For business. For growth. For life.

APPLICATION FORM FOR FINANCING

A) COMPANY / FIRM INFORMATION

• This form is free of charge.
• The Bank does not appoint any third party for financing application activity.

Company/Firm Name

Company/Firm Registration Registration Date (dd/mm/yy)

No.

Address Company/Firm

Main Business Activities

Company/Firm Telephone No. Company/Firm E-mail

Address

Total Financing RM Purpose of Financing

Contact Person*:
Full Name MyKad No. Position Telephone No.

* Directors/Shareholders/Owners (who are not third parties)

The following documents has to be submitted together with this application form:
1) If a firm – copies of the identity cards of the owners or partners;
2) If a ‘Sdn Bhd’ company – copies of the identity cards of all the shareholders and directors;
3) Official registration document for firms: and
4) Business Official documents (such as MAA, Form 9, Form 24 and Form 49)

B) DECLARATION
I/We hereby confirm that :-
1. All information forwarded to Small Medium Enterprise Development Bank Malaysia Berhad (hereafter to be referred to as SME
Bank) as per the document checklist above and any additional information to be provided to SME Bank from time to time are updated
and complete.
2. To the best of my/our knowledge, there is no false or misleading statement contained in, or material omission from, the information
that is provided to SME Bank in relation to the application.
3. I/We authorize SME Bank to verify the information provided with any other party, and furnish it to those who are deemed necessary.
4. SME Bank reserves the right to reject the application if the details provided are deemed to be incorrect.
5. Directors of the company are not declared bankrupt.
6. The company does not have any financing facilities with other financial institutions except those disclosed herein.

Small Medium Enterprise Development Bank Malaysia Berhad 49572-H

Menara SME Bank, Jalan Sultan Ismail, 50250, Kuala Lumpur. | Call Centre: 03-2603 7700
E-mail: [email protected] | Website: www.smebank.com.my | Facebook.com/smebank | Twitter.com/sme_bank

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 For business. For growth. For life.

APPLICATION FORM FOR FINANCING

7. I/We authorize SME Bank to forward this application to other relevant party should this application is not within SME Bank’s scope
of financing.
8. I/We authorize SME Bank to verify and/or conduct any checks and/or obtain any information and/or confirmation at any time and
from time to time now and/or in the future, with or from any credit/financing reference/reporting agencies, including but not limited to
CCRIS, CTOS, CRR and/or any other agencies and/or from any financial institution(s) and to provide such aforesaid party(s) with the
required information requested to enable SME Bank to ascertain my/our status and/or any other person, individual and/or entity
related to and/or associated with me/us as may be required by SME Bank for the purpose of considering this application and thereafter
if this application is approved for the purposes of the grant and/or continued maintenance of the facility; and/or recovery of financing
owing under this facility; and/or any purpose related to or in connection with the facility applied for; and/or for any other purpose that
is required or permitted by any law, regulations, guidelines and/or relevant regulatory authorities.
9. For financing which does not exceed RM250,000.00 and requires a guarantor, I/we agree to:
a. Disclose in writing to the guarantor of the financing facility obtained from any of the financial institution(s) and the
assurances given by me/us to the other side. A copy of the letter will be given to SME Bank.
b. Authorize SME Bank to disclose information relating to the financing of correspondence between me/us and SME Bank to
the guarantor for the duration of the financing.
10. I/We authorize SME Bank to disclose my/our information to the following parties:
a. The Government, fund provider, ministries or other authorities, agencies or bodies which have jurisdiction over SME Bank;
b. The auditor, lawyer or professional advisors appointed by SME Bank;
c. The collateral provider under the financing facility;
d. SME Bank’s group of companies;
e. In accordance with any subpoena or other legal provisions or in connection with any legal action, suit or proceeding related
to financing facilities;
f. According to any law; and
g. As required by Bank Negara Malaysia.
11. I/We authorize SME Bank to disclose my/our information with the Bank’s strategic partner for the purpose of automatic onboarding
as registered user and financing disbursement through “ODELA” platform
12. Disclosure to SME Bank group of companies to simplify the operations, business, cross-selling and other purposes of SME Bank
and/or it subsidiaries provided that the disclosure for cross selling purposes will not be carried out if I/we disagree by informing SME
Bank via the phone or mail (which can be changed by SME Bank from time to time by notifying me/us) Level 8 Menara SME Bank,
Jalan Sultan Ismail, PO Box 12352, 50774 Kuala Lumpur, Tel: 03-2603 7700
13. I/We have read the "Personal Data Protection" ('Notice') before completing this form. By submitting personal data, I/we, and by
signing this form, I/we hereby authorize and agree to the terms of the Notice is available on SME Bank's website at
www.smebank.com.my and Enterprise Centers
14. ‘Opt-Out’ Clause
If you/your company does not want to receive any marketing materials about the products and / or special offers on SME Bank.
Please mark here.

If you/your company does not want to be automatically enrolled in the ODELA platform. Please mark here.

15. I/we also declare that I/we am/are free from any act of bankruptcy, not involved in any unlawful activities under the Anti-Money
Laundering, Anti-Terrorism Financing and Proceeds of Unlawful Activities Act 2001 (AMLATFPUAA 2001) and/or any legal action.
I/we declare that my/our business does not fall under the illegal financial scheme activities. I/we undertake that all information
provided to SME Bank is true, complete and was done in a transparent manner. I/we hereby agree to accept any decision made by
SME Bank with regard to my/our financing application.

