HIRE PURCHASE APPLICATION FORM (Individual)

Conventional Hire Purchase Islamic Hire Purchase
 
Personal Dealer
 FOR INDIVIDUAL ONLY
   
Name  
Tel no. (House)
Tel no. (Office)
Tel no. (Mobile)
Email
Citizenship  
New IC/ID No.  
Old I/C No.  
IC/ID Issued at  
Date of Birth dd mm yyyy
Marital Status
Name of Employer/Business  
Office Location  
Designation  
Duration in Company/Business  
Actual Monthly Income   RM  
Vehicle Status New    SecondHand    Reconditioned   
Make  
Model  
Year of Make  
Vehicle Registration No. (if secondhand)  
Financing Amount Required RM
Hire Purchase Calculator  
Financing Tenure Required  
Branch  
   
(Please select branch to handle your account)
Payment Mode eSI    DirectDebit    CA/SA   
   
 DECLARATION
   
I hereby authorised Malayan Banking Berhad to verify the information from whatever source deems appropriate and to disclose any information relating to my financial standing to any Maybank Group of Companies, The Association of Finance Companies, Bank Negara Malaysia and any other relevant authorities.
 
Malayan Banking Berhad reserves the right to reject this application at its sole discretion without assigning any reason whatsover.