Common Reporting Standard (CRS) Individual Self-Certification Form

Please enter your NRIC / Passport Number (as in Bank’s record)

NRIC/Passport

NRIC Passport
This field is mandatory.

NRIC Number

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Passport

{{ formCustom.passportIdentifier.$error.required ? 'This field is mandatory.' : ( (formCustom.passportIdentifier.$error.format) ? 'Field value is invalid.' : processNationalityAgeErrorMessage('Your age must be between #MIN# years old to #MAX# years old') ) }}

Notes:

•The Common Reporting Standard (CRS) is an internationally-agreed standard introduced by the Organisation for Economic Co-operation and Development (OECD) for the automatic exchange of financial information between participating countries / jurisdictions. Under the CRS rules, we are required to collect information on the tax residence of our customers. The CRS is effective in Malaysia from 1 July 2017.

•Individual account holder, sole trader or sole proprietor owned by an individual. For joint or multiple account holders, use a separate form for each individual person.

•Please note that this self-certification form is for CRS purposes only. If you are a US Person under the US Internal Revenue Service (“IRS”) regulations, you may also need to fill in an IRS W-9 Form, in addition to this form.

•As a financial institution, Hong Leong Bank Berhad (HLBB) / Hong Leong Islamic Bank Berhad (HLISB) is not able to provide tax advice to its customers. For more information on tax residence, please consult your professional tax adviser or visit http://www.oecd.org/tax/automaticexchange/crs-implementation-and-assistance/tax-residency/.  

Part 1 – Identification of Individual Account Holder / Owner of Sole Proprietorship

Part 1 – Identification of Individual Account Holder / Owner of Sole Proprietorship

Part 1 – Identification of Individual Account Holder / Owner of Sole Proprietorship

Salutation

Mr Miss Mrs Ms/Mdm Dr
This field is mandatory.

Full Name (as per NRIC / Passport)

Full name (as per NRIC) is required

NRIC Number

{{ formCustom.ic1.$error.required || formCustom.ic2.$error.required || formCustom.ic3.$error.required ? 'NRIC no. is required' : ( (formCustom.newIC.$error.format) ? 'NRIC no. is not valid' : processAgeErrorMessage('Your age must be between #MIN# years old to #MAX# years old') ) }}

Passport Number

Passport is required

Passport Expiry Date

This field is mandatory. Field value is invalid.

Date of Birth

This field is mandatory. Field value is invalid.

Current residential address

Current residential address is required

Country

This field is mandatory.

Postcode

This field is mandatory.

Mailing Address: (please only complete if different from the residential address shown above)

Current residential address is required

Country

This field is mandatory.

Postcode

This field is mandatory.

Are you ONLY a Malaysian tax resident?

Are you ONLY a Malaysian tax resident is required

Country/Jurisdiction of Tax Residence and related Taxpayer Identification Number or equivalent number (“TIN”)

Please complete the following table indicating (i) where the Account Holder is tax resident; and (ii) the Account Holder’s TIN for each country/jurisdiction indicated.

Country/Jurisdiction of Tax Residence and related Taxpayer Identification Number or equivalent number (“TIN”)

Please complete the following table indicating (i) where the Account Holder is tax resident; and (ii) the Account Holder’s TIN for each country/jurisdiction indicated.

Country/Jurisdiction of Tax Residence and related Taxpayer Identification Number or equivalent number (“TIN”)

Please complete the following table indicating (i) where the Account Holder is tax resident; and (ii) the Account Holder’s TIN for each country/jurisdiction indicated.

Please complete the following table with your tax residency details

Country/Jurisdiction of tax residence

1

This field is mandatory.

TIN

This field is mandatory.

If no TIN available, enter Reason A, B or C

Reason A Reason B Reason C
This field is mandatory.

2

This field is mandatory.
This field is mandatory.
Reason A Reason B Reason C
This field is mandatory.

3

This field is mandatory.
This field is mandatory.
Reason A Reason B Reason C
This field is mandatory.

4

This field is mandatory.
This field is mandatory.
Reason A Reason B Reason C
This field is mandatory.

5

This field is mandatory.
This field is mandatory.
Reason A Reason B Reason C
This field is mandatory.

Reason A - The country/jurisdiction where the Account Holder is a tax resident does not issue TINs to its tax residents

Reason B - The Account Holder is otherwise unable to obtain a TIN or equivalent number

Reason C - No TIN is required. (Note: Only select this reason if the domestic law of the relevant jurisdiction does not require the collection of the TIN issued by such jurisdiction)

Please explain in the following boxes the reason you are unable to obtain a TIN if you selected Reason B above.

1

This field is mandatory.

2

This field is mandatory.

3

This field is mandatory.

4

This field is mandatory.

5

This field is mandatory.

Please ensure your details are correct before you proceed

Part 1 – Identification of Individual Account Holder / Owner of Sole Proprietorship

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{{getReviewField('dateOfBirth')}}

{{getReviewField('residentialAddress')}}

{{getReviewField('residentialCountry')}}

{{getReviewField('residentialPostcode ')}}

{{getReviewField('mailingAddress')}}

{{getReviewField('mailingCountry')}}

{{getReviewField('mailingPostcode ')}}

Are you ONLY a Malaysian tax resident? {{getReviewField('taxResidentRadio')}}

Part 2 – Country/Jurisdiction of Tax Residence and related Taxpayer Identification Number or equivalent number (“TIN”)

Country / Jurisdiction of tax residence

TIN

Reason Type (If no TIN available)

Reason

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{{getReviewField('tinExplanation1')}}

{{getReviewField('taxCountry2')}}

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{{getReviewField('tinExplanation2')}}

