CASH MANAGEMENT, Menara Bank Islam,Tingkat 18, No.22, Jalan Perak,
50450 Kuala Lumpur. EMAIL:
. NO TEL: 03 2782
1315 ...
eBANKER REGISTRATION FORMS MONETARY FACILITIES PACKAGE CASH MANAGEMENT, Menara Bank Islam,Tingkat 18, No.22, Jalan Perak,50450 Kuala Lumpur. EMAIL:
[email protected] NO TEL: 03 2782 1315 / 1314 / 1319 FAX NO.: 03 2782 1350 /1351
1. CUSTOMER INFORMATION (Please use capital letters) CORPORATE CUSTOMER NAME ROC NUMBER: POSTAL ADRRESS (Please do not use P.O Box mail) (Address preferred for PIN Mailer delivery purposes)
-
TEL. N0.
PREFERRED CORPORATE ID
-
FAX NO. 3
2
1
Please provide three (3) choices
2. CORPORATE ADMINISTRATOR DETAILS CORP. ADMINISTRATOR NAME
NRIC
DESIGNATION EMAIL ADDRESS CORPORATE ADMINISTRATOR'S SIGNATURE:
MAXIMUM NUMBER USER ALLOWED users can log in/access at the same time
(dd/mm/yyyy)
DATE Customer is required to inform Bank Islam in writing of any termination, changing or new appointment of Corporate Administrator
3. DESIGNATED ACCOUNTS (Bank Islam's current account only) i.
EDIT
DELETE
ACC. APPROVAL LIMIT (RM)
ACCOUNT NUMBER
ii.
ADD
ACCOUNT NAME ACCOUNT NAME ACC. APPROVAL LIMIT (RM)
ACCOUNT NUMBER
iii. ACCOUNT NAME ACCOUNT NUMBER
ACC. APPROVAL LIMIT (RM)
iv. ACCOUNT NAME ACC. APPROVAL LIMIT (RM)
ACCOUNT NUMBER
iv. ACCOUNT NAME ACC. APPROVAL LIMIT (RM)
ACCOUNT NUMBER
ACCOUNT APPROVAL LIMIT is the amount that can be transferred out from your account per transaction. You can limit the amount and it is up to the client to specify how much. The limit can be amended by sending the same form to us in order for us to update the limit. Please use own paper as attachment if your Designated Account more than 5.
CUSTOMER'S DECLARATION We hereby confirm that the above information is correct . (dd/mm/yyyy)
DATE
Authorised Signature
Authorised Signature
Company Stamp
Page 1 of 4
4. AUTHORISERS DETAILS
ADD
I-VEST SMART CARD user (who authorize all monetary transactions)
EDIT
DELETE
i.AUTHORISER NAME NRIC
DESIGNATION EMAIL ADDRESS ii.AUTHORISER NAME
NRIC
DESIGNATION EMAIL ADDRESS iii.AUTHORISER NAME
NRIC
DESIGNATION EMAIL ADDRESS iv.AUTHORISER NAME
NRIC
DESIGNATION EMAIL ADDRESS iii.AUTHORISER NAME
NRIC
DESIGNATION EMAIL ADDRESS
Please use own paper as attachment if your Authoriser is more than 5. Please attach together with photocopy of I.C for each Authoriser and a cheque for DIGICERT SDN BHD. The cheque is for Smart Card Payment. Each Smart Card price is RM 360.00 (Peninsular) and RM 363.00 (Sabah/Sarawak).
5. STAMP DUTY CHARGE eBANKER AGREEMENT - 2 COPIES We
hereby authorize Bank Islam to debit RM 20.00 of the followings from our account number:
6. LETTER OF INSTRUCTION - STANDING INSTRUCTION We hereby authorise the Bank to make periodically monthly payment of RM30.00 for eBanker Subscribtion Fee by way of debiting our Current Account and credit to the transferee account 14153010033701. This instruction shall take into effect from 15th day of the following month and shall remain in force until termination of eBanker service.
