PUBLIC BANK GROUP

APPLICATION FOR EMPLOYMENT

PLEASE NOTE :

 ALL INFORMATION SUPPLIED WILL BE HELD IN STRICTEST

CONFIDENCE Please affix recent
passport size
photograph here
 WRITE NIL WHERE NOT APPLICABLE (non-returnable)

 ATTACH APPENDIX IF SPACE PROVIDED IS INSUFFICIENT

I. PERSONAL PARTICULARS

Full Name as in I.C.

(include aliases, if any)
Residential address
(include postcode)
Postal address
(if different from
residential address)
E-mail address

Telephone No: i) House ii) Handphone iii) Office

iv) Other convenient place

(Please indicate name of contact person)

Socso No. Income Tax No. EPF No.

Sex Date of Birth Age
I.C. No. Race Height (cm)
(Enclose photocopy) Weight (kg) Religion
Nationality Hometown Place of Birth
Driving Licence No. & Class
(Please state whether licence is a full or provisional “L” licence)

II. FAMILY PARTICULARS

i) Marital Status : Single/Married/Widowed/Separated/Divorced (please circle)

If married, please complete the following :

Spouse’s Name I.C. No.

Spouse’s Occupation Name of Company

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II. FAMILY PARTICULARS, cont.

Name of Children Sex Age Date of School/Occupation

Birth

ii) Father’s/Guardian’s Name Occupation

Mother’s Name Occupation
Parent’s/Guardian’s Address

Name of Brothers/Sisters Sex Age Occupation Name of Firm/School

III. EDUCATIONAL/PROFESSIONAL QUALIFICATIONS

(Please attach copies of testimonials/certificates/transcripts)

i) Name of School, College and/or From To Qualifications Grade (include CGPA

University (Year) (Year) Achieved where applicable)

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III. EDUCATIONAL/PROFESSIONAL QUALIFICATIONS, cont.

ii) PROFESSIONAL/COMMERCIAL COURSES BEING UNDERTAKEN

Name of Course Manner of Stage/Sections Self imposed target date for full
Study successfully completed completion of the course

IV. LANGUAGES AND DIALECTS

(Please indicate your mother tongue within brackets)

i) Spoken
ii) Written

V. EMPLOYMENT HISTORY
(List current/latest employment first)

Date Name & Position(s) Basic Salary & Name, Designation Reasons for
Address Held Allowances & Contact No. Of Leaving
From To of Employer Initial Last drawn Immediate Supervisor

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VI. OTHER INFORMATION

Pursuant to the Anti-Money Laundering and Counter Financing of Terrorism (AML/CFT) - Banking and
Deposit-Taking Institutions (Sector 1) BNM Document, the Bank is required to evaluate your personal
information, including any criminal records, your employment history and financial history.
(Please circle)
A. i) Do you have any outstanding loans/credit line? Yes/No
ii) Do you or any of your immediate family members * have any borrowings from any Yes/No
Company in the Public Bank Group?
* Immediate family members include parents, spouse, children and their spouse, siblings and their spouse.
iii) Have you ever been charged or convicted of a criminal offence? Yes/No
iv) Are you a bankrupt? Yes/No
v) Do you have any independent means of other sources of income? Yes/No
vi) Are you currently holding any directorship in any Company? Yes/No
vii) Do you have any physical disabilities, chronic ailment or handicap? Yes/No
viii) Have you suffered from any major illness, nervous breakdowns or accidents which require Yes/No
hospitalisation?
ix) Have you been on constant/long term medication due to any illnesses? Yes/No

If you have answered Yes to any of the above, please provide details in the space provided.

x) Have you ever applied to or been interviewed by any Company in the Public Bank Group? Yes/No
(If yes, please indicate position applied, date interviewed (if any) and name of Company)

B. Required to be completed only if candidate is applying to be employed as a Trainee Dealer/Dealer

or Broker:-

i) I am not an undischarged bankrupt whether within or outside Malaysia. Yes/No

ii) I do not have a judgement debt that has been returned unsatisfied in whole or in part. Yes/No
iii) I have not been issued a prohibition order from dealing or broking within or outside Yes/No
Malaysia.
iv) I have not been convicted, whether within or outside Malaysia, of an offence involving Yes/No
fraud or other dishonest act or violence.
v) I have not been convicted of an offence whether within or outside Malaysia and neither am Yes/No
I subject to pending proceedings which may lead to a conviction, for breach of banking,
securities or insurance laws.
vi) I have not engaged in any business practices appearing to Bank Negara Malaysia and Yes/No
Securities Commission or any other supervisory authority to be deceitful or oppressive or
which otherwise reflect discredit on my method of conducting business.
vii) I have not been engaged in or associated with any other business practices or otherwise Yes/No
conducted myself in such a way as to cast doubt on my competence and soundness of
judgement.

VII. RELATIVES
List below any of your relatives who are (i) working in the Public Bank Group, or (ii) Unit Trust/Insurance
Agents, or (iii) both of the aforementioned.

Name of Relative Relationship Name of Company/Agency

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VIII. SHOULD YOU BE SELECTED PLEASE INDICATE

i) Expected Salary (RM) :

ii) Period of Notice Required :
iii) Date able to commence duty :

IX. COLLECTION, RECORDING AND RETENTION OF PERSONAL DATA

1. I understand that in order for the Company to consider my application for employment herein, the
Company is required to evaluate my personal information and my credit information including any
criminal records against me, my employment history and financial history (“My Personal Data”). My
Personal Data, whether relating directly or indirectly to me, may be collected, recorded, stored by the
Company and/or disclosed to, shared with, received from or forwarded to any bureau/agency approved by
Bank Negara Malaysia (BNM) or licensed credit reporting agency or any service provider appointed by
the Company. I hereby further consent and authorise the Company to obtain and verify any information
about me including My Personal Data from any parties deemed relevant for purposes of this application
including reference checks with previous employers.

2. I understand that the Company will not be able to consider/process my application herein for employment
or continue to employ me, as the case may be, unless the Company can disclose to, share with or receive
My Personal Data from the relevant parties in compliance with Personal Data Protection Act 2010 and
Credit Reporting Agencies Act 2010.

3. I am aware that pursuant to Section 19(2) of the Anti-Money Laundering, Anti-Terrorism Financing and
Proceeds of Unlawful Activities Act 2001, the Company is required to guard against and detect any
offence under the Act and to this end is required to ensure high standards of integrity of its employees and
to evaluate the personal, employment and financial history of its employees. In compliance with this
requirement, I consent for the Company to conduct checks on my personal and credit/financial
information as and when deemed necessary by the Company.

X. DECLARATION

I hereby declare that the particulars and answers given in this application form are to the best of my knowledge
and belief true and correct. I further declare that my personal data and/or information that have been made
available in this Application for Employment and/or all other information or documentation submitted by me for
the purposes of my employment with the Company may be processed for the purpose of employment as follows:

i) verification of any of My Personal Data and any personal data provided in this application form including
reference checks with previous employers

ii) In the event of there not being an immediate offer of employment from the Company, my application will be
kept for future consideration or may be referred to the other entities within the Group for their consideration.

I understand that the Company reserves the right to terminate my service without notice or compensation at any
time should the Company discover that any of the said particulars and answers were false, untrue or incorrect at
the time of completion of this form.
I hereby undertake to notify the Company immediately should the particulars supplied above be changed in any
way in future.

Signature of Applicant : Date :

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