{{getReviewField('taxCountry3')}}

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{{getReviewField('tinExplanation3')}}

{{getReviewField('taxCountry4')}}

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{{getReviewField('tinExplanation4')}}

{{getReviewField('taxCountry5')}}

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{{getReviewField('tinReason5Label')}}
{{getReviewField('tinExplanation5')}}

Reason A - The country/jurisdiction where the Account Holder is a tax resident does not issue TINs to its tax residents

Reason B - The Account Holder is otherwise unable to obtain a TIN or equivalent number

Reason C - No TIN is required. (Note: Only select this reason if the domestic law of the relevant jurisdiction does not require the collection of the TIN issued by such jurisdiction)

Please check the Disclaimer checkbox to proceed
Please check the Disclaimer checkbox to proceed
Please check the Disclaimer checkbox to proceed
Please check the Disclaimer checkbox to proceed
Please check the Disclaimer checkbox to proceed

Key in the 6-Digit OTP sent to your mobile

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Tell us what you do for a living

Tell us what you do for a living

Tell us what you do for a living

Your Occupation

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Your Occupation Description

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Your occupation description is required

Your employment type

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Your employment type is required

Employment Sector

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Employment sector is required

Industrial Sector

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{{ind.indLabel}}
Industrial sector is required

Your annual income

RM

Your annual income is required You need to have a minimum income of MYR 24000 per annum to be eligible for a credit card. {{ "You need to have a minimum income of MYR 24000 per annum to be eligible for a credit card.".replace('24000', '12000') }}

Tell us about your current employment

Tell us about your current employment

Tell us about your current employment

Your company name

Your company name is required

Your company contact number

Your company contact number is not valid Your company contact number is required

Your company address

Your company address is required

Postcode

{{formCustom.officePostcode.$error.required ? 'Company postcode is required' : 'Please enter a valid postcode'}}

City

{{city.officeCityCodeLabel}}
This field is mandatory.

City

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State

{{state.officeStateCodeLabel}}
This field is mandatory.

State

This field is mandatory.

Country

This field is mandatory.

When did you start working at your current place of employment?

When did you start working at your current place of employment?

When did you start working at your current place of employment?

This field is mandatory.

Previous employer’s name

Previous employer’s name is required

Previous employer’s contact number

{{ formCustom.prevEmployerOffGenLine.$error.required ? 'Previous employer’s contact number is required' : 'Previous employer’s contact number is not valid' }}

Previous field of work

{{occupation.occNameLabel}}
Previous field of work is required

Previous Length of Service/Business

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
0 1 2 3 4 5 6 7 8 9 10 11
Previous length of service/business is required

Where would you like your card to be delivered?

Where would you like your card to be delivered?

Where would you like your card to be delivered?

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Upload your documents

Upload your documents

Accepted formats: .jpeg, .jpg, .pdf or .png

Max file size: 5MB per document

Accept .pdf, .png, .jpeg or .jpg format only. Max file size: 5MB per document.

You may skip this for now and upload your documents later. 

You are so close to completing your application.

Just click below to upload a copy of your NRIC!

 

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Max file size: 5MB per document
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
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FD Receipt No

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Cancel My FD Pledge

Accepted formats: .jpeg, .jpg, .pdf or .png

Max file size: 5MB per document

Accept .pdf, .png, .jpeg or .jpg format only. Max file size: 5MB per document.

You may skip this for now and upload your documents later. 

You are so close to completing your application.

Just click below to upload a copy of your NRIC!

 

Accepted formats: .jpeg, .jpg, .pdf or .png

Max file size: 5MB per document
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Please upload file format in .pdf, .png, .jpg or .jpeg only. Maximum file size is 5MB each only.
Document upload is required

FD Receipt No

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Cancel My FD Pledge

Key in the 6-Digit OTP sent to your mobile

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Please complete your details to submit this application

Please complete your details to submit this application

Please complete your details to submit this application

Full Name (as per NRIC)

This field is mandatory.

Email Address

Field value is invalid. This field is mandatory.

NRIC No.

{{ formCustom.ic1.$error.required || formCustom.ic2.$error.required || formCustom.ic3.$error.required ? 'This field is mandatory.' : ( (formCustom.newIC.$error.format) ? 'Field value is invalid.' : processAgeErrorMessage('Your age must be between #MIN# years old to #MAX# years old') ) }}

Mobile Number

{{ formCustom.mobileNumber.$error.required ? 'This field is mandatory.' : 'Field value is invalid.' }} Your One-Time-Password (OTP) will be sent to this mobile number and is required to submit this application.

Sorry, you are not eligible for this application.

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Sorry, you are not eligible for this application.

You already have an active credit card application which is pending documents from you. Please upload the documents via Application History in Connect Online.
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We are sorry!

The Passport number entered could not match with our record.

Please click “CRS Form” button to download the CRS Self-Certification Form to confirm your tax status and submit to the Bank by 31 December 2023.

You may also email us should you have any questions.
CRS Form

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You already have an active credit card application which is accepted for processing in our system. Please wait for us to process this first.
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Sorry, you are not eligible for this application.

Sorry, your current credit card status does not allow us to proceed with this request.
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Sorry, you are not eligible for this application.

We regret to inform you that we are unable to proceed with your application. Please contact your nearest branch for assistance.
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We are sorry!

The NRIC number entered could not match with our record.

Please click “CRS Form” button to download the CRS Self-Certification Form to confirm your tax status and submit to the Bank by 31 December 2023.

You may also email us should you have any questions.
CRS Form

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You already have an active personal loan / financing application which is pending disbursement in our system. Please wait for us to process this first.
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Your current or savings account is not available.
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We regret to inform you that we are unable to proceed with your application. Please contact your nearest branch for assistance.
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