OVER-THE-COUNTER BANK GUARANTEE APPLICATION
Over-The-Counter Bank Guarantee (OTCBG) / Over-The Counter Bank Guarantee-i (OTCBG-i)
Please mark where applicable	Date of Application: - -
AmBank (M) Berhad (196901000166 (8515-D)) AmBank Islamic Berhad (199401009897 (295576-U))
New Issuance Renewal
1. Applicant (Full Name & Address): Contact Details Contact Person : Contact Number : E-mail Address :	2. Latest Financial Year (dd/mm/yy): 3. Annual Turnover (RM): 4. No. of Employees:	5. Beneficiary (Full Name & Address):
6. OTCBG/OTCBG-i Amount (Currency & Figures):	7. Customer Ref. No.:
8. Purpose of OTCBG/OTCBG-i:
9. Choose either to: a. Issue on the Bank’s Standard Format, OR b. Issue as per FORMAT ENCLOSED (subject to Bank’s approval)
10. Effective Date : From - - To - - (Expiry Date) Please state reason below if Effective Date is backdated. (subject to approval by the Bank) I/We hereby indemnify the Bank for all consequences and liabilities arising from the back dating and certify that I/we have not defaulted during the back-dated period and that the authorized signatory/(ies) on the Application Form and Indemnity were present and available during the backdated period. 11. Claims Period: from expiry date (if 9b is checked, the claim period is as per the enclosed format).
12. Bank Charges: Please debit my/our Account No.: with you for the cash payment of 100% equivalent to the full amount of the OTCBG/OTCBG-i and all charges, commission, fees, out-of-pocket expenses, etc. in connection with the OTCBG/OTCBG-i. Such charges shall include those for account of Beneficiary which could not be recovered by the Bank.
13. Delivery of the Original OTCBG/OTCBG-i to: Please hold for my/our collection by representative named herein: IC No.: Please courier to: - My/Our address as above Branch: I/We shall not hold the Bank liable for any loss, damages or delay by stamping office and/or courier company or the release of the OTCBG/OTCBG-i to any person that the Bank in good faith believes to be authorized to receive the same, except where such losses or damages are caused by the Bank’s gross negligence, willful default or fraud. AMBIZ/E/OTCBG OTCBG-i/04-2020

OVER-THE-COUNTER BANK GUARANTEE APPLICATION – cont’d
14. Stamping of OTCBG/OTCBG-i (Select one only) by the Bank; or by me/us and I/we undertake to ensure that the original OTCBG/OTCBG-i is stamped immediately with stamp duty office and I/we shall forward copy of the stamped OTCBG to the Bank at TBSC-KL@ambankgroup.com. Any penalty and/or loss resulting in non-stamping of the original OTCBG/OTCBG-i will be borne by me/us.
15. Additional Instructions:
In consideration of my/our request, the Bank to issue the OTCBG/OTCBG-i and in accordance with the above instructions, I/we hereby irrevocably and unconditionally agree to fully abide by the terms and conditions of this Application Form and terms appearing in the Over-the-Counter Bank Guarantee Application Terms and Conditions/Over the Counter Bank Guarantee-i Application Terms and Conditions (the “T&C”) under document Reference No.: AMBIZ/E/OTCBG T&C/04-2020 or TC(OTCBG/RV2-BI/042020) and/or website and/or other relevant Agreements which have been and will be advised to us by you and currently in force in the Bank. This Application Form and the T&C are to be construed and enforced in accordance with the laws of Malaysia. I/We hereby declare that I/we are aware of and in full compliance with the Strategic Trade Act 2010 and all the regulations and requirements connected thereto. I/We will comply with the Foreign Exchange Administration Rules (“FEA”) relating to dealings in currency, borrowing/financing & guarantee, investment in foreign currency asset, payments, security & financial instrument, and export of goods at all times.
I/We hereby confirm that I/we have chosen the language in this form as the language of this Application Form. This chosen language shall prevail in the event of differences in meaning over the version of Application Form in any other language. Declaration of Authorized Signatory(ies) I/We, undersigned, declare that the details furnished above are true and correct and I/we shall undertake to inform you of any changes therein immediately. I/We declare that I/we am/are the Authorized Signatory(ies) of the Applicant and have full authority of the Applicant to submit this Application Form and the T&C together with the accompanying documents (where applicable) to request for the issuance of an OTCBG/OTCBG-i on behalf of the Applicant; and I/we irrevocably confirm that the Applicant has agreed to be bound by the terms and conditions of this Application Form and the T&C. In consideration of you agreeing to the issuance of an OTCBG/OTCBG-i at my/our request, I/we irrevocably and unconditionally agree that I/we shall be personally liable to you for any losses, damages, costs, expenses whatsoever which you may incur or suffer directly or indirectly arising from you relying on the information given by me/us/the Applicant in this Application Form and the T&C or as a result of a breach by me/us/the Applicant of the terms and conditions of this Application Form or the T&C for whatsoever reasons. Further Declaration (applicable to all type of companies under the Companies Act, 2016) I/We further declare in reference to the Companies Act, 2016 that: - The Applicant has the full authority under its Constitution (formerly known as M&A) for this application; OR The Applicant does not have a Constitution Authorized Signatory(ies) With Company’s Authorized Rubber Stamp Note: This Application Form is to be signed by the Applicant’s Authorized Signatory(ies). For the avoidance of doubt, Authorized Signatories for the purpose of this application means any person(s) authorized and mandated in writing by the Applicant to operate the deposit account maintained with the Bank. The Applicant is obliged to inform the Bank should there be any changes in the Authorized Signatories. AMBIZ/E/OTCBG OTCBG-i/04-2020