at any time I/We or other third party(ies) acting for or representing me/us is/are involved in the
transaction contemplated in this matter breaches this clause and/or is being investigated for bribery or corruption, then the Bank shall be
entitled to terminate this transaction with immediate effect without any liability with written notice to me/us. When this happens, I/We shall
be liable to fully indemnify and hold the Bank and/or any of the Bank’s Agent harmless from and against any and all claims, losses, liabilities,
damages, penalties, costs and expenses howsoever arising as a result thereto.

4. I/We agree that the faxed / scanned copy of this Application Form received by the Bank shall also be deemed as my/our original and conclusive
application. I/We shall produce the original to the Bank upon request.
5. REMINDER: The Applicant is reminded to read and understand the terms and conditions of the Privacy Notice of AmBank Group which is made
available at AmBank branches and website.
AmBank/AmBank Islamic may, from time to time, offer products, promotions and services that may be of interest to you. Say ‘YES’ to great offers
and promotions from AmBank/AmBank Islamic.
 Yes, I/we would like to receive marketing promotions from AmBank/AmBank Islamic.
 No, not at this point of time.
I/We, hereby give my/our consent for AmBank/AmBank Islamic to process my/our personal data for the intended usage as stated under the Privacy
Notice. I/We, hereby, also confirm that this declaration will prevail over any previous declarations made by me/us.
Should you decide later that you no longer wish to receive any marketing promotions from AmBank/AmBank Islamic, all you have to do is notify
us by calling 03- 2178 8888 or email customercare@ambankgroup.com.
6. REMINDER: The Applicant is reminded to read and understand Product Disclosure Sheet(s) (PDS) and General Terms and Conditions (GTC)
for the relevant product(s).
7. I/We choose the following language for my/our contract:  English  Bahasa Melayu
8. No Other Mortgage Application
Save as has been disclosed to the Bank by me/us, I/we, neither jointly nor singularly: (i) am/are acquiring any other residential property which
requires me to apply for financing or (ii) am/are applying any loan/financing to finance/refinance the same property as my/our application herein
and I/we hereby undertake to immediately inform the Bank in the event that any of the aforesaid situation arises.
9. My First Home Scheme
I/We declare that for My First Home Scheme, I/we:
 am/are a Malaysian citizen(s) and am/are a first-time house buyer(s) and confirm the house is purchased for my/our own occupation.
 have not been granted any Government-related assistance in the form of subsidies, incentives, funds or any forms for the purchase of my/our
first home.
 Single Applicant: My monthly household income does not exceed RM5,000 per month
 Joint Applicants: Our monthly income does not exceed RM5,000 per month individually.
BNM Affordable Home Scheme
I/We declare that for BNM Affordable Home Scheme, I/we:
 am/are a Malaysian citizen(s) and am/are a first-time house buyer and confirm the house is purchased for my/own occupation.
 have not been granted any Government-related assistance in the form of subsidies, incentives, funds or any forms for the purchase of my/our
first home.
 my/our monthly household income does not exceed RM4,360 (Scheme 1) and RM5,000 (Scheme 2) per month.
MRTA/MRTT/MLTA (As per Application form)
I/We hereby agree that I/we wish:
 not to sign up for MRTA/MRTT/MLTA and further acknowledge that I/we or my/our next-of-kin is fully responsible to pay off the balance
outstanding of the financing amount in the event of Total Permanent Disability (TPD) or Death.

