Application Form

remittance Application Form

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Monthly Income

Nil $1,000-$2,999 $6,000-$9,999 $15,000-$19,999
$1-$999 $3,000-$5,999 $10,000-$14,999 Above $20,000

Have you, any member of your immediate family or any of your close associates been, in the past or currently, a politically exposed person?

Yes
No

Ownself Sibling Relative Friend
Spouse Parent Child Others

Malaysia India Taiwan Hong Kong Bangladesh UK Others
Indonesia China Thailand Philippines Australia USA

I hereby confirm that the information above is true and accurate

Date :

Sender’s Signature :