Auto Financing Application (Individual)

1 APPLICANT DETAILS

PERSONAL DETAILS

Name as per NRIC

Permanent home address

Postcode

State Country

Email address

Home phone number Mobile phone number

Mailing address (complete if different from above)

Postcode

State Country

New NRIC number Old NRIC number

Salutation

Mr Madam Miss Others

Other identification (complete if you do not have an NRIC)

Passport Army/ PoliceSpecify number

Date of birth (dd/mm/yyyy)

If not Malaysian, what is your residence status?

Non-Malaysian resident

Permanent resident

Malaysia My 2nd Home

Nationality

Malaysian Others

Race

Malay Chinese Indian Others

Bumiputra

Yes No

Page 1 of 4 (06/10)

Enquiries 03 - 2295 6688

Marital status

Single Married Others

Number and age(s) of dependant children

Age(s)

Duration at permanent address

Gender

Male Female

Years Months

EMERGENCY CONTACT DETAILS

Are you an existing CIMB Group customer?

Total working experience(current and all previous employment) Years Months

Position

Employer's phone number (use 'ext' to indicate extension number)

Main monthly gross income

RM RM

Other monthly income

Type of company

CIMB Group

Financial Institution

Government Agency

Bursa Listed

Non Profit Organisation

Private Limited Company

Public Limited Company

School/College

MNC (Non FI) Sole Proprietor/Partnership

Employment type

Employed (Fixed)

Employed (Non Fixed)

Unemployed (without income, Pensioner, Housewife, Student)

Own Business (Non Professional)

Unemployed (with other income)

Postgraduate

Diploma

Highest level of education obtained

Secondary Primary Others

Professional qualification Degree

Size of current employment company

Small (50 employees)

Current residence status

Owned - charged

Owned - not charged Company quarters Parents

Rented Relatives

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

EMPLOYMENT DETAILSEmployer's name

Full Name As In NRIC

Relationship With Main Applicant

Occupation Date employed (dd/mm/yyyy)

Yes No

Home phone number Mobile phone number

Employer's address

Postcode

State Country

Page 1 of 6

Page 2 of 4

2 SPOUSE DETAILS (Complete only if your spouse is not a guarantor)

3 GUARANTOR DETAILS

Name as per NRIC New NRIC number Old NRIC number

PERSONAL DETAILS

Name as per NRIC

Email address

Home phone number Mobile phone number

New NRIC number Old NRIC number

Salutation

Mr Madam Miss Others

Other identification (complete if you do not have an NRIC)

Passport Army/ PoliceSpecify number

Date of birth (dd/mm/yyyy)

If not Malaysian, what is your residence status?

Non-Malaysian resident

Permanent resident

Malaysia My 2nd Home

Nationality

Malaysian Others

Race

Malay Chinese Indian Others

Bumiputra

Yes No

Marital status

Single Married Others

Number and age(s) of dependant children

Age(s)

Gender

Male Female

Relationship to applicant

Duration at permanent address

Years Months

Mailing address (complete if different from above)

Postcode

State Country

EMPLOYMENT DETAILS

Are you an existing CIMB Group customer?

Yes No

Occupation

Total working experience (current and all previous employment)

Years Months

Department

Employer's phone number (use 'ext' to indicate extension number)

Employer's name

Main monthly gross income

RM RM

Other monthly income

Type of company

CIMB Group

Financial Institution

Government Agency

Bursa Listed

Non Profit Organisation

Private Limited Company

Public Limited Company

School/College

MNC (Non FI) Sole Proprietor/Partnership

Employment type

Employed (Fixed)

Employed (Non Fixed)

Unemployed (without income, Pensioner, Housewife, Student)

Own Business (Non Professional)

Unemployed (with other income)

Postgraduate

Diploma

Highest level of education obtained

Secondary Primary Others

Professional qualification Degree

Date employed (dd/mm/yyyy)

Size of current employment company

Small (50 employees)

Permanent home address

Postcode

State Country

State

Employer's address

Postcode

Country

Current residence status

Owned - charged

Owned - not charged Company quarters Parents

Rented Relatives

Other identification(complete if your spouse does not have an NRIC) Specify number Passport Army/ Police

Home phone number

Mobile phone number

Office phone number

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Page 3 of 4

4 REFEREE DETAILS

Name of referee

5 FINANCE AND VEHICLE DETAILS

6 TRADE-IN DETAILS

Financing promotion typeDeal type

Dealer Direct case

Product type

Fixed rate Variable rate

Application type

New Recon (Unregistered) Used Used recond

Purchase location

Peninsular Malaysia Labuan Langkawi Sabah and Sarawak

Occupation Relationship to applicant

Office phone number (use 'ext' to indicate extension number)Home phone number Mobile phone number