Loan/Financing Application Form v1.18 Oct 2021

Page 17 of 22
  to take partial MRTA/MRTT/MLTA and further acknowledge that I/we or my/our next-of-kin is fully responsible to pay off the difference of the
financing amount and the Sum Assured/Covered payable in the event of Total Permanent Disability (TPD) or Death.
 to take full MRTA/MRTT/MLTA.
10. Credit Card/i
i. Eligibility:
Card Type Platinum Card/-i UnionPay Platinum Card VISA SIGNATURE Card/-i VISA Infinite/-i
Minimum RM24,000 RM60,000 RM80,000 RM120,000
Annual Income
 Minimum age: Principal Cardholder - must be at least 21 years of age. Supplementary Cardholder - must be at least 18 years of age.
 For all Credit Cards, the annual fee is free-for-life with no conditions (except AmBank BonusLink Credit Card) and a yearly fee of RM12 is
chargeable for hardcopy statements.
 Applicant with income of RM24,000 to RM36,000 per annum is subjected to the following Credit Card guideline:
o Cardmember is allowed to hold Cards from two (2) Card issuers only with credit limit not exceeding two (2) times the gross monthly income.
ii. Over-Limit Fee:
 Please tick (✓) one of the boxes below to indicate your agreement to allow your card account to exceed the assigned credit limit. Please note
that any amount in excess of your assigned credit limit is provided at the Bank’s discretion and an Over-Limit Fee will be imposed on any
such amount.
 Yes, I allow my Card account to exceed the assigned credit limit for an amount at the discretion of the Bank and agree to pay the applicable
Over-Limit Fee of 2% of the amount above the credit limit or minimum RM50, whichever is higher. (For AmBank Islamic Credit Card, a fee of
RM50 is charged when service is triggered)
 No, I do not allow my card account to exceed the assigned credit limit#.
#
Not applicable for stand-in processing transactions and fees/management fee imposed by the Bank
iii. I/We hereby:
 accept that the Bank’s Credit Card offers and approval of my/our Credit Card application is subject to the competent regulatory bodies.
 understand that the Bank reserves the right to approve or decline this application. This application form and all supporting documents submitted
to the Bank shall be the sole property of the Bank and the Bank is entitled to retain the same in accordance with any applicable law, regulation
and/or the Bank’s internal policies, irrespective of whether my/our application is approved or rejected by the Bank.
 provide my/our consent to the Bank to share any of my/our information relevant to this financing application with a third parties such as credit
reporting agencies in Malaysia registered under the Credit Reporting Agencies Act 2010, Fraud Bureau and/or other information-sharing
database for the purpose of detecting and/or investigating and/or preventing fraud and I/we shall not hold the Bank and/or such third parties
liable for any loss or damage arising from such sharing of my/our information and/or the processing thereof save and except where such losses
or damages were directly attributable to the Bank’s gross negligence, willful default or fraud. I/We hereby confirm that I/we have obtained the
consent of the third party/parties referred to in this application form for me/us to disclose his/her/their information to the Bank and for the Bank
to use and/or process and/or share his/her/their information for the purposes stated herein.
 authorise the Bank to verify information from whatever source inclusive of the Director General of the Inland Revenue Department and by
whatever means that the Bank may consider appropriate.
 REMINDER: The Applicant is hereby reminded to read and understand the rules and regulations governing the use of the AmBank (M) Berhad,
and/or AmBank Islamic Berhad Visa Card / UnionPay. I/We agree to be bound by the Terms and Conditions specified in the AmBank (M)
Berhad, and/or AmBank Islamic Berhad Cardholder Agreement and including all future amendments thereto.
 Further agree that the Principal Cardholder shall be responsible for all liabilities and obligations of the Principal Cardholder as well as those of
the Supplementary Cardholder(s). The Supplementary Cardholder however shall only be responsible for his own liabilities and obligations.
 Further agree, authorise and permit the Bank to share or disclose all the information provided by me/us to its co-brand partner(s) and/or its
related corporations, where necessary to operate the AmBank Co-brand Credit Card(s) programme in order to provide me/us with services
relating to said programme, to communicate with me/us, to fulfill requests including redemption of co-brand partner’s points and for identification,
validation and verification purposes in relation hereto. I/We agree and consent to receiving SMS notifications from co-brand partner(s) and/or
its related corporations in relation to any matter relevant to the AmBank Co-brand Credit Card(s) which the Bank, co-brand partner(s) and/or its
related corporations may deem necessary from time to time.
 REMINDER: Applicant of the AmBank BonusLink Visa Credit Card is hereby reminded to read and understand the terms and conditions; and
the privacy notice that governs the BonusLink membership. The BonusLink membership terms and conditions is available on the BonusLink
website at www.bonuslink.com.my.
 Agree that the card application form in the Bank’s records shall be conclusive of my/our application for the Bank’s Credit Card.
 REMINDER: The Applicant is hereby reminded to be read and understand the definition and scope of a Connected Parties Transaction under
Section 47 of the Financial Services Act 2013 (‘FSA’)/ Section 57 of the Islamic Financial Services Act 2013 (‘IFSA’) and aware that he/she may
be convicted of an offence and/or be imposed with a fine/penalty under any applicable law and/or regulation in the event any declaration herein
is subsequently found to be false and untrue.
 Undertake to inform the Bank if I/we and my/our guarantor(s) and my/our immediate family members (parents, spouses and children) are related
to any present or future employee(s) of the Bank or the director(s) of the Bank.
11. AmMoneyLine/AmMoneyLine Facility-i
i. Minimum Requirements:
 At least 21 years old and above.
 Minimum Gross Annual Income of RM60,000 per annum.
ii. Upon the Bank’s approval and acceptance of my/our application for the Facility, the Bank shall issue a disbursement letter and credit the amount
of the Facility approved by the Bank into my/our indicated account notwithstanding that the Facility remains unused in the said account,
whereupon it shall be deemed an agreement for the Bank to make available the Facility that has been concluded subject to the terms in this
application, the disbursement Letter and also the Terms and that I/we shall be bound by the terms in this application, the disbursement letter
and also the Terms and no other formal documents are required to be executed between the Bank and I/us. In the event the Bank approves a
lower amount of the Facility than the amount stated in this application and subject to my/our consent/agreement, I/we hereby acknowledge that
the reduced amount approved and credited into my/our indicated account is the total amount of the Facility applied for and granted to me/us by
the Bank and shall not affect the validity of the terms in this application, the disbursement letter and also the Terms and in such an event
“Facility” shall mean the reduced amount of the approved Facility.
iii. Calculation of Total Interest/Profit
a) Total Interest/Profit: Loan/Financing Amount x Flat Interest/Profit Rate x Tenure:
e.g. RM30,000 Loan/Financing Amount x 8.50% Flat Interest/Profit Rate x 5 Years = RM12,750