CUSTOMER'S DECLARATION We hereby confirm that the above information is correct . (dd/mm/yyyy)
DATE
Authorised Signature
Authorised Signature
Company Stamp
Page 2 of 4
7. PRODUCT PROFILE SELECTION (Please tick) Current Account Inquiry
Bill Payment
Statement Inquiry
Foreign Telegraphic Transfer & Foreign Demand Draft
Cheque Status Inquiry
Domestic Cheque Return Inquiry
Statement Request
Cheque Book Requisition
Stop Cheque Application
Release Stopped Cheque Application
Own Account Fund Transfer
Third Party Funds Transfer (Inter/Intra bank, Bank Draft)
Local Telegraphic Transfer (RENTAS)
Banker Cheque Issuance
Salary Crediting
CUSTOMER'S DECLARATION We hereby confirm that the above information is correct . (dd/mm/yyyy)
DATE
Authorised Signature
Authorised Signature
Company Stamp
FOR BANK ISLAM USE Please verify the Account Number (in Page 1) and Company Stamp / Business Registration Number (in Page 1 - 4)
Verified by :
Branch :
Date :
Page 3 of 4
8. SAMPLE : DIRECTORS' RESOLUTION That the Company subscribe to the internet banking service provided by Bank Islam (the Bank) called 'E-Banker Facility'. 1. * That,
SAMPLE ONLY PLEASE PROVIDE ACTUAL RESOLUTION
NAME
DESIGNATION NRIC
SIGNATURE
NAME
DESIGNATION NRIC
SIGNATURE
USING OWN LETTERHEAD
be authorized to execute, for and on behalf of the Company the Agreement between the Company and the Bank pertaining to the EBanker facility in such form as the Bank may prescribe. * That the Common Seal of the Company be affixed on the Agreement between the Company and the Bank pertaining to the EBanker facility in such form as the Bank may prescribe. 2. That the Corporate Administrator identified in CORPORATE ADMINISTRATOR DETAILS be authorized to receive on behalf of the Company, the initial security identification from the Bank for the purpose of operating the E-Banker Facility. 3. That the persons identified as Authoriser in AUTHORIZER DETAILS will act as a person to authorize the banking transactions through EBanker facility. 4 a) That the current account of the Company maintained with the Bank mentioned in DESIGNATED ACCOUNTS for the purpose of effecting transactions under the E-Banker facility. b) That the Bank be authorized to debit from Account No. such sum as may be adequate to defray costs and charges payable to the Bank in relation to the E-Banker facility. c) That accounts listed in Beneficiary Accounts for the purpose of receiving funds transferred from any of the Designated Accounts. 5. That these resolutions be communicated to the Bank and shall remain in force and be binding against the Company until an amendingresolution, if any, is passed by the Board of Directors of the Company and a certified copy thereof shall have been received by the Bank.
9. LETTER OF IRREVOCABLE UNDERTAKING & INDENMNITY Date:
(dd/mm/yyyy)
Bank Islam Malaysia Berhad ( Company No : 98127-X ) 14th Floor, Darul Takaful, Jalan Sultan Ismail, 50250 Kuala Lumpur. Dear Sirs, LETTER OF IRREVOCABLE UNDERTAKING AND INDEMNITY. SUBSCRIPTION TO THE INTERNET BANKING SERVICE PROVIDED BY BANK ISLAM MALAYSIA BERHAD CALLED "E-BANKER FACILITY ” In consideration of you agreeing, at our request to subscribe or use the Internet Banking Service ( "e- Banker Facility") with you, we hereby irrevocably and unconditionally undertake and agree as follows:a) We apply for the e-Banker Facility with your Bank and enclose herewith the particulars of the person(s) authorised to hold access and hereby give consent to each authorised person the right to operate the e-Banker Facility for and on behalf of the Company . b) We undertake to forthwith notify you and shall immediately terminate the e-Banker Facility in the manner prescribed in the Terms and Conditions of e- Banker Facility or as agreed to by the Bank in the event the constitution of the Company has changed. c) We shall indemnify you and shall hold you harmless and at all times keep you fully indemnified from and against all claims, demands, actions, damages , suits, proceedings, expenses including but not limited to legal costs between solicitor and client and all other liabilities of whatsoever nature or description which maybe made or taken against or incurred or suffered by you in connection with or in any manner arising therefrom or out of the said authorisation given by us or any instructions given or purported to be given by the authorised person(s) or failure on our part to inform you promptly of any changes in the constitution of the Company . d) Our liabilities shall be a continuing liability and shall remain in full force and effect until our liabilities are fully discharged to your satisfaction. e) We shall be bound by the Terms and Conditions of the e-Banker Facility . f) We hereby declare that there is no change to the Company's latest mandate for operation of the account. g) We shall not hold you liable for any losses or damages whatsoever suffered by us arising from subscribing or using the e- Banker Facility or anything related thereto . Thank you. Yours faithfully,
Authorised Signature
Authorised Signature
Company Stamp
Page 4 of 4
iVESTmail Reservation Form
iVESTmail Username Reservation
Preferred Name reservation Please write in five (5) selections of iVESTmail username. Only one of these will be your username based upon availability
1 2
3
4
5
Signature: Name:
DIGISIGN ID BASIC / DIGISIGN ID ENHANCED CLASS 2 DIGITAL CERTIFICATION FORM DIGICERT Sdn. Bhd. (457608-K), Lot 2-1, Enterprise 1, Technology Park Malaysia 57000 Kuala Lumpur
INSTRUCTIONS •
This certificate is applicable to Malaysians and foreign individuals above 18 years of age.