Dealer/Seller's name Salesman's name

7 DOCUMENTS ENCLOSED

Make Model

Year made Date of registration Registration number Make Model

Registration number Year made

Duration

%

Interest/Profit ratePrice of vehicle Amount financed

MonthsRMRM

Trade-in value

RM

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

Copy of applicant's NRIC / Passport

Photocopy of Driving License

Photocopy of Registration Card

Latest 3 months bank statements

Latest 3 months salary slip or other income evidence

Latest EA Form / Form B with proof of tax payment / EPF Statement

Address

Postcode State Country

Where is the vehicle kept?

Postcode State Country

Engine capacity (CC)

< 1000 CC 1000 - 2000 CC >2000 CC

Fuel type

Petrol Diesel Others

Page 3 of 6

CIMB Islamic Credit Card Application Details

CIMB Bank Credit Card Application Details

Name To Appear On Card (Not More Than 19 Letters) :

Mothers Maiden Name :

MY PERSONAL DETAILS

Nature of Business :

MY ADDITIONAL EMPLOYMENT DETAILS

u Yes, I wish to apply for a credit card PIN to access ATM andCIMB Clicks

ACCESS TO ATM AND CIMB CLICKS INTERNET BANKING

Please Send My Statement To : Please Send My Card To :

uHome uOffice uHome uOffice

u For My Collection at CIMB Islamic Bank Branch**

**CIMBIslamicBankbranchesareco-locatedatallCIMBBankbranchesnationwide.

MY BILLING AND CARD DELIVERY INSTRUCTIONS

CIMB ISLAMIC CREDIT CARD

u CIMB Islamic Platinum MasterCard (RM48,000minincomep.a.)

u CIMB Islamic Gold MasterCard(RM24,000minincomep.a.)

u CIMB Islamic PETRONAS Gold MasterCard(RM24,000minincomep.a.)

Note:Additionalcreditcardswillshareacombinedcreditlimit.

I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE 3) :

Page 4 of 6

CIMB TOUCH N GO ZING AUTOMATIC RELOAD AMOUNT

Note:If theauto reloadamount isnotspecified,CIMB IslamicBankwillautomaticallysetthedefaultreloadamounttoRM100.

CIMB Touch n Go Zing Card (TouchnGocardlinkedtoCIMBIslamicBankCreditCard)

uI would like to have the complimentary CIMB Touch n Go Zing Card with the following automatic reload amount

Principal Card uRM100 uRM200uRM300

u I wish to unsubscribe from Transaction Alert Services (By checking this box you will stop receiving any Transaction Alerts for your CIMB Islamic Credit Card

Alert me if transaction exceeds (The Banks default value applies if left blank)

uRM1,000 uRM2,000 uRM3,000 uRM5,000

TRANSACTION ALERT SERVICES

I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE 3) :

CIMB PREMIER CARD COLLECTION

u CIMB WORLD MasterCard (RM200,000minincomep.a.)u CIMB Visa INFINITE (RM200,000minincomep.a.)u CIMB Visa SIGNATURE (RM100,000minincomep.a.)

CIMB SMART DRIVERS CARDS

u CIMB PETRONAS Platinum MasterCard (RM48,000minincomep.a.)

u CIMB PETRONAS Gold MasterCard (RM24,000minincomep.a.)

CIMB CREDIT CARDS

u CIMB Platinum MasterCard (RM48,000minincomep.a.)u CIMB Gold MasterCard (RM24,000minincomep.a.)u CIMB Visa Platinum (RM48,000minincomep.a.)u CIMB Visa Gold (RM24,000minincomep.a.)Note:Additionalcreditcardswillshareacombinedcreditlimit.

Name To Appear On Card (Not More Than 19 Letters) :

Mothers Maiden Name :

MY PERSONAL DETAILS

u Yes, I wish to apply for a credit card PIN to access ATM andCIMB Clicks

ACCESS TO ATM AND CIMB CLICKS INTERNET BANKING

u I wish to unsubscribe from Transaction Alert Services (By checking this box you will stop receiving any Transaction Alerts for your CIMB Bank Credit Card

Alert me if transaction exceeds (The Banks default value applies if left blank)

uRM1,000 uRM2,000 uRM3,000 uRM5,000

TRANSACTION ALERT SERVICES

Please Send My Statement To : Please Send My Card To :

uHome uOffice uHome uOffice

u For My Collection at CIMB Bank Branch

MY BILLING AND CARD DELIVERY INSTRUCTIONS

Note:Iftheautoreloadamountisnotspecified,CIMBBankwillautomaticallysetthedefaultreloadamounttoRM100.

