Online Pre-Assessment Form

Credit Application Form
(Pre-Assessment Form)
Company's Name
Company Registration No.
Date of Incorporation

DayMonth Year
Date
Type of Business
Length of Business (in years)
Email
example@example.com
Nature of Business
Registered Address

Street Address Line 1
Street Address Line 2
City State
Zip Code
Correspondence Address

Street Address Line 1
Street Address Line 2
City State
Zip Code
Phone Number

Area Code Phone Number
Facsimile Number

Area Code Phone Number

Shareholders' Details

	Name	NRIC No.	Age	Shareholding (RM)	Shareholding (%)	Relationship
1
2
3
4
5
6
7
8
9
10

Nature of Business

Dealer / Hardware ShopManufacturerContractorGovernment Agency

B. PROJECT DETAILS
Project Awarder
Name of Projects
Amount of Project
Tenure of Project
Date of Commencement

DayMonth Year
Date
Expected Completion

DayMonth Year
Date
Mode of Payment

C. CREDIT DETAILS
Purpose of Application
Amount Applied (RM)
Credit Terms (Days)
e.g. 30-days, 45-days, or 60-days
Value of Collateral
Type of Collateral
Personal Guarantee Details

Name NRIC No. Networth (RM) Relationship
1
2
3
4
5

D. Financial Report

Summary of Comprehensive Income

	2022	2021	2020	2019	2018
Sales / Revenue
LESS: Cost of Sales
Gross Profits
ADD: Other Incomes
LESS: Operating Expenses
LESS: Finance Cost
Profit / (Loss) Before Tax
LESS: Income Tax
NET PROFITS / (LOSSES)

Summary of Financial Position

	2022	2021	2020	2019	2018
Fixed Assets
Current Assets
Cash & Bank Balances
Inventories
Trade Receivables
Oth. Receivables, Deposits & Prepayment
Other Current Assets
TOTAL ASSETS
Current Liabilities
Trade Payables
Other Payables and Accruals
Short-Term Bank Borrowing
Other Current Liabilities

Non-Current Liabilities
Deferred Tax
Term Loans
Other Non-Current Liabilities

Capital & Reserves
Share Capital
Retained Earnings
Accumulated Profits / (Losses)
TOTAL EQUITY & LIABILITIES

E. Banking Details
Name of Bank
Branch
Type of Account
Account No.
Summary of Bank Statement

Debit (RM) Credit (RM) Balance (RM)
1st Month
2nd Month
3rd Month
4th Month
5th Month
6th Month

F. Declaration and Disclaimer
TERMS & CONDITIONS
1. The credit period is 30-days (unless otherwise stated) in the Letter of Offer.
2. All payment must be made in full on the due date and/or within the credit period stated in our invoice/delivery order.
3. Interest charges at 1.5% per month will be charged on the overdue invoice.
4. The company reserves the right to suspend credit or cancel the credit facilities granted without prior notice.
DISCLAIMER*

I/We hereby agree to and accept the terms and conditions as stated above in respect of all present and future business transactions between us and certify that all information given is true and correct.I/We hereby give consent to PERKASA TRADING SDN BHD, SEDCO Group and its subsidiaries to obtain and/or disclose any Credit Information (as defined in the CRA Act 2010) relating to me/our company from and/or to RAM Credit Information Sdn Bhd to verify my/our credit history as you and/or RAM Credit Information Sdn Bhd for opening of account, credit evaluation, credit/account review, credit/account monitoring, debt recovery purposes and scoring solutions. This consent shall remain applicable as long as I/Our company am/is maintaining any transaction with you.I/We hereby agree to receive any future marketing updates from PERKASA TRADING SDN BHD, SEDCO Group and its subsidiaries.
Trading License / Form 9

Browse Files
Cancelof
Letter of Award(s)

Browse Files
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Latest Audited Accounts (3 years)

Browse Files
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Latest Bank Statement (6 months)

Browse Files
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Copy of NRIC (Directors & Guarantors)

Browse Files
Front & BackCancelof

Consent Authorisation
THE GENERAL MANAGER

PERKASA TRADING SDN BHD

6TH FLOOR, WISMA PERKASA, JALAN GAYA

P.O. BOX 11897

88821 KOTA KINABALU

SABAH.

Dear Sir,

CONSENT AUTHORISATION

Pursuant to the Credit Reporting Agencies (CRA) Act 2010 and Bank Negara Malaysia Act 2009, I/we the undersigned do hereby give my/our consent to you and CTOS Data Systems Sdn Bhd ("CTOS"), a registered credit reporting agency under the CRA Act to process my/our company personal data.

By this consent, I/We understand and agree that:-
1. You may conduct credit/trade check, CCRIS and DCHEQS checks on me/us and where applicable with CTOS at any time for as long as I/We have a trade relationship with you or where any dues remain unpaid and outstanding with you, for any one or more of the following purposes:-
  - Opening of Account;
  - Debt Recovery;
  - Credit / Account Review;
  - Credit / Account Monitoring;
  - Credit / Account Evaluation; and/or
  - Legal Documentation consequent to a contract or facility granted by you.
2. You may disclose any information on my/our conductof my/our account(s) with you, to any business entity/ies for bina fide trade checking at any time. I/We am/are also aware and understand that such information will be provided to CTOS, who may in turn share such information to subscribers of their service.
3. Where you require any processing of my/our application to be processes by any processing centre located outside Malaysia (including your Head Office), I/We hereby give consent to CTOS to disclose my/our credit, CCRIS & DCHEQS reports to such locations outside Malaysia.
4. Apart from the above, I/We the undersigned do give my/our consent to you and the CTOS, to process my/ourr personal data as per the PDPA Act.
Signed By

(Authorized Signatory 1) Clear
Signed By

(Authorized Signatory 2) Clear
Should be Empty:

	Debit (RM)	Credit (RM)	Balance (RM)
1st Month
2nd Month
3rd Month
4th Month
5th Month
6th Month

Credit Application Form

B. PROJECT DETAILS

C. CREDIT DETAILS

D. Financial Report

E. Banking Details

F. Declaration and Disclaimer

Consent Authorisation