• Please complete ALL sections of this form when applying for DIGISIGN ID BASIC or DIGISIGN ID ENHANCED digital certificates. • All payments are accepted without prejudice to any legal action. • This application shall only be valid if the identity verification is successful and the digital certificate is accepted by the subscriber. • Please enclose photocopies of the following (enclosed documents are non-returnable): • ONE (1) of the followings: TWO (2)of the followings: − Photocopy of NRIC (both sides) - Valid Driver's License; - Referral letter from current employer; − Passport - Birth Certificate; - 2 credit card bills from different providers; OR - Latest income tax return form (Form J) - 2 bank statements from 2 different banks; - Certificate of Adoption - Any documentation deemed fit by DIGICERT/RA. • Recent drivers license size (25mm x 32mm) colour photograph (for smart cards if applicable)
CUSTOMER INFORMATION (Please complete your details in capital letters) Applicant's name (Mr./ Ms./ Mrs./ Dr.) (as in NRIC/ Passport)
NRIC / Passport # Date of Birth
//
Nationality
(dd/mm/yyyy)
Organisation Name & Address (Address preferred for Certificate Token and PIN Mailer delivery purposes)
Organisation Unit/ ROC # -
Tel (O)
-
Tel (H/P)
Email Address (Not applicable for free web based e-mail e.g. yahoo, hotmail and etc)
ITEMS SELECTED (Please tick () the followings where applicable) Certificate Type
Basic
Enhanced
Certificate Storage Token
Smart Card (SC)
USB Security Device
Compact Disk
Additional items
SC Reader(Serial)
SC Reader(USB)
Client Interface Software
Years
Validity
Certificate Fees RM Floppy disk
Others: MODE OF PAYMENT (Please select your preferred mode of payment) Cheque (for companies only)
Cheque Number:
Name of Bank:
DECLARATION I declare the following to hold for the subscriber that the subscriber certifies that all the above information is true and valid to the best of its knowledge and hereby grants DIGICERT or its appointed Registration Authorities (RA) permission to verify the information from whatever sources DIGICERT or its appointed RA considers appropriate with the understanding that DIGICERT or its appointed RA is bound by the Digital Signature Act 1997 and Digital Signature Regulations 1998 not to release such information unless required to do so by law or by an authority of higher order. Further, I represent the following to all that reasonably rely on the information contained in the certificate that I: hold all authority legally required to apply for issuance of a certificate naming on behalf of the subscriber; and (a) (b) has authority to sign digitally on behalf of the subscriber, and, if that authority is limited in any way, adequate safeguards exist to prevent a digital signature exceeding the bounds of the authority. Further, I agree to be bound by the Terms and Conditions as printed overleaf or any amendments made thereto and I declare that I have notice of all that is contained in the Notice of Acceptance as printed overleaf.
Applicant's signature: __________________
Date: _________________
FOR INTERNAL USE ONLY Application Type:
New
Checklist:
Completed application form
,
Cert. Serial #
Renewal
Replacement
Fully paid subscription fee
All photocopies of identity documents
Expiry Date
Processed by:
___________________________________
Project
SC/ USB Security Device # Approved by:
Name:
_______________________________________
___________________________________
(Registration Personnel)
(Registration Officer)
Request: ID _____________________________ Name of Registration Authority (RA): __________________________________________
Date of Issuance: ______________________
Name: ___________________________________________
TERMS AND CONDITIONS You must read the following Terms and Conditions carefully before applying for, accepting or using a Digital Certificate. If you do not agree to these Terms and Conditions, do not apply for, accept, or use the Digital Certificate. By agreeing to these Terms and Conditions, you are entering into an agreement with DIGICERT SDN. BHD (hereinafter referred to as "the Subscriber Agreement"). This Subscriber Agreement will become effective on the date you submit the certificate application to DIGICERT. By entering into and submitting this Subscriber Agreement (and certificate application) you are requesting that DIGICERT issue a Digital Certificate to you. You must understand fully the information provided by DIGICERT and must be familiar with the following terms: ?
DIGITAL SIGNATURE & CERTIFICATE Technology related information regarding digital signature and certificate is available on DIGICERT's website at http://www.digicert.com.my
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DIGITAL SIGNATURE ACT 1997 & DIGITAL SIGNATURE REGULATIONS 1998 Information regarding digital signature legislation can be obtained from DIGICERT's website at http://www.digicert.com.my
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CERTIFICATION PRACTICE STATEMENT (CPS) DIGICERT's Public Certification Services are governed by the DIGICERT CPS. You agree to use the Digital Certificate and any related CA services only in accordance with the CPS. It is published on the Internet in the DIGICERT repository at http://www.digicert.com.my/CPS and is available via E-mail from:
[email protected].
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RIGHTS, DUTIES & LIABILITIES OF DIGICERT DIGICERT provides limited warranties, disclaims all other warranties, including warranties of merchantability or fitness for a particular purpose, limits liability and excludes all liability for incidental, consequential, and punitive damages as stated in the CPS. All the information provided by the Subscriber in this application form will be kept confidential and will not be disclosed to any third party unless: It is permitted by written law to be used for other purposes; or The person affected has given that person's written consent for the data to be used for other purposes
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RIGHTS, DUTIES & LIABILITIES OF THE SUBSCRIBER You demonstrate your knowledge and acceptance of the terms of this subscriber agreement by either Submitting this application for a Digital Certificate, or Using the Digital Certificate, whichever occurs first
NOTICE OF ACCEPTANCE The following information will be incorporated in your DIGISIGN ID BASIC / DIGISIGN ID ENHANCED digital certificate: • a statement stating that the type of certificate is in accordance with the regulation; • the serial number of the certificate; • * the name of the subscriber; • * the distinguished name of the subscriber; • the public key corresponding to the private key; • an identifier of the algorithms with which the subscriber's public key is intended to be used; • * validity period of the certificates; • the distinguished name of DIGICERT; • an identifier of the algorithm(s) used to sign the certificate; a statement indicating the location DIGICERT's CPS, the method or procedure by which it may be retrieved, its form and structure, • its authorship and its date The items asterisked (*) above will be stated as per the information you have submitted in your application form. Other information required by the Digital Signature Regulations 1998 (Regulation 38) but not listed above shall be incorporated by reference to DIGICERT's CPS. By accepting this certificate, I hereby declare that: a) the subscriber rightfully holds the private key corresponding to the public key listed in the certificate; b) all representations made to DIGICERT or its Registration Authorities to information listed in the certificate are true; c) all material representations made to DIGICERT or its Registration Authorities or made in the certificate and not confirmed by DIGICERT or its Registration Authorities (RA) in issuing the certificate are true; d) acknowledge that the Class 2 certificate may only be used subject to the terms specified in DIGICERT's CPS; e) the subscriber agrees to assume duty to exercise reasonable care on protection and maintenance of the private key ; the subscriber undertakes to indemnify DIGICERT for any loss or damage caused by issuance or publication of the certificate in f) reliance on: • a false and material misrepresentation of fact by the subscriber; • the failure by the subscriber to disclose a material fact, if the representation or failure to disclose was made either with intent to deceive the Licensed Certification Authority or a person relying on the certificate, or with negligence.