Yes, we wish to participate in the Industrial Hire Purchase Deferment Program and consent to the variation of the terms to our Industrial Hire Purchase agreement.

* Registered Business Name
error


* Email Address
error

* Registered Business Number
error

Please key in without space or dash e.g. 864110141234







* Mobile number / Fixed Phone number
error

Please key in without suffix, space or dash: 012123456 or 0377668899

* Retype Email Address
error

* Vehicle Number
error

Please key in without space e.g. BBC1234


6-digit code
error


I hereby confirm that I am an authorized /appointed signatory/personnel to provide consent to opt-in on behalf of the Hirer named above for the specific purpose indicated above.

* Name
error


* Designation
error


* NRIC Number
error

Please key in without space or dash e.g. 864110141234

* Mobile number
error

Please key in without suffix, space or dash: 012123456 or 0377668899

Agreement
Submit2
Next