CC Form 2022
CC Form 2022
CC Form 2022
2022)
Salutation Nationality
Dato Datin Mr Mrs Miss Malaysian
Others Non-Malaysian; Country of Origin:
Identification Number
Political Expose Person (PEP) or Close Associate to PEP (CATP)
Yes No
8 4 0 7 1 7 0 1 6 3 8 7
PAGE 1 of 2
FGROP 002/2022_v1 (Updated on 17.03.2022)
STATEMENT DELIVERY
RESIDENCE DETAILS
L O T 6 4 3 8 0 K G S I N A R A N
B A R U
City S KU D A I City
Postcode 8 1 3 0 0 Postcode
State State
Country M A L A Y S I A Country
EMPLOYMENT DETAILS
Length of Services Y Y M M
PAGE 2 of 2
FBGSV 003/2022_v1 (Updated on 17.03.2022)
PART C: PERSONAL FINANCING/-i APPLICATION FORM
ACCOUNT TYPE
Please tick (√) where applicable Purpose of Account Opening: Personal Loan/Financing
Personal Financing Source of Fund: Credit Facility Approve by FI
Enrolment in Personal Smart Shield (PSS) Yes No
Personal Financing/-i Amount Applied
Personal Financing-i
RM
Civil Sector
Maintain the same monthly payment, in the event of base rate Financing Tenure
(BR) adjustment Yes No
Months
Private Sector/Potongan Gaji Majikan
Pensioners Financing Disbursement Account
Purpose of Application (Please √ one) New Existing;
005 Personal Consumption 037 Booking Fee - Car 038 Debt Consolidation 039 Education
040 Electrical Goods 041 Home Furnishing/Equipment 042 Medical Expenses 043 Online Financing
044 Personal Refinancing 045 Property/House Financing 046 Renovation 047 Travel
SETTLEMENT INSTRUCTION
PRODUCT TYPE
Type of Facility/
Bank/
Financing Financing Amount Outstanding Balance Monthly Payment
Finance Company/
(Housing/Car/ (RM) (RM) Amount (RM)
Other Banks
Personal/Others)
PAGE 3 of 5
FBGSV 003/2022_v1 (Updated on 17.03.2022)
5. DECLARATION OF TAX RESIDENCY STATUS
Please √ where applicable
I/We have been briefed and I/We hereby confirm I/We understand my/our tax residency/FATCA/CRS requirements. I/We
hereby declare that all statements made in this declaration are, to the best of my/our knowledge and belief, correct and complete:
Foreign Account Tax Compliance Act “FATCA” Common Reporting Standard “CRS”
(For U.S. Only) (Other than U.S.)
I am not a U.S. citizen or resident in the U.S. for tax purposes. I confirm that I am a tax resident in Malaysiai.
I confirm that I was born in the U.S. (or a U.S. territory) but am no I confirm that I am NOT a tax resident in Malaysia or any countriesii.
longer a U.S. citizen as I have voluntarily surrendered my citizenship Please specify reason*: ______________________________________________________________________
as evidenced by the attached documents. I confirm that I am a tax resident in Malaysia and other countriesiii.
I confirm that I am a U.S. citizen and/or resident in the U.S. for tax I confirm that I am a foreign tax residentiv.
purposes (i.e. green card holder or resident under the substantial If you have selected iii and iv, please complete the following table:
presence test). No 1 2
Tax Number Country of Tax
Type SSN Social Security Number Resident
(Please √ one) TIN Taxpayer Identification Number Taxpayer
ID No. (TIN)
Reason, Country does not Country does not
if No TIN issue TIN issue TIN
(Please √ one)
Country does Country does
not require the not require the
collection of TIN collection of TIN
Others*: Others*:
__________________________________ __________________________________
*TIN application in progress | not required to register tax file | housewife
| househusband | minor | student | retiree | foreign diplomat in embassy
6. APPLICANT ACKNOWLEDGEMENT:
i. I/We,
the undersigned declare that the above information provided by me/us are true and correct and if the Bank subsequently
discovers that any of the information provided are false, incorrect or incomplete, the Bank may cancel or vary the Facility approved.
ii. I/We agree that the emailed copy(ies) of the application form and/or supporting document(s) received by the Bank are deemed
to be the original application form and/or supporting document(s) and I/We am/are to produce the original application form and/
or supporting document(s) to the Bank upon request.
iii. I/We
have also been advised that I/We may contact RHB Customer Contact Centre by telephone at +603-9206 8118 or by
email at [email protected] or visit any branch of the Bank if I/We do not understand any of the product features,
benefits, product disclosure sheet and/or Terms and Conditions.
Applicant’s Signature Full Name as per NRIC/Passport
I hereby declare that I have sighted the original copies of the documents and all information provided above is truthful and trustworthy.
Name Name
Staff ID Staff ID
Date D D / M M / Y Y Y Y Date D D / M M / Y Y Y Y
PAGE 4 of 5
FBCAR 004/2017_v8 (Updated 6/1/2022)
This is a credit card product issued by RHB Bank Berhad (“RHB Bank”) primarily for payment of goods and
services. Where any amount of the credit utilised by you has not been settled in full on or before the due date,
the unsettled amount will be subject to finance charges.
Credit Limit
RHB Bank offers various types of credit card that suits a customer’s need. RHB Bank credit card’s credit limit
will be determined based on individual credit assessment, annual income and type of credit card applied. The
credit limit for each card entitled by RHB Bank Credit Cardholder subject to RHB Bank’s approval. The
approved credit limit will be made known to you in the credit card welcome pack.
Note:
* Outstanding balance shown on the card statement (the Outstanding Balance)
** Monthly Instalment means an outstanding balance, transaction amount or cash advances that has
converted into monthly instalment that need to be paid in full that form part of the monthly minimum
amount due.
Note:
As the principal card cardholder, you are liable for all transactions incurred by the supplementary card
cardholders.
1
FSHDE 018/2017- Version 11
(Read this Product Disclosure Sheet together with the general RHB Islamic Bank Berhad
terms and conditions governing the Credit Card-i before you Credit Card-i
decide to take this product. Be sure to also read the Visa Card /
Mastercard Cardholder Agreement and Term & Conditions Date: ________________
where applicable. Seek assistance from RHB Islamic Bank
Berhad if you need further clarification on any part of this (To be filled by Branch /
document or the terms) Sales Personnel)
b) Qard : The credit limit of the Credit Card-i is provided by the Bank to the Cardholder based on Shariah concept of
Qard which refers to the Bank lending an amount equivalent to a credit limit to the Cardholder and the
Cardholder is bound to repay an equivalent amount to the Bank.
b) Use the card responsibly, including not to use the card for Shariah non-compliant activity; and
c) Check the monthly statement and report any discrepancy without undue delay