Loan/Financing Application Form v1.18 Oct 2021

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 Effective Interest/Profit Rate (%)

Tenure (Months)
Interest/Profit
Rate (%)
60
12 24 36 48
14.13
8.00 14.45 14.68 14.55 14.35
14.92
8.50 15.34 15.55 15.40 15.17
17.26
9.99 17.95 18.14 17.90 17.58
20.30
11.99 21.44 21.55 21.18 20.74

Note: Interest/Profit Rates Rate are fixed for the entire loan/financing tenure. Final amount approved, loan/financing tenure and Interest/Profit
Rate is subject to credit review. Please be advised that the rates above are for illustration purposes only and the final Interest/Profit Rate may
vary between 8.00% p.a. to 11.99% p.a.
b) Calculation of Monthly Installment
M = L + (LxRxT1) M = Montly Instalment L = Financing Amount R = Profit Rate
T2 T1= Tenure In Year T2 = Tenure In Months

Using the same example as above, instalment to be paid per month is

M = RM30, 000 + (RM30, 000 x 8.50% x 5) = RM 712.50
60
iv. Fees and Charges
• Late Payment Charge
• 1% per annum on outstanding instalment. Calculation: Instalment in arrears x Late payment charge rate x (Days outstanding/365)
• Stamp Duty
As per Stamp Duty Act 1949 (Revised 1989). Stamping fee 0.5% of financing amount disbursed.
12. Term Loan/Financing-i Secured By ASB/ASB 2 Certificate
 I/We hereby authorise the Bank to examine my Eligibility to Purchase ASB/ASB 2 units for the purpose of loan/financing.
 In the event the Bank approves a lower amount of the Facility than the amount stated in this application, I/we hereby acknowledge that the
reduced amount approved is the total amount of the Facility applied for and granted to me/we by the Bank and shall not affect the validity of the
terms in this application, and also the General Terms and Conditions and in such an event “Facility” shall mean the reduced amount of the
approved Facility
  DTA/ RTT option:
 I/We wish to obtain insurance/takaful coverage from AmMetlife/AmMetLife Takaful (arranged by Bank)
 I/We wish to obtain insurance/takaful coverage from other companies (arranged by customer)
 I/We do not wish to obtain any insurance/takaful coverage

REMINDER: The Applicants are hereby reminded to read and understand the terms and conditions of
this application before signing below.

