Micro Credit Application
Page 1 - 7
A. Applicant
B. Family
C. Credit Card History
D. Micro Credit Details
E. Guarantor
F. Declaration
G. Attachments
A. APPLICANT DETAILS 申请人资料
Name 姓名 *
Chinese Name 中文姓名 *
Gender 性别 *
-- Select --
Male 男
Female 女
NRIC No. 身分证号码 *
Age 年龄 *
Date of Birth 出生日期 (DD/MM/YYYY) *
Mobile No. 手机号码 *
Home No. 住宅电话号码
Email 电邮地址 *
Address 地址 *
Postal Code 邮区 *
City 城市 *
State 州属 *
-- Select --
W.P. Kuala Lumpur
Selangor
Johor
Kedah
Kelantan
Melaka
Negeri Sembilan
Pahang
Perak
Perlis
Pulau Pinang
Sabah
Sarawak
Terengganu
W.P. Labuan
W.P. Putrajaya
Residential Status *
Owned 拥有
Rented 租
Parents 父母
Others 其他
Monthly Income *
每月收入 (RM)
Source of Income *
收入来源
Name of Contact Person (In Case of Emergency) *
联系人姓名 (紧急时)
Contact No. 联络号码 *
Relationship with Applicant 与申请人关系 *
-- Select --
Spouse
Son
Daughter
Father
Mother
Brother
Sister
Friend
Aunty
Uncle
Cousin
Brother-In-Law
Sister-In-Law
Others
How did you hear about YPPKM ? *
请问您是透过哪一个管道知道 YPPKM ?
Facebook 脸书
TV/Radio 电视电台
Newspaper 报章
Friend 朋友
Others 其他
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