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RETAIL - CORPORATE CUSTOMER DECLARATION FORM

A. BUSINESS DETAILS.
Name of Business (*)
Please field Name of Business!
Postal Code : (*)
Please field Postal Code!
Email :
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Business Registration No : (*)
Please field Business Registration No!
Tel No 1 : (*)
Please field Tel No 1!
Fax : (*)
Please field Fax!
Nature/Description of Business: (*)
Please field Nature/Description of Business!
Address : (*)
Please field Address!
State : (*)
Please field State!
Website :
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Registration Date: (*)
Please field Registration Date!
*Tel No 2:
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Type of Business: (*)
Please field Type of Business!

B. DIRECTORS, SHAREHOLDERS AND BENEFICIAL OWNER (IF ANY)

1. Please fill the form if any :

Name as in IC/Passport: (*)
Please fill Name as in IC/Passport!
Postal Code : (*)
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Position : (*)
Please field Position!
Nationality : (*)
Please field Nationality!
Date of Birth : (*)
Please field Date of Birth!
Address : (*)
Please field Address!
State/Country : (*)
Please field State/Country!
IC/Passport No: (*)
Please field IC/Passport No!
*Passport Expiry Date :
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Contact No : (*)
Please field Contact No!

2. Please fill the form if any :

Name as in IC/Passport: (*)
Please fill Name as in IC/Passport!
Postal code : (*)
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Position : (*)
Please fill Position!
Nationality : (*)
Please field Nationality!
Date of Birth : (*)
Please fill Date of Birth!
Address (*)
Please field Address!
State/Country : (*)
Please fill State/Country!
IC/Passport No : (*)
Please fill IC/Passport No!
*Passport Expiry Date :
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Contact No : (*)
Please field Contact No!

C. AUTHORISED PERSONNEL TO TRANSACT AT PREMISES.

IC/Passport : (*)
Please fill Name as in IC/Passport!
Postal code : (*)
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Position : (*)
Please fill Position!
Nationality : (*)
Please field Nationality!
Date of Birth : (*)
Please fill Date of Birth!
Address : (*)
Please field Address!
State/Country (*)
Please fill State/Country!
IC/Passport No : (*)
Please fill IC/Passport No!
Contact No : (*)
Please field Contact No!

D. CHECKLIST & DECLARATION.

Upload Your File(s) Here :
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Registry of Business (ROB)/ Registry of Companies (ROC)

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Form 24

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Form 49

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Please attached a ID's copy..

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Memorandum of Association (MOA)
Name Of Person : (*)
Please Fill Name
IC/Passport No : (*)
Invalid Input
Title/Position : (*)
Invalid Input