Application for HLB / HLISB Payment Relief Assistance Plan

 

Please complete this form to apply.

* Registered Company Name
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* Applicant Contact Number (e.g.01x12345678):
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* Applicant Full Name
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* Company Registration Number
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* Email:
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* Applicant IC Number
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* Loan / Financing Account No (1) e.g. 00xxxxxxxxx:
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* Loan/Financing Account Type
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IMPORTANT- After the successful submission, you will receive a Supplementary Letter of Offer via email. You are REQUIRED TO ACCEPT the offer by following the instructions given to you in the email. If you do not accept the offer within 7 days of the date of the email, the offer will be cancelled.


Loan / Financing Account No (2):
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If you have more than 1 account

Loan/Financing Account Type
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IMPORTANT- After the successful submission, you will receive a Supplementary Letter of Offer via email. You are REQUIRED TO ACCEPT the offer by following the instructions given to you in the email. If you do not accept the offer within 7 days of the date of the email, the offer will be cancelled.


Loan / Financing Account No (3):
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If you have more than 2 account

Loan/Financing Account Type
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IMPORTANT- After the successful submission, you will receive a Supplementary Letter of Offer via email. You are REQUIRED TO ACCEPT the offer by following the instructions given to you in the email. If you do not accept the offer within 7 days of the date of the email, the offer will be cancelled.


Loan / Financing Account No (4):
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If you have more than 3 account

Loan/Financing Account Type
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IMPORTANT- After the successful submission, you will receive a Supplementary Letter of Offer via email. You are REQUIRED TO ACCEPT the offer by following the instructions given to you in the email. If you do not accept the offer within 7 days of the date of the email, the offer will be cancelled.


By submitting this form, I hereby declare that*:

I understand that*:


If you require further details on the changes to your loan/financing obligations before confirming your submission, or are having issues submitting your form, please contact your Relationship Manager, or call 03-7626 8899,or Email PaymentRelief@hlbb.hongleong.com.my

By submitting this form, I hereby confirm that I have read and agreed to the contents of the Privacy Notice. I further acknowledge and agree that all personal data provided by me and/or acquired by Hong Leong Bank Berhad (“HLBB”) and Hong Leong Islamic Bank (“HLISB”) from the public domain, as well as personal data that arises as a result of the provision of services to me will be subject to the Privacy Notice.

I confirm that the mobile/fixed phone number provided herein is accurate and shall be used by you to calls, SMS and Whatsapp.