Online Credit Application Form
Personal Infomation (*denotes compulsory fields)
(All information provided below will be treated with UTMOST CONFIDENTIALITY and will NOT be revealed to anyone whosoever)
* Please state amount applying for
:
(RM)
* Name
:
Gender
:
-- Your Gender --
Male
Female
Marital Status
:
-- Your Marital Status --
Single
Married
Divorce
Widow/ Widower
Date Of Birth
:
[dd/mm/yyyy]
* I/C Number
:
[000000-00-0000]
No. Of Dependents
:
Home Address
:
Residential Type
:
-- Residential Type --
Own House
Rent-Room
Rent-House
Telephone
:
* Mobilephone
:
Employment Information (if applicable)
Company Name
:
Company Address
:
Position
:
Salary
:
Years Employed
:
Company Tel:
:
Copyright © 2005 F.K. CAPITAL BERHAD. All Rights Reserved.