Signature for all Declarations above:

__________________________ ___________________________________
Signature of Main Applicant Signature of Joint Applicant/Guarantor
Date: Date:
Name: Name:
Note: IT IS A SERIOUS OFFENCE TO SUBMIT FORGED DOCUMENTS AND/OR INCORRECT OR MISLEADING INFORMATION IN THE
LOAN/FINANCING APPLICATION. The provision of this application form does not constitute approval and the Bank reserves the right to reject any
application by disclosing the reason. Unless otherwise stated, all fees/prices/charges/quotations indicated in this document are exclusive of any taxes
where applicable and shall be additionally borne by you.

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 PURCHASE REQUEST
Term Financing-i Secured by ASB/ASB2 Certificate
 AmMoneyLine Facility-i

For the purpose of this financing, I/we hereby make a request to AmBank Islamic (“Bank”) to purchase commodity# on my/our Undertaking to
Purchase (Wa’d) below.

Furthermore, if my/our purchase request is accepted by Bank, I/we understand that the Bank as my/our agent/representative shall sell the
commodity# on my/our behalf at the price equivalent to financing amount approved on my/our behalf and the proceeds will be disbursed in
accordance with General Terms and Conditions and the Approval and Disbursement Notice to be issued by the Bank upon approval of this Facility.

 I/We hereby acknowledge the Purchase Request and declaration above.

Undertaking to Purchase (Wa’d)
I/We hereby absolutely undertake to purchase from Bank, the same Shariah compliant commodity traded on a platform approved by Bank at
the Bank selling price, which is equal to the approved amount for the financing plus profit margin of the Bank.
 I/We have received a copy of the PDS.

REMINDER: The Applicants are hereby reminded to read and understand the terms and conditions
of this Purchase Request before signing below.

__________________________ ___________________________________
Signature of Main Applicant Signature of Joint Applicant/Guarantor
Name: Name:
Date: Date:
#
“Commodity” means Shariah-compliant commodity which includes but not limited to crude palm oil, oleo chemicals, rubber, cocoa and soya
products or such other acceptable commodities (excluding ribawi items in the category of medium of exchange such as currency, gold and silver),
traded on Bursa Suq al-Sila’ and/or any other available platform approved by the Bank.

UNDERTAKING TO PURCHASE (WA’D)

Term Financing-i secured by ASB/ASB2 certificate

 AmMoneyLine Facility-i

Upon the Bank’s purchase of the Shariah-compliant commodity pursuant to my/our Purchase Request, I/we hereby irrevocably undertake to immediately
purchase from the Bank, the same Shariah-compliant commodity at the Bank’s Selling Price which is the aggregate of the commodity cost equivalent to
the amount approved for financing plus the Bank’s margin of profit. As the purchaser of the commodity, I/we shall have the right to take delivery of the
commodity at my own cost and expenses. Breach of any of the terms of my undertaking herein given shall constitute an Event of Default under the
General Agreement. I/we hereby undertake to indemnify the Bank (forthwith upon demand by the Bank) for any claim, cost, expense, loss and damages
(each on actual cost basis, whereby loss of business opportunity and costs of funds are both excluded) that shall have been suffered by the Bank as a
result of such breach Provided Always that in such event of breach the Bank shall have invoked its rights under this Undertaking within two (2) days from
the date of discovery of the breach failing which this Undertaking to Purchase shall be deemed as revoked and shall be of no force and effect. Upon
fulfilment of our undertaking herein and in accordance with the terms herein given, this Undertaking to Purchase shall be of no further force and effect
whereupon I/we shall be deemed to have been discharged of my/our undertaking herein given. This Purchase Request and Undertaking to Purchase
shall be irrevocable (in the absence of any prior written consent of the Bank), binding on me and my/our successors in title, permitted assignees or heirs
and personal representative and shall be construed in accordance with law of Malaysia with the issuance of this Purchase Request and Undertaking to
Purchase.

