A. TO BE FILLED UP BY CUSTOMER/DIISI OLEH PELANGGAN Name / Nama : NRIC no. / No. k/p : Email / Emel : Address / Alamat : Bank account no. / no.bank akaun : / Phone no. / : H/P / T.bimbit Hse / Rumah : No. telefon Off / Pejabat I am/my family member is a COVID-19 patient 1 / Saya/ahli keluarga saya ialah pesakit COVID-19 1 Unexpected medical expenses 2 / Belanja perubatan di luar jangkaan 2 Spouse's business 3 /salary 4 affected / Perniagaan 3 /gaji pasangan 4 saya terjejas Others / Lain-lain : Pilihan saya untuk menjelaskan baki ansuran dan untung tambahan akibat daripada penangguhan tersebut: increase financing tenure / menambah tempoh pembiayaan partial payment during relief period 5 / bayaran separa dalam tempoh pelepasan 5 Others: / Lain-lain : Extension of financing tenure beyond retirement is to be made via deduction of: / Pension fund 6 / Bayaran untuk sambungan tempoh pembiayaan selepas pesaraan akan dibuat melalui: Dana pencen 6 Compulsory documents to be attached / Lampiran wajib: 1. Confirmation letter from hospital/doctor / Surat pengesahan dari hospital/doktor 2. Hospital/medical bills / Bil hospital/perubatan 3. Registration Certification (ROC) & relevant documents showing spouse's shareholding / Sijil Pendaftaran Perniagaan (SSM) dan dokumen berkenaan yang menunjukkan pegangan saham pasangan 4. Letter from spouse's employer / Surat daripada majikan pasangan 5. Proof of standing instruction for partial payment / Bukti arahan bayaran berjadual 6. Consent letter for pension deduction / Surat kebenaran potongan pencen 7. Any other relevant supporting documents / Lain-lain document yang berkenaan Declaration / Pengisytiharan : Signature / Tandatangan Date / Tarikh : TEMPORARY COVID-19 FINANCIAL RELIEF REQUEST FORM / BORANG PERMOHONAN PELEPASAN KEWANGAN SEMENTARA I hereby declare that the above information together with the supporting document(s) provided herein are true and accurate. I understand that the Company has sole and absolute discretion to defer the same and repayment shall resume immediately after the financial relief period expires. By signing this form, I have expressly agreed to pay the additional profit arising from such deferment and consented to Company collecting, storing and processing the above data(s) in relation to this request. / Saya dengan ini mengisytiharkan bahawa maklumat dan dokumen-dokumen yang diberikan di atas adalah benar dan tepat. Saya memahami bahawa penangguhan bayaran adalah atas budi bicara Syarikat dan bayaran balik akan diteruskan serta merta selepas tempoh pelepasan kewangan tamat. Dengan menandatangani di atas borang ini, saya telah memberi persetujuan nyata untuk membayar untung tambahan akibat daripada penangguhan tersebut dan membenarkan Syarikat untuk mengumpul, menyimpan dan memproses data berkenaan premohonan di atas. My request for deferment of monthly instalment to alleviate my financial burden due to / This temporary financial relief request must be submitted before 30.04.2020 via pertanyaan @yir.com.my/[email protected]. Due to system limitation, customer's salary deduction will be refunded manually subject to approval of this request. / Permohonan pelepasan kewangan sementara ini mesti dihantar sebelum 30.04.2020 melalui pertanyaan@ yir.com.my/[email protected]. Disebabkan had sistem, gaji pelanggan yang dipotong akan dibayar balik secara manual tertakluk pada kelulusan permohonan ini. Saya memohon penangguhan ansuran bulanan untuk meringankan beban kewangan saya kerana: My option to settle remaining instalments and additional profit arising from such deferment / Note / Nota :