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APPLICATION FORM
TYPE OF FACILITY*
(Please select all relevant options)
Factoring-I
Letter of Credit-I
Bank Guarantee-I

Amount




A. PARTICULARS OF APPLICANT

Company Name*


Type of Company*

Private Limited
Partnership
Proprietorship

Date Of Incorporation / Registration*

Incorporation / Registration Certificate No.*


Registration Address*


Business Address*

Phone*
Fax
Email*

Contact Person / Contact Number*


Nature of Business*

Authorized Capital*
Paid-Up Capital*

Company Status*

Bumiputera
Non-Bumiputera
Foreign Company

Company Shareholders

Note: Please use a separate attachment if the space below is insufficient.


















Board of Directors

Note: Please use a separate attachment if the above space is insufficient.























Top Management Personnel

Note: Please use a separate attachment if the above space is insufficient.


















Bank Reference

Note: Please use a separate attachment if the above space is insufficient.























Name of Company Auditor




B. PARTICULARS OF CONTRACT / PURCHASE ORDER (PO)

1. CONTRACT
Contract / PO No.*
Amount*

Description*


Remarks


2. EMPLOYER

Name*


Address*

Contact Person*
Contact Number*

3. SUPPLIER

Name*


Address*

Contact Person*
Contact Phone / Fax*

Cost of Purchase*
Terms of Purchase*
Expected Date of Delivery*

Remarks




C. CONTRACT SUMMARY
Contract / PO Amount*
Total Purchase Cost*

Gross Profit*
Percentage of Gross Profit*
Expected Repayment Period from Employer*



D. DOCUMENTS TO BE SUBMITTED WITH THIS APPLICATION
  1. A certified copy of Memorandum and Article of Association of your company (for limited company only). For sole-proprietorship or partnership, a copy of the Business Registration certificate.
  2. A certified copy of Form 9, 13, 24, 44, 49 & Annual Return.
  3. Company Profile (To include resume on directors / shareholders personnel - form attached).
  4. Photocopy I/C of all directors and shareholders.
  5. Original copy of the contract / purchase order.
  6. A copy of the supplier's quotation or proforma invoice and the relevant catalog for the products contacted for, where available.
  7. Audited account for the last 3 years, if available.
  8. Latest 3 months bank statements.
  9. A copy of Registration Certificate with the Ministry of Finance.
  10. Copies all existing banking facilities i.e. OD / Term Loans / LC / TR / BG offer letters.
  11. List of Track Record.
  12. List of anticipated contracts (to include tender participation).



E. NON-REFUNDABLE APPLICATION FEE OF RM 110.00 IS TO BE FORWARDED TOGETHER WITH THIS APPLICATION, PAYABLE BY CHEQUE OR BANK-IN TO AN ACCOUNT WHICH WILL BE ADVISED BY IKHTIAR FACTORING

I / We certify that the above information and the facts set forth in this application (including any supplemental document(s), if any, attached to and made a part of this application) are true and correct. I / We hereby authorise you to obtain any Credit Information related to my / our company from RAM Credit Information Sdn Bhd and other credit reporting agencies or any source deemed appropriate to verify my / our credit history as it may deem fit under any applicable law, regulation, guidelines, regulatory requirement or directive in respect of any credit application or credit evaluation purpose.

Date*

This is a computer generated document and requires no signature.




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Factoring-I

Letter of Credit-I

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A factoring finance financial institution approved by the Ministry Of Finance since year 2000 and governed under the Financial Services Act 2013 (FSA 2013), previously a Scheduled Institution under the Banking and Financial Institution Act (BAFIA). A Musyarakah Partner to Perbadanan Nasional Berhad (PNS) and wholly owned by MOF Inc.
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