REMINDER: The Applicants are hereby reminded to read and understand the terms and conditions of
this Undertaking to Purchase before signing below.
Yours faithfully,

__________________________ ___________________________________
Signature of Main Applicant Signature of Joint Applicant/Guarantor
Date: Date:
Name: Name:
IC No.: IC No.:

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 APPOINTMENT OF AMBANK ISLAMIC BERHAD AS PURCHASE AND SALE AGENT (“APPOINTMENT OF AGENT”)
Term Financing-i secured by ASB/ASB2 certificate

 AmMoneyLine Facility-i

From: (Principal’s Name)

To: AMBANK ISLAMIC BERHAD (“Bank”)

Date:

Sir/Madam,

Appointment of AmBank Islamic Berhad as Purchasing and Sale Agent Pursuant to the Term Financing-i ASB/ASB2/AmMoneyLine Facility-i
Facility (“Facility”)

I/We, the Principal, refer to the above matter and to the Term Financing-i ASB/ASB2 General Terms and Conditions/AmMoneyLine Facility-i General
Agreement (“Agreement”). The Agreement shall, upon the acceptance and approval by the Bank of my application for the Facility (as stated via the
Bank’s approval), constitute the master agreement for the said Facility.

Terms defined in the Agreement shall have the same meaning as in this Appointment of Agent, unless stated otherwise, and terms in the Agreement
relating to the agency therein contained shall be deemed to be incorporated herein.

1. AGENCY/WAKALAH
I/We hereby irrevocably and unconditionally appoint the Bank as my agent to:

(a) Murabahah Sale Contract: To execute and perform the Murabahah Sale Contract for the purchase of the Commodity by me/us from the Bank at
the Bank’s Selling Price and upon conclusion of the Murabahah Sale Contract, to deal with the Commodity in the following manner:

(b) Murabahah Sale Contract: To execute and perform the Murabahah Sale Contract for the purchase of the Commodity by me/us from the Bank at
the Bank’s Selling Price and upon conclusion of the Murabahah Sale Contract, to deal with the Commodity in the following manner:
#
(aa) be kept in the warehouse and I/we will bear all the resulting costs and expenses and I/we authorise the Bank to deduct all due amounts
from my account.
#
(bb) be delivered to ………………………………………………………………………………………………………………………………and I will
bear all the resulting costs and expenses and I/we authorise the Bank to deduct all due amounts from my account.
#
(cc) be sold to a third-party purchaser at a price of at least equivalent to Commodity cost price for cash and on spot basis.
#
Tick (/) which ever that is applicable. Please choose option (cc) if you/the Customer wishes to obtain proceeds of the Facility

(c) Sale Agency: Upon conclusion of the Murabahah Sale Contract and if I/we opt for the Commodity to be sold to third party purchaser as the Bank
deems fit and proper (“Commodity Purchaser”), the Bank is to execute and perform the sale of the Commodity to the commodity purchaser at the
amount equivalent to the Facility Amount and to deliver and cause to deliver the Commodity to the commodity purchaser and to collect proceeds
from such sale and to pay such proceeds to me through a designated account for the purpose of this Facility or to third party on my behalf in
accordance with the terms of the General Agreement and the Facility.

(d) Administrative: In executing and performing the agency herein contained, the Bank is hereby authorised:
(i) to sign and execute all documents and do all acts and observe and perform all obligations required to be done in connection with or imposed
under any agreement of sale of the Commodity for the purpose of the Murabahah Tawarruq transactions.
(ii) to delegate its rights and duties as an agent herein to any third party as the Bank in its full discretion deems necessary to do all acts necessary
for the execution and performance of the Murabahah Tawarruq transactions including all administrative duties regarding purchasing of the
Commodity from the Bank.
(iii) do all things as fully and effectually as I/we could do in connection with it as if I/we arepersonally present including taking possession (physical
or constructive) of the Commodity.
(iv) to accept the proceeds from the sale of the commodity from the third-party buyer and transfer the proceeds to AmBank (M) Bhd, an agent of
ASNB-PNB in any method deemed suitable and appropriate by the Bank (only applicable for “Term Financing-i ASB/ASB2”).

