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IndividualCorporate

Financing Details

Apply loan Amount

Name of Facility Apply : 1. Cash Loan against Listed Shares (Cash drawdawn)

Loan Purpose

Collateral / Security

Name of Listed Company (Counter)
Stock Code No.
No. of shares to be pledged (unit)
Current Share Price (previous day closing price) (RM)
Current Market Value (RM)

Loan Type (Please Choose)

i. Short Term (Flexible Plan)
Features :
• Service of interest or profit every months
• 3 Months Tenure only and rollover every 3 months up to 12 Months max.
ii. Term Loan (Fixed)
Features :
• Service of interest /profit plus principal monthly
• Min 1 year up to 5 years

Name of Facility Apply : 2. IPO Financing (Initial Public Offering)

Purpose of Loan
IPO Subscription

1. Public Balloting Application – ESA

Name of Company to be Listed
IPO Price per share (RM )
No.of shares apply (unit)
Apply Margin of Financing (%) (RM )

2. Private Placement – MITI

Name of Company to be Listed
IPO Price per share (RM)
No.of shares apply (unit)
Apply Margin of Financing (%)

3. Private Placement – Investment Bank

Name of Company to be Listed
IPO Price per share (RM )
No.of shares apply (unit)
Apply Margin of Financing (%)

4. Pink Form

Name of Company to be Listed
IPO Price per share (RM)
No.of shares apply (unit)
Apply Margin of Financing (%)

Name of Facility Apply : 3. ESOS (Employee share Option scheme)

Purpose of Loan
Exercise of share option (ESOS)
Name of Company(Counter)
Stock Code No.
Exercise Price Per Share (RM )
No.of shares entitlement
Current Market Price

Personal Particulars

Full Name*
NRIC number*
Home/Postal Address
Telephone No.*
(House)

(Handphone)
Email Address*
Citizenship*
Marital Status*
No of Dependent

Employment Particulars

Types of Employer

Name of Employer
Company Number
Nature of Business
Address/Branch
Telephone No.
(Office)

(Facsimile)
Position/Department
Years Employed
Gross Annual Income

Spouse Particulars

Full Name*
NRIC no.*
Citizenship*
Name of Employer*
Position/title

Bank Account Particulars

Bank Name*
Bank Account No.*
Bank Branch*
(I hereby authorize SJCSB to remit/deposit any cheque due to me arising from the sale of my shares to the above Current/Saving Account No.)

Documents to be submitted

Photocopy of NRIC / Endorsed Temporary IC / Passport / Armed Forces or Police Personnel Authority Card *
Photocopy of the latest EA Form / Salary slip (2 months) / Bank statement (2 months)*
Allotment/Allocation Letter
Letter confirming acceptance of Allotment
CDS Account Maintenance
Others


Statement of Income & Expenditure (attach Latest Paysheet / Tax Assessment Form)

Self (RM)
Spouse (RM)
a) Monthly Salary (net)
b) Other Income Source
c) Family Expenses, Financial Commitment e.g Loan repayment, Insurance Premium etc

Asset and Liabilities

Asset
Units
Value (RM)
Title Particulars (Property) / Description (Other assets)

Liabilities

Financial Institution
Loan Type
Loan Outstanding
Monthly Repayment
Account Number
*Required Field

Declaration

  1. We hereby declare that we are not insolvent nor placed under receivership and do not have any litigation case pending or threatened against us for any debt due.
  2. We hereby declare that the information given in this application form is true and correct and we have not withheld any material facts or information from you. I further authorize you to verify the information given from any source and in such manner, as you shall deem fit.
  3. We declare and agree that this application is subject to your approval you are absolutely entitled at your sole discretion to reject the application or impose such conditions and/or restrictions as you may deem fit without giving any reasons thereto.

We declare all of the above is true.*

Financing Details

Apply loan Amount

Name of Facility Apply : 1. Cash Loan against Listed Shares (Cash drawdawn)

Loan Purpose

Collateral / Security

Name of Listed Company (Counter)
Stock Code No.
No. of shares to be pledged (unit)
Current Share Price (previous day closing price) (RM)
Current Market Value (RM)

Loan Type (Please Choose)

i. Short Term (Flexible Plan)
Features :
• Service of interest or profit every months
• 3 Months Tenure only and rollover every 3 months up to 12 Months max.
ii. Term Loan (Fixed)
Features :
• Service of interest /profit plus principal monthly
• Min 1 year up to 5 years

Name of Facility Apply : 2. IPO Financing (Initial Public Offering)

Purpose of Loan
IPO Subscription

1. Private Placement – MITI

Name of Company to be Listed
IPO Price per share
No.of shares apply(unit)
Apply Margin of Financing (%) (RM)

2. Private Placement – Investment Bank

Name of Company to be Listed
IPO Price per share (RM)
No.of shares apply (unit)
Apply Margin of Financing (%) (RM)

3. Pink Form

Name of Company to be Listed
IPO Price per share (RM)
No.of shares apply (unit)
Apply Margin of Financing (%) (RM)

Company Particulars

Comapny Name*
Business Registration No*
Date of Incorporation*
Place of Incorporation
Nature of Business*
Business /Registered Address*
Email Address*
Contact No.*
(Telephone)

(Facsmile)
Board of Directors*
NRIC No.*

Financial Data

Share Capital
Authorised Share Capital (RM)
Issued and Fully Paid Up (RM)
Net worth (RM) as at:
Total Borrowing (RM) as at:

Bank Account Particulars

Bank Name*
Bank Account No.
Bank Branch*
We hereby authorize SJCSB to remit/deposit any cheque due to us arising from the sale of our shares to above Current/Saving Account No.

Documents to be Submitted

Please tick (/) on below box.
Certified true copy of Memorandum and Articles of Association & Form 9/Constitution
Certified true copy of latest Form 44
Certified true copy of latest Form 49
Certified true copy of latest Form 24/Annual Return
Certified true of the latest audited and management accounts
Certified true of Directors’ Resolution authorising the acceptance of the facility and naming the persons authorised to sign documents on behalf of the Company to operate the facility and their specimen signature
Certified true copy of Annual Report; and/or,
Certified true copy of Audited Account (last 2 years); and/or,
Certified true copy of Bank Statement (last 2 months)
Certified true copy of Company Management Report
Certified true copy of NRIC of Directors / Shareholders
Photocopy of Letter of Allotment
Letter confirming acceptance of Allotment
Letter to be issued to Issuing House / Agent (IPO)
Letter of Guarantee and NRIC of Guarantor (if applicable)

All detail and pertinent information relating to the corporate exercise
*Required Field

Declaration

  1. We hereby declare that we are not insolvent nor placed under receivership and do not have any litigation case pending or threatened against us for any debt due.
  2. We hereby declare that the information given in this application form is true and correct and we have not withheld any material facts or information from you. I further authorize you to verify the information given from any source and in such manner, as you shall deem fit.
  3. We declare and agree that this application is subject to your approval you are absolutely entitled at your sole discretion to reject the application or impose such conditions and/or restrictions as you may deem fit without giving any reasons thereto.

We declare all of the above is true.*