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  1. Personal
  2. Repayment Assistance
  3. Flood Relief Programme
  4. Individual

Flood Relief Programme Form: Individual
Borang Program Bantuan Banjir Pelanggan Individu

Important Note: All fields are required. Your application will not be submitted without completing all the required information.
Nota Penting: Semua ruangan perlu diisi. Pemohonan anda tidak akan dihantar tanpa melengkapkan semua maklumat yang diperlukan.

Full Name (as per NRIC) / Nama Penuh (mengikut Kad Pengenalan)

NRIC Number (Numbers only) / Nombor Kad Pengenalan (Nombor sahaja)

Mobile Number (e.g. 0123456789, non-Malaysian numbers, please add '+ country code', e.g. +65xxxxxxx for SG) / Nombor Telefon Bimbit (contohnya, 0123456789. Untuk nombor telefon bukan dari Malaysia, sila sertakan “+ kod negara”, contohnya, +65xxxxxxx untuk SG)

Email Address / Alamat E-mel

Supporting income document 1
Maximum File size : 1MB File Type : .pdf or .jpg only

At least one (1) document is required to be submitted

Supporting income document 2
Maximum File size : 1MB File Type : .pdf or .jpg only

This field is required

Supporting income document 3
Maximum File size : 1MB File Type : .pdf or .jpg only

This field is required

Account Number 1 (14 digits, e.g 88810001234567)

Account Number 2 (14 digits, e.g 88810001234567)

Account Number 3 (14 digits, e.g 88810001234567)

Note: The above are subject to fulfillment of the term and conditions and in accordance with BNM’s policies and guidelines and Bank’s internal guidelines. / Nota: Perkara di atas adalah tertakluk pada pemenuhan terma dan syarat serta selaras dengan dasar dan garis panduan BNM serta garis panduan dalaman Bank
By submitting this form, I hereby declare that / Dengan penyerahan borang ini, saya dengan ini, mengisytiharkan bahawa:
My loan/ financing is presently not under rehabilitation with Credit Counselling and Debt Management Agency (AKPK) / / pinjaman/pembiayaan saya kini tidak di bawah pemulihan Agensi Kaunseling dan Pengurusan Kredit (AKPK);
I am not declared a bankrupt or subject to a bankruptcy proceeding / Saya tidak diisytihar muflis atau menghadapi prosiding muflis
I do not have a guarantor for my loan/financing; OR I have obtained consent from my guarantor (if any) on my selected option above / Saya tidak mempunyai penjamin untuk pinjaman / pembiayaan saya; ATAU Saya telah mendapat persetujuan daripada penjamin (jika ada) mengenai pilihan saya di atas.

I understand that / Saya memahami bahawa:
I have the option to engage the Bank to revise the monthly repayment/payment amount and/or schedule if there is an improvement in my financial situation to reduce overall borrowing/financing costs; / Saya mempunyai pilihan untuk berbincang dengan Bank bagi menyemak semula amaun dan/atau jadual pembayaran balik/pembayaran bulanan jika kedudukan kewangan saya telah bertambah baik untuk mengurangkan kos pinjaman/pembiayaan keseluruhan;
I agree to furnish the Bank with additional information/supporting documents as may be required by the Bank after my application for the Remedial Programme has been approved; / Saya bersetuju untuk memberikan kepada Bank maklumat/dokumen sokongan tambahan seperti yang mungkin diperlukan oleh Bank selepas permohonan Program Pemulihan saya telah diluluskan;
If I have any instalment payments that are overdue and unpaid by more than 90 days on the date of the application, I agree for the Bank to offer me a customised solution that is more suitable for my financial circumstances or to share my loan/financing details with AKPK for further financial advice on managing my debt; and/ Jika saya mempunyai sebarang bayaran ansuran yang tertunggak dan tidak berbayar yang melebihi 90 hari pada tarikh permohonan, saya bersetuju untuk Bank menawarkan kepada saya penyelesaian khusus yang lebih sesuai dengan kedudukan kewangan saya atau untuk berkongsi butiran pinjaman/pembiayaan saya dengan AKPK bagi mendapat khidmat nasihat kewangan selanjutnya bagi menguruskan hutang saya; dan
The Bank reserves the right to modify/rescind the Flood Relief Programme if I have been found to have made false, misleading or incomplete representation in this application form; and / Bank berhak untuk mengubah suai/membatalkan Bantuan Banjir tersebut sekiranya saya didapati telah membuat penyataan palsu, mengelirukan atau tidak lengkap dalam boring permohanan ini.
I understand and am fully aware that for conventional loan, the monthly interest will be compounding at the prevailing rate at the point of moratorium and for Islamic financing, there will be non-compounding profit, in accordance with Shariah principles. / Saya memahami dan menyedari sepenuhnya bahawa untuk pinjaman konvensional, pengkompaunan faedah bulanan akan dikira pada kadar semasa ketika moratorium dan untuk pembiayaan berlandaskan Islam, akan terdapat keuntungan tanpa pengkompaunan, selaras dengan prinsip Syariah.

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Thank you for filling out our form. Our Bank officer will contact you within 3- 5 calendar days upon receipt of your application.
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