2. COMPLETION
Upon the completion of the above mentioned Murabahah Tawarruq transactions, the Bank’s appointment as agent herein shall automatically be
terminated.

3. LIMITED AGENCY
Save and except as expressly stated in this Appointment of Agent, the appointment of the Bank as my/our agent shall not create or be deemed to create
a partnership or a joint venture between ourselves, nor shall it establish a relationship of principal or agent in any other relationship between us.
4. INDEMNITY
I/We hereby undertake to indemnify the Bank from all claims, losses, costs, expenses or damage that the Bank may suffer or incur as a result of fulfilling
the Bank’s agency function as set out above save and except in the event of ta’addi (misconduct), taqsir (negligence) or mukhalafah al-shurut (breach of
specified terms) on part of the Bank in executing and performing the agency herein contained and in such a case, the Bank shall be liable and shall
compensate for loss or damage including any actual cost suffered by me/us.

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 5. GAINS IN MURABAHAH SALE CONTRACT
In the event that any act of the Bank as appointed herein results in gain exceeding the requirement imposed by me/us (such as selling at the higher price
or buying at a lower price) or then that the Bank is authorised for, the Bank shall disclose this to me/us and the Bank must not retain any portion of the
exceeding gains without my consent.
6. TERMINATION
If any of the following shall have occurred:
(a) either Party fails to perform any of its obligations under this Appointment of Agent and where such failure is capable of being remedied, is not being
remedied within a period specified in this Appointment of Agent for such failure/breach to be remedied or where such period is not expressly
stipulated, within fourteen (14) Business Days, from the date either Party becomes aware of the failure/breach or having been notified of the
failure/breach; or
(b) any representation, warranty or statement which is made by either Party is incorrect or misleading in a material respect on or as of the date such
representation, warranty or statement is made or given or deemed made or given, or if repeated at any time with reference to the facts and
circumstances subsisting at such time would have been incorrect; or
(c) it is or will become unlawful by the laws of Malaysia for either Party to perform or comply with any of its obligations under this Appointment of Agent;
or
(d) an encumbrancer bailiff, trustee or administrator or receiver or similar officer takes possession of or is appointed in respect of, all or any part of the
assets of either Party or distress or any form of execution is levied or enforced upon or sued out against any such assets, or any security interest
which may for the time being affect any of its assets becomes enforceable; or
(e) either Party is or becomes, insolvent or threatens to suspend or suspends payment of any of its debts (whether of principal, interest or profit) as
they fall due or is deemed to be unable to pay its; or
(f) either Party who is a natural person dies or becomes incapacitated or of unsound mind or shall have been served with a custodian sentence or be
guilty of any offence against any law; or
(g) any step is taken for the winding-up, dissolution, liquidation or a petition for winding-up or bankruptcy is presented against either Party and/or any
one commits an act of bankruptcy or enter into any arrangement or composition with its creditor then and in any of the above events (“Termination
Event”), the innocent Party may by notice in writing to the breaching Party, terminate this Appointment of Agent whereupon, any asset or rights of
mine entrusted with the Bank shall be returned to me/us, and the Bank shall be entitled to the agreed agency fee. PROVIDED THAT the termination
shall not affect or prejudice the rights of any Party which have accrued prior to the date of termination of this Appointment of Agent.
7. AGENCY FEE
Unless waived by the Bank, where requested by the Bank at any time, I/we shall pay agency fee of Ringgit Malaysia Ten (RM10.00) to the Bank in
consideration of the appointment and performance of the Bank as my/our agent.

8. PRINCIPAL BOUND
I/We shall be bound by any contract or agreement that the Bank enters into on my/our behalf with any third party pursuant to this Appointment of Agency.

9. I/We hereby irrevocably instruct the Bank to remit the proceeds of the commodity sale stated above to AmBank (M) Bhd, an agent of ASNB-PNB
(only applicable for “Term Financing-i ASB/ASB2”).

REMINDER: The Applicants are hereby reminded to read and understand the terms and conditions of
this document and the General Agreement before signing below.

__________________________ ___________________________________
Signature of Main Applicant Signature of Joint Applicant/Guarantor
Date: Date:
Name: Name:
IC No.: IC No.:

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