CIMB TOUCH N GO ZING AUTOMATIC RELOAD AMOUNT

CIMB Touch n Go Zing Card (TouchnGocardlinkedtoCIMBBankCreditCard)

uI would like to have the complimentary CIMB Touch n Go Zing Card

with the following automatic reload amount

Principal Card uRM100 uRM200uRM300

Nature of Business :

MY ADDITIONAL EMPLOYMENT DETAILS

SMSA 9 0 4 9

** This declaration shall apply to all CIMB Bank Berhad and CIMB Islamic Bank Berhad (the Bank) product(s) which you apply for as stated in this application form and above table.

DECLARATION/DISCLOSURE BY APPLICANT**

In addition to my Auto Financing Application, I hereby acknowledge that I am applying for the following products in this application form :

Products Applicants Initial

CIMB Islamic Credit Card

CIMB Bank Credit Card (Conventional)

FOR ALL PRODuCTS:

(i) I/We declare that I/we have/do not have outstanding debt payment obligation from banks and non-banks (e.g. cooperative building societies, credit companies and merchants that provide credit sales)

Particulars of the main applicants outstanding debt payment obligation are as follows (no declaration from the main applicant denotes that this declaration is not applicable) :

(ii) I/We declare that the information furnished in this form are true, accurate and complete and I/we have not withheld any information which may prejudice my/our financing/loan application or have a bearing on your financing decision.

(iii) Application(s) remains the Banks property regardless of whether the facility is approved and the Bank reserves the right to reject the application(s) at its sole discretion without any reasons whatsoever.

(iv) I/We have not committed any act of bankruptcy and/or been adjudged a bankrupt.

(v) I/We shall comply with the Banks requirements in respect of my/our loan/financing application and understand that the Banks offer of the loan/financing shall be subject to the Bank performing any necessary verification. The Bank refers to CIMB Bank Berhad or CIMB Islamic Bank Berhad (as the case may be), being the licensed financial institution offering the loan/financing product(s) referred to this application form.

(vi) I/We confirm that the Bank or the Banks representative is authorized to verify and/or make any checks and/or obtain any information and/or confirmation, with or from any source, or from any credit reference agencies, including but not limited to CCRIS, FIS and/or any other agencies and/or from any financial institution, on me/us and/or any other person, individual and/or entity as the Bank may deem fit, for any purposes which the Bank deems fit.

(vii) In connection with the Bank Negara Guidelines on Credit Transactions and Exposures with Connected Parties, I/we hereby declare that (no declaration from the applicant(s) denotes that this declaration is not applicable) :

u I am a staff of the CIMB Group1

u To the best of my knowledge, I have close relative(s)2employed under the CIMB Group. Particulars of my close relatives in CIMB Group and whether they have acted as my guarantor :

1 CIMBGroupmeansCIMBBankBerhadorCIMBIslamicBankBerhadorCIMBInvestmentBankBerhadorothersubsidiariesorcompaniescontrolledbytheaforesaidrespectivebankinginstitutions.

2 Closerelative(s)includeparents/spouseofstaffincludingthespousesdependents/children/spouseofthechildren/brotherandsister/spouseofbrother/sisterandanyotherdependentsandpersonswhomayinfluence/beinfluencedbythestaff.

(viii) Subject to the provisions below which (i) prohibit disclosure of information to Group Companies if objected to by me/us; and (ii) require my/our express consent for disclosure of information to third parties for the stated purposes, I/we hereby agree and authorise the Bank to disclose to any of its agents, service providers, auditors, legal counsel, professional advisors, security providers and guarantors in or outside Malaysia and to companies within the group of the Bank as well as companies within the group of CIMB Group Holdings Berhad, the Banks ultimate holding company (the Group Companies) whether such Group Companies are residing, situated, carrying on business, incorporated or constituted within or outside Malaysia any information relating to me/us, my/our affairs and/or any accounts maintained by me/us with the Bank for facilitating the business, operations, facilities and services of or granted or provided by the Bank and/or the Group Companies to their customers.

