DEALERSHIP NAME: Month : Name of Campaign :

Customers Scheme ( OPTION 1)

Kindly follow below details for claim purpose, otherwise submission of claim will not be entertained by HMSB. 1. All submission claims must fill up claim form. 2. Cash rebate voucher must attached with claim form. 3. HMSB reserved the rights to suspend the payout, if any discrepency or data manipulation found in the claim submitted. 4. Only applicable for CKD models: City, Civic, Accord and CRV exclude City SE.

No

Cust. Name

Cash Rebate Voucher Serial No.

Booking No#

Booking Date

Car Model

Car Reg No#

Date of reg.

Cash Rebate Amount (RM)

Total
Acknowledged by:

Sales Manager Signature and Company Stamp Name: Date:

DEALERSHIP NAME: Month : Name of Campaign :

KAH MOTOR

JLN TAR

(W107)

Customers Scheme ( OPTION 2)

Kindly follow below details for claim purpose, otherwise submission of claim will not be entertained by HMSB. 1. All submission claims must fill up claim form. 2. Cash rebate voucher must attached with claim form. 3. HMSB reserved the rights to suspend the payout, if any discrepency or data manipulation found in the claim submitted. 4. ONLY fill up the Booking No. at the After Change column, IF customer have different booking number.

No

Cust. Name

Cash Rebate Voucher Serial No.

Booking No#

Booking Date

Original Booking Car Model

After Change Booking Car Model No. Car Reg No# Date of reg.

Cash Rebate Amount (RM)

SORIANA BT ADNAN

DO-TF-0000703 437974 10/5/2011

CITY E

437974 CIVIC 1.8 PUTRAJAYA5173 31-Oct-11

2000

WAN SYARUL NIZAM BIN WAN YUSOFF

DO-TF0000708 DO-TF0000697

438100 10/7/2011

CITY E

438100

CIVIC SL

WVX221

31-Oct-11

2000

NG CHIN KENG

435271

9/9/2011

CITY E

435271 INSIGHT

WVY9857

3-Nov-11

2000

Acknowledged by:

Total

6000

Sales Manager Signature and Company Stamp Name: SIM CHEE WEI Date: 16/2/12

DEALERSHIP NAME: Month : Name of Campaign :

Customers Scheme ( OPTION 3)

Kindly follow below details for claim purpose, otherwise submission of claim will not be entertained by HMSB. 1. All submission claims must fill up claim form. 2. Cash rebate voucher must attached with claim form. 3. HMSB reserved the rights to suspend the payout, if any discrepency or data manipulation found in the claim submitted. 4. Only applicable for CKD models: City, Civic, Accord & CRV exclude City SE.

No

Cust. Name

Cash Rebate Voucher Serial No.

Original Booking that cancelled Booking No# Booking Date Booking No#

New Booking Car Model Car Reg No# Date of reg.

Cash Rebate Amount (RM)

Total Total
Acknowledged by:

Sales Manager Signature and Company Stamp Name: Date:

GIFT REQUEST FORM

DEALERSHIP NAME: Month : Name of Campaign :
Customers Scheme ( Complmentary Gift)

Kindly follow below details for claim purpose, otherwise submission of claim will not be entertained by HMSB. 1. All gift redemption must fill up the Gift Request form. 2. This form is also use for Complimentary Gift claims of Option 1 and 2. 3. Cash Rebate voucher Serial No. column only fill up for Option 1 and 2. 4. Gift will be rejected, if any discrepency or data manipulation found in the Gift Request form submitted. 5. HMSB will not replaced or refund, if any lost or damaged of the gift after dealer have ackknowledged received of the gift. 6. This form must submit not later than 15th and 30th of the every month, in order to get delivery within next 1-2 weeks. 7. Only applicable for CKD model : City, Civic, Accord and CRV exclude City SE

No

Cust. Name

Cash Rebate Voucher Serial No.

Booking No#

Booking Date

Car Model

Car Reg No#

Date of reg.

Acknowledged by:

Sales Manager Signature and Company Stamp Name: Date:

GIFT ACKNOWLEDGEMENT FORM

DEALERSHIP NAME: Month:

This form to be filled by dealers when delivery gift to customer and signature from customer are required. 1. All gift redemption by customers must fill up this form. 2. NO replaced or refund, if any lost or damaged of the gift after customer have ackknowledge received of the gift. 3. Gift only claimable by customer who entitled under the HMSB customer scheme that stated in the Terms and Condition. 4. Kindly return this form to HMSB every bi-weekly of the month for compilation and stock monitoring purpose.

No

Date

Customer Name

IC No.

Car Registration No.

Type of Gift

Customer Signature

Sales Advisor Name & Signature

Acknowledged by:

Sales Manager Signature and Company Stamp Name: Date:

Re-issue Voucher Request Form

DEALERSHIP NAME: Date: 1. This form is used for customer who lost their voucher and submit to HMSB for re-issuing of Cash Rebate Voucher. 2. Each customer only entitled for 1 time of requesting for re-issue of the Cash Rebate Voucher. 3. It will takes about 2-3 working days of processing the voucher to be re-issue and sent to dealers.

No

Date

Customer Name

IC No.

Cash Rebate Voucher Serial No.(if applicable)

Customer Signature

Sales Advisor Name & Signature

Acknowledged by:

Sales Manager Signature and Company Stamp Name: Date: