SIR Credit Bureau Application Form

BORANG PERMOHONAN UNTUK SELF-INQUIRY REPORT
APPLICATION FORM FOR SELF-INQUIRY REPORT

Sila isikan dengan lengkap / Please complete the form

Sila nyatakan tujuan awda / Please state your purpose

3. Nama Penuh (seperti yang dicetak dalam Kad Pengenalan awda) / Full Name (as printed on your ID Card) *This question is required.

4. Tarikh Lahir / Date of Birth *This question is required. This question requires a valid date format of DD/MM/YYYY.

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5. Kad Pengenalan / ID Card *This question is required.

Nombor ID Kebangsaan / National ID Number *This question is required. This question requires a valid number format.

Nombor Pasport / Passport Number *This question is required.

Nombor Kad Pengenalan Angkatan Bersenjata Diraja Brunei (ABDB) *This question is required.

Nombor Kad Pengenalan Polis Diraja Brunei (PDB) *This question is required.

6. Nombor Telefon / Phone Number *This question is required. This question requires a valid number format.

7. Emel (bagi kegunaan pendaftaran akaun Sistem Biro Kredit) / E-mail (for the purpose of registration to the Credit Bureau System) *This question is required. This question requires a valid email address.

8. Alamat Penuh / Full Address *This question is required.

9. Dokumen Pengesahan / Verification Documents

Salinan Kad Pengenalan (Muka Depan) / ID Card (Front Page) *This question is required.

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Salinan Kad Pengenalan (Muka Belakang) / ID Card (Back Page) *This question is required.

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Gambar Diri Sendiri dengan Kad Pengenalan / Self-Portrait with ID Card *This question is required.

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Dokumen Lain (jika ada) / Other Document (if any)

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Pengakuan Subjek / Declaration by the Subject *This question is required.

Saya mengaku bahawa maklumat-maklumat yang diberikan di atas adalah benar dan tepat dan dokumen-dokumen bagi permohonan ini adalah salinan asal yang benar. Saya telah membaca, memahami dan bersetuju dengan Terma-Terma Perkhidmatan.

I hereby declare that all information furnished above is true and correct and all the documents provided for this application are true copies of the original. I have read, understood and agreed to the Terms of Service.

Tandatangan / Signature *This question is required.

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