Small Medium Enterprise Development Bank Malaysia Berhad 49572-H

Menara SME Bank, Jalan Sultan Ismail, 50250, Kuala Lumpur. | Call Centre: 03-2603 7700
E-mail: [email protected] | Website: www.smebank.com.my | Facebook.com/smebank | Twitter.com/sme_bank

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 For business. For growth. For life.

APPLICATION FORM FOR FINANCING

CUSTOMER DECLARATION

In accordance to Bank Negara Malaysia (BNM) Policy Document on Financing Facilities with Connected Parties (dated 13 July 2016), SME
Bank (the Bank) needs to identify any customer who is deemed connected with the Bank. Therefore, please declare if you are regarded as a
Connected Party with SME Bank (please refer to the Glossary for full definition of Connected Parties). However, please do take note that
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pursuant to Section 28(3A) of the Development Financial Institution Act 2002 (DFIA 2002), the Bank shall not grant any financing facility to
any corporation in the shares of which any of the Bank’s members, directors or officers (including their close relatives**) has any interest
which, in aggregate, is in excess of 50%.

Customer is connected with SME Bank Yes No

Details of Connected Parties (please refer to Definition of Connected Parties)

Relationship with
Name of Connected Party Name of SME E-mail address in SME
Capacity* I/C No SME Bank’s
in Your Company Bank’s Personnel Bank
Personnel

Please state if your company is one of the following:

Connection of Your Company with SME Bank Yes / No
1. Your company controls#, or is controlled by Connected Parties (including their close relatives in the case of
individuals).
2. Your company influences##, or is influenced by Connected Parties (including their close relatives in the case
of individuals).
3. Connected Parties (including their close relatives) is a director, partner, executive officer, agent or guarantor
of your company, your subsidiaries and/or entities controlled by your company.
4. Your company is a subsidiary of, or an entity that is controlled by, SME Bank and its Connected Parties
(including their close relatives).
5. Your company is guaranteed by SME Bank’s Connected Parties (including their close relatives).
Note: Should you need to declare more than the spaces provided in the table above, please attach the detailed declaration in a separate sheet.

Definition of Connected Parties

Customers that are connected* to below person and its close relatives**:
1. SME Bank’s Board of Director’s members;
2. SME Bank’s Controlling Shareholder#;
3. SME Bank’s Influential Shareholders##;
4. SME Bank’s Executive Officer (Senior Management); and/or
5. SME Bank’s officer who is responsible for or has the authority to appraise and/or approve financing facilities or review the status of
existing financing facilities, either as a member of a committee or individually.

* Connected means the above person has the capacity in the customer company, by way of one or more of the following:
1. Director;
2. Controlling Shareholder#;
3. Influential Shareholders##;
4. Executive Officer (Senior Management);
5. Officer; and/or
6. Guarantor.

Small Medium Enterprise Development Bank Malaysia Berhad 49572-H

Menara SME Bank, Jalan Sultan Ismail, 50250, Kuala Lumpur. | Call Centre: 03-2603 7700
E-mail: [email protected] | Website: www.smebank.com.my | Facebook.com/smebank | Twitter.com/sme_bank

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 For business. For growth. For life.

APPLICATION FORM FOR FINANCING

** Close relative means those family members who may be expected to influence or be influenced by the above listed individual,
as well as dependents*** of the individual. Close relatives include, but not limited to, the individual's:
1. Spouse and dependents of the spouse;
2. Child (including step children and adopted children) and spouse of the child;
3. Parent;
4. Parent-in-law; and
5. Brother or sister and their spouses. Page 3/4
*** This refers to any person who is financially dependent on the individual or his spouse for his livelihood, e.g. a person who receives
financial assistance on a regular basis from the individual/spouse.

# Controlling Shareholder – Definition & Scope

A person shall be deemed to be a controlling shareholder if he fulfills any of the following criteria, whether individually or with other
persons acting in concert with him:
1. Controls more than 50% of the voting rights;
2. Holds more than 50% of the issued share capital whether directly or indirectly (excluding preference shares);
3. Controls the composition of the Board of Directors;
4. Has the power to appoint and/or remove all or a majority of the Board of Directors;
5. Controls the controlling shareholder or the company; or
6. Is a person in accordance with whose directions or instructions, a director of the company or its holding company are accustomed to
act.

## Influential Shareholders – Definition & Scope

A person shall be deemed to be an influential shareholder if he fulfills any of the following criteria, whether individually or with other
persons acting in concert with him:
1. Holds 20% or more interest in shares of the company, but is not a controlling shareholder; or
2. Has the power to appoint at least one person to the Board of Directors.

DECLARATION
It is hereby declared that the information and particulars furnished above are true and correct to the best of my/our knowledge and belief and
nothing has been concealed.

……………………………………….
(Authorized Personnel)

Name :
Position :
Company Stamp :
Date :

Small Medium Enterprise Development Bank Malaysia Berhad 49572-H

Menara SME Bank, Jalan Sultan Ismail, 50250, Kuala Lumpur. | Call Centre: 03-2603 7700
E-mail: [email protected] | Website: www.smebank.com.my | Facebook.com/smebank | Twitter.com/sme_bank

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