Disclosure to Group Companies shall be for facilitating the operations, businesses, cross-selling and other purposes of the Bank and/or the Group Companies provided always that disclosure for cross selling purposes shall not be effected if such disclosure is objected by me/us by contacting the Bank at the following telephone number or address (which may be changed by the Bank from time to time by notice to me/us): 19th Floor, Menara Bumiputra Commerce, 11 Jalan Raja Laut, 50350 Kuala Lumpur, Tel No.: 1300-880-900.

Further,wheretheBankintendstosharemy/ourinformation(excludinginformationrelatingtomy/ouraffairsoraccount)withthirdpartiesforstrategicalliances,marketingandpromotionalpurposes,(3)

u I/Weherebygivemy/ourconsenttotheabovedisclosuretothirdparties. u I/Wedonotconsenttothegivingoftheabovedisclosuretothirdparties.

(ix) I/We also acknowledge that it is a requirement by Bank Negara Malaysia (BNM) that all information relating to this application, whether successful or otherwise must be updated and/or transmitted to the Central Credit Reference Information System (CCRIS), a database maintained by BNM.

No. Name of Entity Amount of Outstanding Debt (RM) Monthly Instalment Amount (RM)

1

2

Name I/C / Passport No. Relationship Acted As Guarantor (Indicate Yes or No)

u Yes u No

u Yes u No

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(x) CIMB Touch n Go Zing Card

In addition to the declaration where I have confirmed that any credit card issued to me shall be subject to the Banks Cardmember Agreement, I also agree to abide by the terms and conditions of the Touch n Go Zing Card (hereinafter collectively referred to as the Card) and any other terms and conditions imposed by Touch n Go Sdn. Bhd. (hereinafter referred to as TNGSB) and/or the Bank from time to time in respect of the use of the Touch n Go features of the Card. I am aware the Card has an automatic reload amount of RM100, RM200 or RM300 and that the automatic reload fee of RM1.50, RM2.00 or RM3.00 respectively is payable. I confirm and irrevocably authorize the Bank to debit my CIMB Bank/CIMB Islamic Bank Credit Card account, as the case may be, for each reload and automatic reload fee (where chargeable) whenever the account balance drops to RM50 and below. In the event that I wish to cancel my Card, there will be a refund processing fee of RM5 charged. A RM10 fee is also chargeable for new Card replacements. By signing and/or using the Card I agree to be bound by the terms and conditions imposed by the Card and other variations or amendments thereof. I understand that the Zing Card remains the property of TNGSB, as the case may be, upon request.

(xi) For Credit Card

I/We hereby request the Bank to issue, upon approval of this application, the credit card(s) which I/we have indicated. I/We acknowledge that the use of the credit card(s) issued to me/us shall be subject to the Banks Cardholder Terms and Conditions (Cardmember Agreement) which will be sent to me/us with the credit card(s) upon the approval of this application, and I/we further agree to be bound by the terms and conditions set forth in the Cardmember Agreement upon issuance or use of the credit card(s). I, the Principal Applicant further agree to accept joint and several liability for all amounts incurred arising from the use of the Principal and/or Supplementary credit card(s) issued pursuant to this application or at any time thereafter at my and/or the Supplementary Applicants request. I/We further understand that the Bank shall not hold the Supplementary Applicant jointly and severally liable for the debts or amounts incurred by the Principal Applicant or other Supplementary Applicant(s). I/We understand that the credit card(s) when issued shall at all times remain the property of the Bank and must be duly returned upon request by the Bank. I/We further agree to accept liability for all amount incurred arising from the use of my/our credit card(s) issued pursuant to this application or at any time thereafter at my/our request.I hereby confirm having read, understood and retained a copy of Product Disclosure Sheet that explains the benefits and my duties to my application for the Product(s) that I/we applied for.

I hereby confirm having read, understood and retained a copy of Product Disclosure Sheet that explains the benefits and my duties to my application for the Product(s) that I/we applied for.

I am aware that the full terms and conditions of the product(s) that I applied for is/are also available in:

Hire Purchase : www.cimbbank.com.my 03 - 2295 6688

Islamic Hire Purchase : http://cb.cimbislamic.com.my 03 - 2295 6688

CIMB Islamic Credit Card : http://cb.cimbislamic.com.my 03 - 6204 7788

CIMB Credit Card : www.cimbbank.com.my 03 - 6204 7788

DECLARATION/DISCLOSURE BY APPLICANT** ... contInueD

Main Applicants Signature :

Date :

Guarantors Signature :

Date :

Page 6 of 6

BANK USE ONLY

Serviced by :

Application ID :

Outlet : Date :

SMSA

Branch No.

i-Branch No.

Employee No.

For Credit Card application