Payment Relief Assistant Plan – Individual Form

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Application for HLB/HLISB Payment Relief Assistance Plan

Please complete this form to apply.

* Name

* ID Type

* ID Number

* DOB

* Mobile Number

* Alt Contact Number

* Email Address

* State

* City

* Residential Status

* Marital Status

* No. of dependents

* HLB/HLISB Loan / Financing Account No (1)

* Loan/Financing Account Type

Applicant

Employment Status

* Monthly Gross Income (Current)

* Monthly Net Income (Current)

* Monthly Gross Income (Previous)

Spouse

Employment Status

* Monthly Gross Income (Current)

* Please select your reason for seeking assistance:

>50% Income or Cashflow Reduction

25-50% Income or Cashflow Reduction

Unemployed/Loss of Job

Self employed and Business Closure

Please upload the following documents that are required to assess your application:

*Please expect a call or visit from a HLB/HLISB credit officer as part of our assessment process

(Accept .pdf, .png, .jpeg or .jpg format only. Maximum file size for all document is 7MB.)

LOAN/FINANCING DETAILS WITH OTHER FINANCIAL INSTITUTIONS

* Bank

* Facilities

* Account Number

Reset Facility

Add Facility

* Other Loan Commitment (Non bank)

* Please select your new HLB/HLISB Payment Relief Assistance Plan:

Pay Interest / Profit only for 6 months, with reduced interest/profit rate

50% reduction of instalments for 6 months

Reduced instalment with reduced interest/profit rate and an extended loan tenure

Extended loan/financing tenure for 2 years

I don't need additional help for the time being

Note: In the event we are unable to provide the assistance you require, we shall refer your application to AKPK for further assistance.

For your mortgage / home financing, kindly note that all joint borrowers / applicants MUST accept the new Letter of Offer (which will be sent to you via e-mail) in order for the new plan to take effect. Please fill in your joint borrower(s) / applicant(s) information:

Joint borrower / applicant (1)

* Name

* Mobile Number

* ID Number

* Email Address

Joint borrower / applicant (2)

* Name

* Mobile Number

* ID Number

* Email Address

Joint borrower / applicant (3)

* Name

* Mobile Number

* ID Number

* Email Address

Joint borrower / applicant (4)

* Name

* Mobile Number

* ID Number

* Email Address

By submitting this form, I hereby declare that*:

My loan/financing is presently not under rehabilitation with Credit Counselling and Debt Management Agency (AKPK);

I am not an undischarged bankrupt or subject to a bankruptcy proceeding; and

I understand that*:

Normal interest/profit will continue to be charged during the deferment period;

I have the option to engage the Bank to revise the monthly repayment/payment amount and/or schedule if my financials improve to reduce overall financing/borrowing costs;

I agree to furnish the Bank with additional information/supporting documents as may be required after my Payment Relief Assistance has been approved;

Where required, I will be notified by the bank via email or call to sign relevant documents/ accept my Payment Relief Assistance plan to complete the legal documentation, including those related to guarantors or joint accounts and/or variation agreements for Hire Purchase/ Fixed rate loan/financing

The Bank reserves the right to modify/rescind the Payment Relief Assistance if I am found to have made false, misleading or incomplete representation in this application

If I have missed my instalments that are due and unpaid by more than 90 days at the date of application, I agree for the bank to offer me a customised solution that is more suitable for my financial circumstances or to share my loan/financing details with AKPK for further financial advice on managing my debt and allowing AKPK to access my CCRIS information

In the event my application is processed for a HLB Relief Assistance Plan, I understand that my current Relief Assistance Plan will be terminated and the new Plan will take effect the following month upon approval and acceptance by me as applicable.

I declare that the information provided here is true and accurate

Please read the Privacy Notice carefully before clicking Agree.

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 call 03-7959 1888, 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.

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Application for HLB/HLISB Payment Relief Assistance Plan

Please complete this form to apply.

* Name

* ID Type

* ID Number

* DOB

* Mobile Number

* Alt Contact Number

* Email Address

* State

* City

* Residential Status

* Marital Status

* No. of dependents

* HLB/HLISB Loan / Financing Account No (1)

* Loan/Financing Account Type

Employment Status

* Monthly Gross Income (Current)

* Monthly Net Income (Current)

* Monthly Gross Income (Previous)

Employment Status

* Monthly Gross Income (Current)

* Bank

* Facilities

* Account Number

* Other Loan Commitment (Non bank)

* Name

* Mobile Number

* ID Number

* Email Address

* Name

* Mobile Number

* ID Number

* Email Address

* Name

* Mobile Number

* ID Number

* Email Address

* Name

* Mobile Number

* ID Number

* Email Address

Thank you for your enquiry.

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